In modern medicine, physical therapy is used for many diseases. Movement therapy is now an integral part of complex therapy. Physiotherapy It has not only local, but also a general healing effect on the sick organism. Dosed movement stimulates all body functions, including strengthening the nervous system and has a tonic effect. This contributes to the elimination of the disease process. Physical exercises stimulate blood circulation, increase metabolism, increase redox processes in tissues, prevent and eliminate venous blood stagnation in the pelvic area. When performing physical exercises, a large number of tiny blood vessels are revealed, which leads to improved tissue nutrition. In turn, in tissues that are well supplied with nutrients, infectious processes are eliminated faster, healing and recovery processes are accelerated.
As you know, physical exercises strengthen and train muscles, and the female uterus is just a muscular organ, therefore, with many gynecological diseases physical therapy is the main method of treatment. In particular, in chronic adnexitis, it successfully helps the main treatment and is included in the complex of resolving therapy.
The task of physical therapy in chronic inflammatory diseases is to raise the general tone of the body, improve respiratory function, blood circulation, eliminate congestion in the pelvic area, strengthen the abdominal muscles and pelvic floor, promote the resorption of inflammatory processes.
CONTRAINDICATIONS.
When starting exercise therapy, ideally should consult a doctor, which will give instructions on the permissible load, dosage and nature of the exercises.
Contraindications for exercise physiotherapy exercises are: severe circulatory failure, exacerbation of chronic coronary insufficiency (angina attacks), aneurysm of the heart and aorta, peptic ulcer and duodenum in the acute stage, blood diseases, hypertonic disease with constant high level pressure (above 220/120 mm Hg), hypotension (blood pressure below 90/50 mm Hg), acute infectious diseases in the febrile stage, significant myopia (-15 diopters) in combination with persistent changes in the fundus (high intraocular pressure, risk of retinal detachment), severe forms of diabetes mellitus (in the stage of decompensation). Contraindications to classes are also acute inflammatory processes of the female genital organs, accompanied by high fever, bleeding, irritation of the pelvic peritoneum, closed purulent processes until the opening of the purulent focus and the creation of a good outflow, the presence of a cyst on the leg, ectopic pregnancy or suspicion of it.
Starting the first classes of physiotherapy exercises, you need to give yourself a little physical activity and only gradually increase it. The older you are, the slower your physical activity should increase. Remember that in most cases, physical activity increases the acceleration of movements, however, with some exercises, for example, when lifting and straightening the legs from the starting position lying on your back, a slow pace, on the contrary, makes the exercise more difficult.
For regulation of physical activity also use the following methods:
- If you move from a lying position to a sitting position with the help of your hands, this is not difficult, but if you put your hands behind your head, then it will be much more difficult.
- As the range of motion increases, the exercises become more difficult.
The starting position must be chosen taking into account the functional capabilities of the body. So, it can be difficult for obese women to do exercises in the initial position lying on their back, since the contents of the abdominal cavity are shifted upward, which greatly complicates the work of the heart and lungs. In these cases, a high pillow should be placed under the head, and the exercises themselves should be performed lying not on the floor, but on a bed or couch. It will be much easier for weakened or elderly people to perform exercises in the initial sitting position instead of the initial lying position. Women with high blood pressure are not recommended to exercise in the knee-elbow position (standing on all fours), as well as deep bending of the trunk forward, during which there may be a rush of blood to the head and an increase in intracranial pressure.
When exercising, breathe freely and naturally. Make sure you don't hold your breath. When bending the torso, bending it is more convenient to do: straightening up - exhale, and bending - inhale. In between difficult exercises, do breathing exercises (breath rhythmically and deeply through your nose) or try to relax as much as possible (if you are lying or sitting on a chair).
Each exercise therapy session should begin with a warm-up. Perform the most difficult exercises for you in the middle of the complex with a gradual decrease in load towards the end. Always end with breathing and relaxation exercises.
To obtain the desired effect, you need to exercise regularly: at least 2-3 times a week. The duration of the lesson is on average 20-25 minutes. You should wear clothes that do not restrict movement. It is advisable to conduct classes with music.
And now we offer you a set of physical exercises with inflammatory gynecological diseases.
Starting position - standing:
- Sipping, hands up - inhale. Run 4-6 times.
- Tilt of the body with a turn, on the turn - exhale. Run 4-5 times in each direction.
- Tilts to the side. Breathing is even. Perform 4-5 times in each direction.
- Squats on the exhale. Run 5-10 times.
- Imitation of boxing. Breathing is even. Perform 5-10 strokes with each hand.
Starting position - kneeling:
- Bend over, touching your heels with your hands - inhale, then lean forward - exhale. Run 4-8 times.
Starting position - lying on your back:
- Perform “bicycle” leg movements, repeat 5-10 times with each leg. Breathing is even.
Starting position - lying on your stomach.
- Inhale. Spread your legs to the sides - exhale. Run 5-10 times.
Starting position - standing:
- Bending, standing on a chair legs at the knee, bend on the exhale. Run 5-6 times with each leg.
- Clench your hands in front of your chest. Spread your arms to the sides - exhale. Run 3-5 times.
Physical exercise can even be done under strict bed rest: at a slow pace, perform passive movements of the arms and legs, active movements in the small joints of the arms and legs, breathing exercises of moderate depth (the duration of the lesson is about 10 minutes). Even with such simple exercises there is an increase in neuropsychic tone, a decrease in the depression of a sick person, stimulation physiological mechanisms fight disease and improve the functional state of the body. When the doctor allows you to sit, sit on a chair and make active movements with your arms and legs, exercises for the muscles of the body (duration of the session - 15 minutes), when you can walk - walk calmly (duration of walking - 70-80 steps).
Here are some examples of physical exercises that you can do in recovery:
- Lying on your back - pull your legs with your heels to the pelvis, spread apart and bring your legs bent at the knees, raise straight legs, pull your legs bent at the knee and hip joints to your chest in turn, make circular movements with your legs, imitate cycling, swimming in style "breaststroke".
- Sitting on the floor - bring and spread legs with resistance, tilt the body to the right and left foot, turn the body.
Therapeutic movements for gynecological and urological diseases
Do not divide problems into male and female
Unfortunately, in our "psychoneurotic" age, there are not so many men and women who would not have any problems in the urogenital area. And it's not even the numerous sexually transmitted infections. Just a crazy beat modern life often does not allow people to stop for a minute, listen to their body, and then go to an appointment with a gynecologist or andrologist (who needs someone).
But if, nevertheless, you took the time to consult with a specialist and he discovered that you have some kind of sore, the presence of which many of us do not like to talk about, do not panic!
In addition to the prescribed treatment, you should do ... no, not sex - do gymnastics. Now there is a huge number of gymnastic complexes with which you can solve many problems associated with the urogenital area.
There are many exercises that have a beneficial effect not only on the pelvic region, but also on the entire genitourinary system. These exercises are very useful, but, unfortunately, few people know about them.
The female body is certainly different from the male, and many of the diseases of the above system have significant differences, but they also have much in common. Firstly, they are associated specifically with the genitourinary system; secondly, they cause a lot of inconvenience and often cause pain; thirdly, they do not allow us to fully live and love.
But it is not necessary to divide diseases into men's and female. It is better to seriously think about what caused your ailments, because many problems lurk primarily within ourselves.
With any, even the most progressive and effective, treatment, the psychological factor plays an important role, and if a man and a woman live in harmony with each other, then their vital organs also function harmoniously, which in itself promises good health.
Gymnastics for women
Gymnastics of Slavic Charmers
Now all over the world, all kinds of gymnastic complexes have become very popular and fashionable, which are based on the rituals inherent in ancient cultures.
In any decent fitness center, you will definitely be offered to do either yoga, or tai chi, or pilates, or other newfangled, but in fact well-forgotten old types of gymnastics.
Most of these exotic types of exercises came to us from the East. However, it is worth considering: did not our ancestors come up with something similar, more suitable for us?
Of course, such complexes exist. In ancient times, the Slavic peoples had their own gymnastics, which helped our great-great-grandmothers to be seductive and infinitely feminine.
Gymnastics of Slavic enchantresses there is more than one century. Already after the first classes in such gymnastics, women feel how the attitude of men towards them is changing: they simply do not give them a pass, showing all kinds of signs of attention.
Enchantress gymnastics gives a huge healing effect. When performing these exercises, the memory of the family is awakened, the forces given to the woman by nature itself, as well as the intuition bestowed by her, are activated.
Such gymnastics can be practiced at any age, it is available to both girls and grandmothers. Special physical training is not required for this. Exercises are done for yourself, to feel your body, its beauty. The most important thing is to enjoy this activity. Perform only those exercises that you like and that you want to do at the moment.
Exercises enchantress gymnastics are aimed not only at the formation of a healthy and beautiful body, the development of the muscles of the hip joint and lower abdomen (for the prevention and treatment of female diseases, as well as ensuring easy childbirth), but also to activate the energy centers of the body.
EXERCISE 1Starting position- standing, legs shoulder-width apart, slightly bent, feet parallel, arms bent in elbow joints, the elbows are laid back and slightly brought together, the shoulders are lowered, the hands are bent and pressed by the place of the fold to the lower back, the fingers are relaxed (Fig. 121, a).
Take a shallow breath, while slightly lifting up on your toes. The hands move slowly forward without losing contact with the body.
Turn the palms of the hands towards the body and, sliding under the chest, begin to press them on the body (Fig. 121, b).
Raising your chest with your palms, connect them with the back in the center of the chest. After that, continue the movement, raising your palms higher and higher up.
Straighten your arms at the elbows, continuing to raise the brushes up, at the same time intertwining them and forming something resembling a bud with the palms (Fig. 121, in).
As you exhale, slowly lower your arms and
Repeat this exercise at least 7 times.
EXERCISE 2Starting position- standing, hands on the belt.
Slowly lift your leg up, keeping your knee out to the side. Make sure that the foot is at the level of the kneecap of the leg on which you are standing (Fig. 122).
As you exhale, slowly return to starting position. Repeat this exercise at least 7 times with each leg.
EXERCISE 3Starting position- on my knees. Spread your knees shoulder-width apart. Make sure your shins are parallel. Move your feet, and distribute your body weight evenly on both legs. Make sure that your knees remain in the same position as in the starting position.
Perform a familiar movement with your hands, as in the first exercise.
When you raise your hands up, keeping this position of the hands, lean as much as possible to the right side. Make sure that the body does not twist when tilted, and the head does not fall down.
Inhale while bending, exhale when straightening.
After tilting, return to the starting position. Repeat tilts at least 7 times in each direction.
EXERCISE 4Starting position- on my knees. Lean forward and lean on your elbows. Make sure that the hips are perpendicular to the floor surface, and the palms are on the back of the head (Fig. 123, a).
Pull your left leg to your chest and push it back with a back arch (Fig. 123, b).
After tilting, return to the starting position. Repeat the exercise at least 7 times with each leg.
EXERCISE 5Starting position- as in the third exercise.
Sit on your feet. Tilt your torso forward and push it forward; the cheek should touch the floor.
In this position, we perform the movement with our hands, as in the first exercise, but at the end of this exercise, the arms are spread apart, and the palms are looking up.
During the entire exercise, make sure that the deflection in the lower back is maintained.
The movement of the hands is done on inspiration;
EXERCISE 6Starting position- lying on your back, arms are located along the body with palms up.
While inhaling slowly, stick out your lower abdomen. All attention should be directed to the navel.
While exhaling slowly, hug your knees with your hands, press your chin to the jugular (sternum) fossa and try to stretch the imaginary string stretched along the spine to the crown as much as possible (Fig. 124).
Return to starting position.
Repeat the exercise 7 times.
EXERCISE 7Starting position- lying on your back, arms are perpendicular to the body at shoulder level, palms down. The legs are spread shoulder-width apart, the heels are pressed to the floor, the socks are raised up (Fig. 125, a).
Taking a slow breath, stick out the lower abdomen; all attention is directed to the navel.
At the same time, turn your head to the right, and the toes of your feet to the left. Try not to take your heels off the floor (Fig. 125, b).
After that, sharply turn your head and feet in different directions, without lifting your heels and palms from the floor (Fig. 125, in). Raise your pelvis and mentally move your attention from the tailbone to the top of the head along the line of the spine.
Return to starting position. Lower the pelvis and mentally walk in the opposite direction: from the crown along the spine and then to the tailbone.
Repeat the exercise 7 times.
EXERCISE 8Starting position
Place your left heel on your right ankle.
Taking a slow breath, stick out the lower abdomen, all attention is directed to the solar plexus area.
At the same time turn your head to the right and your feet to the left. Try not to lift your right heel off the floor.
Then sharply turn your feet and head in opposite directions, without lifting right heel and left palm off the floor. At the same time, lift your pelvis and move your attention along the line along the spine - from the coccyx to the top of the head.
EXERCISE 9Starting position- as in the previous exercise.
Place your left heel on the toe of your right foot.
Taking a slow breath, stick out the lower abdomen, all attention is directed to the pubic region.
At the same time, turn your head to the right and your feet to the left, trying not to lift your right heel off the floor.
After that, sharply turn your feet and head in different directions, without lifting your right heel and left palm from the floor, at the same time lightly lift your pelvis, moving your attention along the line along the spine - from the coccyx to the crown.
As you exhale, lower your pelvis and, moving your attention along the spine - from the crown to the tailbone, return to the starting position.
Repeat the exercise 7 times for each leg.
EXERCISE 10Starting position- as in the previous exercise.
Bend your legs and place your feet as far apart as possible and as close to your buttocks as possible; knees are raised.
Taking a slow breath, stick out the lower abdomen; all attention should be directed to the region of the spleen.
At the same time, turn your head to the right side, and your knees to the left, trying not to tear your feet off the floor.
After that, sharply turn your knees and head in opposite directions so that your knees touch the floor. Try not to tear off your feet and left palm from the floor. Easily lift your pelvis and mentally move your attention along the spine - from the coccyx to the top of the head.
As you exhale, lower your pelvis and, mentally moving your attention along the spine - from the crown to the tailbone, return to the starting position.
Repeat the exercise 7 times for each leg.
EXERCISE 11Starting position- as in the previous exercise.
Bend your legs and put them together, feet should be as close to the buttocks as possible, knees pointing up.
Taking a slow breath, stick out the lower abdomen; all attention is directed to the area of the liver.
At the same time, turn your head to the right side, and your knees to the left, trying not to tear your left foot off the floor (Fig. 126, a).
Turn your knees and head sharply in different directions, without lifting your left palm from the floor, and pressing your right foot to the floor (Fig. 126, b).
At the same time, lift your pelvis and mentally move your attention along the spine - from the coccyx to the top of the head.
As you exhale, lower your pelvis and mentally move your attention along the spine - from the crown to the tailbone, then return to the starting position.
Repeat the exercise 7 times for each leg.
EXERCISE 12Starting position
Bend your knees, pull your heels closer to your buttocks.
Taking a slow breath, stick out the lower abdomen; all attention is directed to the region of the stomach and duodenum.
At the same time, resting on the floor with your elbows, legs and crown, lift your body up, lightly squeezing the pelvis and mentally moving your attention along the spine - from the tailbone to the crown.
Remaining in this position and maintaining balance, cross your arms over your chest (Fig. 127). Hold your breath for as long as possible.
As you exhale, lower your pelvis down first, and then, moving your attention along the spine - from the crown to the tailbone, and the whole body. Place your arms along your body and return to the starting position.
Repeat the exercise 7 times.
EXERCISE 13Starting position- as in the previous exercise.
Taking a slow breath, grab your ankles with your hands, stick out your lower abdomen; all attention is directed to the area of the appendix.
At the same time, raise your pelvis and arch your back, keeping your feet on the floor and mentally moving your attention along the spine - from the coccyx to the top of the head (Fig. 128).
Remaining in this position, hold your breath for as long as possible.
As you exhale, lower your pelvis and, mentally moving your attention along the spine - from the top of your head to the tailbone, lower your body down and place your hands along the body. Return to starting position.
Repeat the exercise 7 times.
EXERCISE 14Starting position- lying on your back, arms along the body, palms down. The legs are spread apart shoulder-width apart, the heels are pressed to the floor, the socks are raised up.
Taking a slow breath, bend your legs, hug your knees, lift your buttocks off the floor and roll on your back on the floor from the bottom up, mentally moving your attention along the spine from the tailbone to the crown.
As you exhale, continuing to hug your knees, raise your shoulders and roll across the floor from top to bottom, mentally moving your attention along the spine - from the crown to the tailbone, then return to the starting position.
Repeat the exercise 7 times.
EXERCISE 15Starting position- standing on all fours, legs and feet extended back parallel to each other at shoulder width.
Taking a slow breath, stick out the lower abdomen; all attention is directed to the navel. Hands all the time rest on the floor (Fig. 129, a).
As you exhale, tilt your head to your chest and arch your back as high as possible (Fig. 129, b), at the same time press the tongue to the palate and pull the stomach in as much as possible, slightly raising the pelvis and mentally moving the attention along the spine - from the coccyx to the top of the head.
Return to starting position.
Repeat the exercise 7 times.
EXERCISE 16Starting position- standing on all fours, hands slightly wider than shoulders.
Taking a slow breath, stick out the lower abdomen, all attention is directed to the pubic area. Without moving your hands and pressing your tongue to the palate, relax your whole body and slide forward at a minimum distance from the floor until your chest is in line with your hands and your head rests on the floor with your forehead.
As you exhale, without straightening and without raising your head, sit on your heels. Resting your forehead on the floor, press your chin to the jugular (sternal) fossa and stretch your neck so that the crown and spine lie in one line.
At the same time, pull your stomach in as much as possible. Make sure your abdominal muscles are tense.
Return to starting position.
Repeat the exercise 7 times.
EXERCISE 17Starting position- standing, the body is as relaxed as possible, the feet are separated to the width of the shoulders, the weight of the body is evenly distributed on both legs.
Taking a slow breath, spread your arms to the sides perpendicular to the body, raising them to shoulder level, palms down (Fig. 130, a).
Raise your head, slightly retracting your chin, so that the top of your head and spine are in line.
On inspiration, relax and smoothly twist the body together with relaxed arms and head to the left until it stops, trying to keep the top of the head in line with the spine, and the palms were at shoulder level (Fig. 130, b). At the same time, mentally move your attention along the line of the spine - from the coccyx to the top of the head.
As you exhale, relax and smoothly return the body to its original position until it stops, also mentally moving your attention along the line of the spine, but already from the top of the head to the coccyx.
Try to keep the top of your head in line with your spine, and your palms at shoulder level.
EXPLANATIONSThis set of exercises contributes not only to balancing the energy balance between the right and left parts of the body, but also to the effective restoration of wasted forces.
Thanks to such gymnastics, the spine becomes flexible, the digestive organs and the genitourinary system are strengthened, the work of the hormonal glands is normalized, and the energy centers located in the abdomen and pelvis protect them from all kinds of diseases.
Rejuvenating the body, these exercises provide him with excellent health until old age.
Exercise is indispensable for pregnant women (up to three months of pregnancy). They can be practiced during menstruation to relieve pain caused by energy blockages in the lower abdomen.
However, do not be overly zealous when performing the exercises of this complex. It is best to start with three repetitions of each exercise, adding one repetition weekly until you bring them to seven. At the same time, you should carefully listen to your feelings, if you feel discomfort, return to the previous norm.
Listen to your body with your heart, not your mind.
Self-massage for gynecological diseases
This book contains self-massage exercises that anyone can perform, and on their own, without help. medical worker. When doing self-massage, you need to remember that it should be done on a naked body. Moreover, many experts advise taking a general or local bath beforehand.
The duration of the massage is from 5 to 10 minutes. With an exacerbation of the disease, the touch of the hands should be weak, and at the stage of remission they can be quite strong. If the part of the body being massaged is extremely painful and inaccessible to touch, then the neighboring healthy area is massaged.
Women, the elderly and children are allowed only a weak and short-term massage.
And one more important note: self-massage is performed on a hard surface.
EXERCISE 1Starting position- sitting on a chair, hands clasp the knees from the inside, the chin is pressed to the chest, the muscles of the pelvis and back arch the back (the pelvis and back stretch to the back of the chair), the legs are spread apart shoulder-width apart (Fig. 131).
We start the self-massage session with rolling (“wiping the pants”). The buttocks pressed against the seat of the chair move forward, and the neck moves in the opposite direction. The arms remain straight.
After that, the buttocks begin to move in the opposite direction, the body takes starting position.
EXERCISE 2Starting position- as in the first exercise, only the knees are now brought together and the hands hold them from the inside.
We perform rolling in the same way as in the first exercise.
When moving the pelvis forward, the knees move apart, and when moving backward, on the contrary, they shift.
Perform 7 rolls back and forth.
This exercise is even more effective in the treatment of many gynecological diseases, as well as diseases of the urogenital area.
EXERCISE 3Starting position- as in the first exercise, but the hands are intertwined in the castle, and the arms are straightened and raised with palms up (Fig. 132).
Maintaining balance and tilting the body back as much as possible, perform springy jerks with the chest forward.
Make sure that the hands during this exercise maintain a single line with the back, the heels cannot be torn off the floor.
When the pelvis moves forward, the knees are divorced, and when moving backward, they move. During a jerk with the chest forward, you need to exhale sharply, and during the reverse movement, exhale.
Perform at least 7 chest jerks forward.
EXERCISE 4Starting position- as in the third exercise; it is necessary to fix the position of a jerk with the chest forward.
We make three sharp springy turns of the body to the left (Fig. 133), at the expense of "four" we return to starting position.
Perform at least 7 chest turns in each direction.
EXERCISE 5Starting position
In fact, the fifth exercise is a continuation of the fourth.
It is necessary to repeat two springy movements without stopping, but now first to the right and then to the left.
Perform at least 7 turns in each direction.
EXERCISE 6Starting position- as in the first exercise, only the hands are transferred to the back of the head, the elbows are lowered down, the knees are connected (Fig. 134).
With springy movements of the hands, we press the palms on the back of the head three times, with each pressure we move the pelvis further and further back.
At the end of the exercise, the pelvis slowly moves forward, at the same time the knees are pulled apart, the arms are straightened up, and the body is turned to the left.
EXERCISE 7Starting position- as in the sixth exercise.
First, we make one springy pressing with the palms on the back of the head, then we stretch our arms up, turning the torso to the left. Try to take the pelvis back as far as possible, increasing the range of motion. The greater the amplitude, the more significant the result is achieved.
Repeat the exercise at least 7 times with body turns in each direction.
EXERCISE 8Starting position– sitting on the floor, legs spread as wide as possible.
Pull your socks towards you and point them to the sides. Make sure your heels do not come off the floor. Rest your palms on the floor behind you. Try to keep your back and arms straight. Bending your head forward, draw in your stomach and hold your breath for a short while.
After that, move your hands from behind your back forward, lean forward and place your hands on the floor in front of you.
Now slowly, without taking your hands off the floor, move forward on your buttocks, gradually leaning lower and lower.
After counting to seven, exhale, move your hands back so that they are behind the body, and start the exercise from the beginning.
Repeat the exercise at least 7 times.
EXERCISE 9This exercise is a set of movements that are elements of shiatsu massage.
Massage is performed by pressing with the thumb or palm pads. Pressure should not cause discomfort.
First, massage the sacrum. With circular movements of the fingers, we act on points located in the midline of the sacral vertebrae, moving from bottom to top, to the lower back.
Then we massage the inner edges of the mammary gland - 4 times on each side.
After a chest massage, we move on to the lumbar region in the kidney area in order to improve the functioning of the adrenal glands. We begin the movement from the bottom up, performing simultaneous circular movements with the fingers wound behind the back.
We finish the exercise with a massage of the temples, while simultaneously performing circular movements with our fingers.
EXERCISE 10Starting position- lying on the stomach.
We strongly press on the vertebrae of the lumbar region on both sides at waist level.
After that, gently massage the buttocks simultaneously on both sides.
We complete the exercise by gently pressing on the points of the thyroid gland (on the front surface of the neck, along the course of the carotid arteries).
EXPLANATIONSBy doing the exercises described above, you are doing something similar to the work of a chiropractor. Thanks to these exercises, the vertebrae and discs of the spine fall into place, the condition is normalized muscular systems s. They are very useful for body shaping: the abdominal muscles are strengthened, the waist is formed.
The complex has a beneficial effect on the work of most internal organs, its effect on the body can be called universal. On its basis, developed special complexes exercises that can be performed to improve and prevent diseases of the chest cavity, lungs, heart, and also the organs of the genitourinary system.
Forget the climax!
The following set of exercises contributes not only to the rejuvenation of a woman, but also to the stimulation of the endocrine glands, which in the postmenopausal period begin to malfunction.
Experts say that due to the normal and productive work of these glands, youth is prolonged. If you already have problems in the urogenital area, this complex will greatly facilitate your life, strengthen the organs weakened by the disease, restore health and good mood.
The set of exercises brought to your attention includes very active body movements and breathing exercises. To cope with such a load, it takes some time for the body to get used to it. Therefore, in the first week of training, perform 3 repetitions of exercises, after each of them rest 30-60 seconds and breathe in a normal rhythm.
Each week, add one rep and reduce your rest time by 10 seconds. Remember that after completing the entire set of exercises, you need a good rest.
At the beginning of classes, concentrate on the correct execution of the exercise itself: the strength of movements, their smoothness and rhythm. Make sure that the chest is bulging and motionless, and the face is relaxed (no grimaces!).
Later, when you have mastered the complex well, concentrate on the area below the navel ( Bottom part abdomen). It is here that the maximum contraction of the muscles at the time of exhalation should occur. When you rest, also concentrate on this area of the body.
Women suffering from pronounced pulmonary and gynecological diseases, it is better to refrain from performing the exercises of this complex.
Those with heart problems can do the suggested exercises, but they will need a longer period of preparation; in addition, during classes they need to be extremely careful and listen carefully to their feelings.
EXERCISE 1Starting position- standing straight, legs together.
Spread your fingertips pointing up, and thumbs squeeze the nostrils (Fig. 135).
Open your eyes, stretch your lips with a tube.
After that, vigorously, with a whistle, inhale the air, puffing out your cheeks.
Close your eyes, bring your chin as close as possible to the jugular (sternal) fossa and hold your breath for as long as possible.
Return to starting position, open your eyes and exhale the air through your nose slowly, without any effort. Repeat the exercise 7 times.
EXERCISE 2Starting position- as in the first exercise. Close your mouth, plug your ears with your two thumbs, and close your eyes with your index fingers. The middle and ring fingers are located around the mouth, the lips are elongated with a tube (Fig. 136).
Inhale, puffing out your cheeks and lowering your chin to the jugular fossa of the chest, and hold your breath.
Return to the starting position, open your eyes and exhale the air through your nose slowly, without any effort.
Repeat the exercise 7 times.
EXERCISE 3Starting position- as in the first exercise.
Relax your neck and with a sharp movement turn your head first to the right shoulder (Fig. 137), then to the left.
Repeat the exercise 7 times.
EXERCISE 4
Starting position- as in the first exercise.
Relax your neck and with a sharp movement tilt your head forward first (Fig. 138, a), then back (Fig. 138, b).
When moving back, the head should touch the neck; when moving the head forward, the chin should touch the chest.
Repeat the exercise 7 times.
EXERCISE 5Starting position- standing, as in the first exercise, or better sitting on a stool. Keep your back as straight as possible. Inhale, pushing out the chest strongly. This position of the chest should be maintained throughout the exercise.
Exhale slowly, drawing in your stomach. Do not overdo it with the tension of the abdominal muscles, that is, do not pull it in hard, trying in this way to influence the amount of exhaled air. In this case, the strength of the exhalation itself is important.
For control, you can put one hand on your chest, the other on your stomach.
Try not to make sudden movements in the chest area, the shoulders should remain motionless.
EXERCISE 6Starting position- lying with your back on the floor or on a mat, legs raised up at an angle of 80–90 degrees, arms spread apart (Fig. 139).
Slowly lower your legs to the left to a 45-degree angle. Then return them to their original position.
Repeat the same on the other side.
Perform the exercise 7 times in each direction.
EXERCISE 7Starting position- lying with your back on the floor or on the mat, legs are brought together and lie on the floor, arms are spread apart.
Raise your legs off the floor at an angle of 30-45 degrees, and then cross with each other 3-7 times, changing their position.
Return to the starting position.
Repeat the exercise 7 times.
EXERCISE 8Starting position- as in the seventh exercise, hands are on the belt.
Slowly raise your upper body as high as possible, but no more than 45 degrees from the floor (Fig. 140).
Stay in this position for as long as you can, then slowly return to the starting position.
EXERCISE 9Starting position- as in the seventh exercise, we hold our hands above our heads.
Slowly lift your upper body off the floor (Fig. 141).
Repeat the exercise at least 7 times.
EXERCISE 10Starting position- lying on his stomach, hands clasped behind at the level of the waist.
At the same time, tear off the upper and lower parts of the body from the floor so that only the stomach touches the floor (Fig. 142).
Stay in this position for as long as you can, then slowly return to the starting position.
Repeat the exercise at least 7 times.
EXERCISE 11Starting position- lying on your back, arms along the body.
Raise one leg and keep it up as long as possible (Fig. 143), then slowly return it to its original position.
Repeat the exercise at least 7 times with each leg.
EXERCISE 12Starting position- sitting on the floor, legs bent at the knees, feet with the help of hands as close as possible to the buttocks.
Taking a slow breath, spread your knees wide, trying to reach the floor (Fig. 144).
As you exhale, slowly return them to their original position. Repeat the exercise at least 7 times.
EXERCISE 13Starting position- sitting on the floor, feet shoulder-width apart, arms lowered.
Performing a slow breath, turn the body to the right (Fig. 145, a), moving straight arms to the sides.
As you exhale, slowly return to the starting position. Do the same on the other side (Fig. 145, b).
EXERCISE 14
Starting position- lying on your back, legs straightened, hands under your head.
Performing a slow breath, raise the pelvis as high as possible (Fig. 146).
As you exhale, slowly return to the starting position.
Repeat the exercise at least 7 times in each direction.
EXPLANATIONSThe above complex is aimed at improving the genitourinary and digestive systems. Thanks to their implementation, the spine is strengthened. In addition, all the movements of these exercises help to restore blood circulation in the genitals and muscles, train the muscles involved in sexual intercourse, activate biologically active points associated with the genitourinary system, and produce endorphins - good mood hormones.
All exercises included in this complex should be performed daily, best of all - in the morning.
Gymnastics for the prevention of female diseases
Treat your body with love, cherish and cherish it! This will allow you to maintain attractiveness and youth for many years, and you will never need the help of cosmetologists and surgeons. And most importantly - you will never have a single problem with the genitourinary system!
All that nature has endowed a woman with is the components of your attractiveness.
attractiveness- this is the harmony of the soul, body and external data, the ability to present oneself, a special look, unique smile and inimitable gesture. We can say that this is the very highlight that a man subjectively notes in every woman he likes.
Staying attractive and healthy is the dream of many women, especially those who have reached the so-called Balzac age. Many women put an end to themselves and their appearance too early. We hope that the following exercises will help them restore their lost health and regain confidence in their attractiveness.
EXERCISE 1Starting position- kneeling, leaning on the floor on bent forearms.
Bend your left leg at the knee and slowly lift it until your thigh is in line with your spine (Fig. 147).
Lower and raise your leg in short, strong movements. Breathing is arbitrary.
EXERCISE 2Starting position- standing, legs wide apart, socks slightly apart.
Squat down so that the hips and shins form a right angle (Fig. 148). Place both hands on your knees and slowly rock up and down. The gluteal muscles are maximally tense.
EXERCISE 3
Starting position- standing, feet shoulder-width apart, hands on the belt.
Jump in one place, turning your hips and torso in opposite directions.
EXERCISE 4Starting position- lying on your back, legs bent at the knees, hands palms up, spread apart.
Raise and lower your pelvis off the floor. The gluteal muscles are maximally tense.
Repeat the exercise 7-14 times.
EXERCISE 5Starting position- standing on toes, arms lowered along the body.
Raise your right leg and bend it at the knee. The left leg remains straight. Freeze in this position and stay in it as long as possible, trying to maintain balance (Fig. 149). Returning to the starting position, change your leg.
Repeat the exercise 7-14 times for each leg.
EXERCISE 6Starting position- lying on your side, propping your head with your right hand, your left hand lies in front of your chest.
Bring your left leg back and place it on a full foot. Leaning on it, try to raise your right leg, straightened at the knee joint, then lower your leg without touching the floor with it (Fig. 150).
Repeat the exercise 7-14 times for each leg, changing the position of the body accordingly.
EXERCISE 7Starting position- lying on the right side, leaning on right hand, legs slightly bent at the knees.
Rotate the left leg first inward - knee to knee, then outward - heel to heel.
Repeat the exercise 7-14 times for each leg.
EXERCISE 8Starting position- standing, hands on the belt.
Take a wide step-lunge forward, leg slightly bent. Pull the leg back with a raised heel to the maximum and then press the foot to the floor (Fig. 151).
Repeat the exercise 7-14 times for each leg.
EXERCISE 9Starting position- standing, resting his hands on the wall. Put your right leg forward, bend at the knee; put your left foot back, pressing the heel to the floor (Fig. 152).
Bend and unbend the knee of the right leg without lifting the heel from the floor.
Repeat the exercise 7-14 times for each leg.
EXERCISE 10Starting position- lying on your back, hands placed under your head.
Raise your straight legs up and begin to spread and bring them together with strong and sharp movements.
Repeat the exercise 14-28 times.
EXERCISE 11Starting position
Bend your knees, spread your shins and raise your pelvis as much as possible. Make sure that the hips, stomach and chest are in the same line.
After taking this position, raise and lower the pelvis, strongly straining the buttocks (14-28 times).
Rest 5-6 seconds, returning to the starting position.
Perform at least 7 up-down cycles.
EXERCISE 12Starting position- standing facing the chair, slightly leaning forward and holding his back with his hands.
Standing on a straight right leg, swing back with your left (Fig. 153).
EXERCISE 13
Starting position- on your knees, leaning on the floor with your hands.
Perform swings with your right foot back, sideways (Fig. 154) and forward.
Repeat the exercise 14-28 times for each leg.
EXERCISE 14Starting position- sitting on the floor in front of a stool, leaning on the floor with his hands.
Slowly lift your legs together above the stool. Transferring them over the stool, just as slowly lower them to the floor.
Repeat the exercise 7-14 times.
EXERCISE 15Starting position- lying on your back, legs apart shoulder width apart, feet parallel to each other.
Raise the pelvis as high as possible above the floor and firmly squeeze the buttocks with your hands (Fig. 155). Freeze in this position and stay in it as long as possible, and then slowly lower your pelvis to the floor.
Repeat the exercise 7-14 times.
EXERCISE 16Starting position- lying on your back, raising your bent legs up.
Start spinning the "bicycle", vigorously stretching and bending your legs (Fig. 156).
Repeat the exercise 14-28 times.
EXERCISE 17Starting position- lying on your back with an emphasis on the shoulder blades, as in the exercise "birch" (Fig. 157); hands support the pelvis from the back.
Slightly bend your knees and begin to rotate them from side to side in a clockwise direction.
Repeat the exercise 14-28 times in each direction.
EXERCISE 18
Starting position- sitting on the floor, bending your legs and clasping your knees with your hands, your shoulders are maximally deployed.
Extend your knees to the sides as much as possible, resisting with your hands. Freeze in this position and stay in it as long as possible, and then bring your knees together.
Repeat the exercise 14-28 times.
EXERCISE 19Starting position- sitting on the floor, bending your knees and pressing your feet to the floor.
Rest your hands on the floor at the back, tear off the body from the floor and rotate it clockwise.
Perform 7 - 14 rotations in each direction.
EXERCISE 20Starting position- lying on the floor with a folded towel or pillow under the lower back.
Grasping your right leg under your knee with both hands, try to pull it up to your forehead. Do not tear off the lower back from the floor (Fig. 158).
Repeat the exercise 7-14 times for each leg.
EXERCISE 21Starting position- lying on your back, arms extended along the body.
With a sharp movement, pull your legs to your stomach and, at the same time tearing your shoulder blades off the floor, lift your body to your bent knees (Fig. 159).
Return to starting position. Repeat the exercise 14-28 times.
EXERCISE 22Starting position- sitting on the floor, leaning on bent forearms.
Bend your right leg at the knee and pull it closer to your body. Stretch your left leg forward (Fig. 160) and swing your leg up and down. Return to starting position and change legs.
Repeat the exercise 14-28 times for each leg.
EXERCISE 24Starting position- lying on your back, raising your legs up, slightly bending them at the knees (Fig. 161, a).
Interlace your fingers behind your head, at the same time pull your legs forward, lifting your buttocks.
Sharply lift your shoulder blades off the floor and then turn your right shoulder and elbow to your left knee (Fig. 161, b).
screw in starting position and repeat the exercise 14-28 times in both directions.
Gymnastics for the prevention of breast tumors
As menopause approaches, regular health checks should be made. By controlling it, you will prevent the occurrence of potential diseases, since their detection in the early stages makes treatment more effective.
Such control is necessary for a woman at any age, but it is after the onset of menopause that such problems as the rapid progression of atherosclerosis and more frequent fractures become the most relevant for them; diabetes mellitus, thyroid diseases, oncological diseases of the breast and female genital organs are more likely to appear.
It is very important to understand that you need to monitor your health yourself. It is necessary to maintain a normal weight, follow a diet in order to prevent atherosclerosis and the occurrence of tumors.
When men are asked what they value in women, they answer: intelligence, kindness - but at the same time they look at the chest.
There is not a single, even very smart, woman who would not be adorned with beautiful breasts, and most importantly, healthy and natural, and not a silicone prosthesis.
EXERCISE 1Starting position- standing, leaning forward with arms outstretched against the wall.
Bend and spread your elbows to the side; at the same time, you should bend as much as possible, trying to reach the wall with your chest.
EXERCISE 2Starting position- lying on your back, bending your knees, arms spread apart (Fig. 162, a).
Slowly raise your hands up (Fig. 162, b), and then slowly, with force, lower them to their original position. Perform at least 10-14 repetitions.
In this and some subsequent exercises, you can use small dumbbells.
EXERCISE 3Starting position- standing, feet shoulder-width apart, arms extended forward (Fig. 163, a)
On inspiration, sharply spread your arms to the sides and take them back (Fig. 163, b).
As you exhale, return your arms to the starting position. Perform at least 10-14 repetitions.
EXERCISE 4Starting position kneeling in front of two chairs.
Leaning your palms on the seats of different chairs, begin to bend your arms while inhaling, lowering your chest as low as possible. As you exhale, return to the starting position. Perform at least 10-14 repetitions.
EXERCISE 5Starting position Standing with hands clasped in front of chest.
While inhaling, start pressing palm on palm with maximum effort (Fig. 164).
After counting to seven, relax as you exhale.
Perform at least 10-14 repetitions.
EXERCISE 6Starting position- emphasis lying, arms wide apart, hands parallel to each other at chest level.
On an inhale, slowly lower yourself down, on an exhale rise up, leaving your elbows slightly bent. Make sure your back is straight.
EXERCISE 7Starting position- lying on your back on the floor or on a bench, arms bent at the elbows, back straight.
As you inhale, push your chest forward as far as possible. Then, as you exhale, slowly squeeze the dumbbells up. At the same time, the hands should be connected, and the elbows should be slightly bent.
You need to perform at least 7 approaches, consisting of 14-28 repetitions.
EXERCISE 8Starting position- lying on a bench, hands joined together are lowered behind the head, the back is straight, the lower back is pressed to the bench.
As you inhale, raise your hands up strictly to the level of your forehead.
As you exhale, lower your hands behind your head.
You need to complete at least 7 approaches, including 14-28 repetitions.
Therapeutic movements for urological diseases in men
These irresponsible men
The number of men who suffer from inflammatory diseases of male organs (prostatitis, urethritis, etc.) has significantly increased. Recently, all kinds of injuries of the genitourinary organs, as well as neoplasms of the genital organs (benign - prostate adenoma and malignant tumors - prostate cancer, etc.) have been very common.
Men and young men who have anomalies in the development of the urogenital area and sexual disorders are recommended to do special gymnastics, and preferably in the nude. In general, now most young people wear very narrow, tight-fitting panties. Unfortunately, the owners of these shorts do not seem to know that all power is not in swimming trunks, but in family shorts!
Tight underwear is very harmful to men's health. The testicles are always in a cramped state, which contributes to stagnation in the spermatic cords (the vas deferens, their arteries and veins, the venous pampiniform plexus, as well as the testicular artery and lymphatic vessels of the testis are pinched). This impedes the development of spermatozoa in the seminiferous tubules of the testis and adversely affects the health of the genital organs.
In addition, it must be remembered that in order to prevent hemorrhoids, you should not use toilet paper after a bowel movement. Men in the East, and in particular in the Caucasus, are always washed away, and with ice water, and such diseases are extremely rare in them.
And one more important information regarding those who like to read a newspaper while sitting on the toilet. At this time, the buttocks are clamped in a stationary position, due to which an additional load is placed on the external constrictor of the anus (sphincter). As a result of this overload, varicose veins submucosal veins lower section rectum, i.e., hemorrhoids, and with congenital weakness of the muscles surrounding the rectum, even a significant portion of the rectum may fall out through the anus!
In yogis, for example, one of the main exercises for impotence is the rhythmic tension and relaxation of the anus. At the same time, the muscle that raises the anus, actively contracting, acts on the prostate gland, contributing to the elimination of congestion in it.
The number of sick and handicapped men is increasing with terrible force, which is why men in our country have such a low life expectancy! ..
Men, do not let yourself wither and dry out ahead of time!
To maintain health, you need to do gymnastics daily. You don't have to sweat for hours gyms- just set aside thirty minutes a day, and you will find a second youth!
Seven Exercises to Solve Men's Problems
The youth and health of a man directly depend on the well-being of his sexual sphere. The Austrian and American psychoanalyst Wilhelm Reich, who introduced the concept of vital energy, in his numerous works confirmed the long-existing hypothesis that a man ages and dies before a woman because he spends most of his vital energy on sexual acts.
This is just a hypothesis, but it is not without rational grain. Therefore, men need to accumulate vital energy in themselves so that it is enough for many years. And the complex will help you with this special exercises.
EXERCISE 1Starting position- sitting on the floor or stool, legs apart shoulder-width apart. Sit straight, free and not slouching (Fig. 165, a).
Bend your elbows, elbows should be down.
Making noisy, short breaths with your nose, squeeze your palms, as if making grasping movements (Fig. 165, b). At this time, the buttocks are sharply tense and compressed along with the anus.
After that, exhale imperceptibly, relax and return to starting position.
Take 7 short breaths in a row, while squeezing the buttocks and palms. Then rest for 15-30 seconds - and again 7 breaths.
Repeat a series of breaths 4-7 times.
Thanks to this exercise, the prostate gland, the initial section of the urethra and the ejaculatory ducts are perfectly massaged, the bladder and rectum are strengthened.
This exercise can be performed several times a day unnoticed by others.
EXERCISE 2Starting position- standing straight, feet shoulder-width apart, slightly bent at the knees. Hands either on the hips or hanging freely along the body. It is advisable to perform this exercise in the nude, and therefore it is better to be alone.
For one minute, make rapid movements of the pelvis back and forth, shaking your manhood, like a pendulum, at a very fast pace. In this case, the inhalation should be short and noisy, and the exhalation should be imperceptible.
At one time, you can do 7 breaths-movements without stopping. After that, stand up straight and rest for 15-30 seconds - you can just walk around the room.
After resting, bend your knees slightly and again perform quick movements with your hips back and forth.
It is advisable to do this exercise several times a day. It's great if this happens in the morning, immediately after waking up. It is good to perform swaying in the bathroom, standing under the shower jets.
This exercise is recommended for dilated veins of the spermatic cord, unilateral and bilateral cryptorchidism, dropsy of the testicle, inguinal hernia, enuresis, impotence, as well as after any surgical operations on the male genital organs. In addition, it enhances sexual potency, helps with radiculitis and osteochondrosis of the lumbosacral spine.
EXERCISE 3Starting position– squatting in front of a large mirror. The exercise should also be performed in the nude.
Try to pull the testicles up as much as possible while taking a short breath. Together with the scrotum, the abdomen and buttocks are simultaneously retracted.
Then, exhaling imperceptibly, relax the scrotum so that the testicles descend again and return to their original position. Run 7 times.
After that, rest for 15-30 seconds and repeat a series of 7 pull-ups 7 times.
EXERCISE 4Starting position- sitting on the floor, legs bent at the knees, arms at the elbows, hands lie freely on the knees, the torso is relaxed.
Taking a sharp breath, push forward left shoulder, lift the left buttock and push the left leg forward, as if taking a step forward with it. The leg should straighten at the knee.
Performing an imperceptible exhalation, straighten the body, lower the buttock to the floor and bend the right leg at the knee (Fig. 166).
Without pause, take a step with your right foot, pushing your right shoulder forward.
Then, after taking 7 steps with each leg, rest for 15-30 seconds and repeat the cycle of movements again.
It is necessary to perform 7 - 14 repetitions of such movements with each leg.
This exercise helps to get rid of a whole bunch of male diseases.
EXERCISE 5Starting position- Lying on your back.
Rub one palm against the other until they become warm. Place your right hand under your head and your left hand under your testicles.
Tighten your legs, pull in the anus, squeeze the testicles with your palm and begin to stretch them, imagining how the energy passes from the back to the head, and from the left hand to the right.
Do this exercise 7 times a day, doing 14 to 21 pulls in one cycle.
EXERCISE 6Starting position- sitting on the floor with a straight back. Place the foot of your left foot on top of your right foot. Rub the left foot on the shin of the right leg (Fig. 167). You need to do this at least 28 times.
Change legs and repeat the movements the same number of times, but with the right leg.
EXERCISE 7Starting position- standing, holding hands with palms forward and spreading them as much as possible to the sides (Fig. 168, a).
The exercise is similar to opening doors. Taking a short sharp breath, forcefully bring the palms of your hands to your chest. Performing an imperceptible exhalation, spread your arms to the side with no less effort (Fig. 168, b).
After making seven such dilutions-information, raise your hands up.
Keeping the position of the hands, lower the arms through the sides from top to bottom.
Then make seven pushing movements through the sides from the bottom up.
Repeat the cycle of breeding-reduction movements 7 times, but already moving your hands behind your back.
The peculiarity of the last exercise is that thanks to it a feeling of muscular joy is formed.
When performing this complex, only pleasant sensations should arise in the muscles.
Charging for the prostate gland
The following set of exercises is useful for men who have disorders in the prostate gland. It helps to increase the outflow of blood from the venous plexus of the prostate gland, urethra, cavernous and spongy bodies, rectum, restoring its microcirculation in them.
All the exercises of this complex are very simple to perform, but nevertheless they create a good tone for the muscles and vessels of the prostate and rectum, help increase arterial blood flow, due to which such a terrible diagnosis as impotence is postponed for a long time.
EXERCISE 1Starting position- standing, legs slightly apart, palms on the hips, closer to the knees, the back is arched.
Take a slow deep breath and, pushing the pelvis forward, tighten the buttocks and pull in the anus and lower abdomen.
Holding your breath for a few seconds, make a barely audible but long exhalation and return to the starting position.
Repeat the exercise 7 times.
EXERCISE 2Starting position- as in the first exercise. Take a slow deep breath, then tilt your torso down a little and, holding your breath for a few seconds, simultaneously begin to draw in the lower abdomen and anus.
After a barely audible, but long exhalation, return to the starting position.
Repeat the exercise 7 times.
EXERCISE 3Starting position- as in the first exercise, only the legs should be slightly wider than the shoulders.
Simultaneously with a deep breath, perform a deep squat, while placing your hands on your shoulders, and lift your elbows high up (Fig. 169).
Holding your breath for a few seconds, tighten your buttocks and after a long, but barely audible exhalation, return to the starting position.
Repeat the exercise 7 times.
EXERCISE 4Starting position- lying on your back, arms along the body (Fig. 170, a).
After taking a deep slow breath, raise your hands up with an effort.
Pull your left knee towards you, press it strongly against your stomach (Fig. 170, b) and, with a long exhalation, return to the starting position.
Repeat the exercise 7 times for each leg.
EXERCISE 5Starting position- lying on your back, legs bent at the knees, arms above your head (Fig. 171, a).
Simultaneously with a deep slow breath, lift the pelvis up, strongly sticking out the stomach (Fig. 171, b).
Hold your breath for 7 to 14 seconds, then exhale for a long time, pull in your stomach and anus strongly and slowly return to the starting position.
Repeat the exercise 7 times.
EXERCISE 6Starting position- lying on your back, legs straight, arms spread apart.
Simultaneously with a deep slow breath, lift your left leg up (Fig. 172, a).
Making a long exhalation, put the raised leg at a right angle to the left (Fig. 172, b).
Return to the starting position and repeat the exercise 7 times for each leg.
EXERCISE 7Starting position- lying on your back, legs bent at the knees, hands under your head (Fig. 173, a).
Taking a deep slow breath, press on the back of the head with your fingers and gently release them, while pulling your knees to your stomach and tensing the muscles of the buttocks (Fig. 173, b).
Then take a long breath and, tensing the abdominal muscles, return to the starting position. Repeat the exercise 7 times.
EXERCISE 8Starting position- lying on your back, legs bent at the knees, heels together (try to move them as close as possible to the buttocks), hands lie on the hips from the inside, near the perineum.
Slowly taking a deep breath, forcefully spread your knees apart - so that the muscles of the perineum tense up (Fig. 174, a).
Simultaneously with a long exhalation, bring your knees together, providing slight resistance with your hands (Fig. 174, b). Return to starting position.
EXERCISE 9Starting position
Taking a slow deep breath, tighten your abdominal muscles and push it out as much as possible.
Simultaneously with a long exhalation, tighten the muscles of the buttocks and strongly retract the lower abdomen and anus.
Return to starting position.
Repeat the exercise 7 times.
EXERCISE 10Starting position- lying on your back, arms along the body.
Taking a sharp breath through the mouth, tighten the muscles of the buttocks as much as possible and sharply retract the anus, while exhaling, relax for 3-7 seconds.
Repeat the exercise 7 times.
EXERCISE 11Starting position- lying on your back, with a hard pillow under the cervical vertebrae.
Slowly taking a deep breath, slowly, simultaneously raise your arms and legs vertically upwards (Fig. 175) and begin to shake them quickly (vibrate). Try to keep your feet and fingers pointing up.
Perform this vibration for at least 40 seconds.
After a long exhalation, return to the starting position.
Repeat the exercise 7 times.
EXERCISE 12Starting position- lying on the left side, left arm under the head, left leg bent.
Slowly taking a deep breath, at the same time lift your right leg and arm up so that the muscles of the perineum stretch (Fig. 176).
Repeat the exercise 7 times.
Exercises for the treatment of sexual disorders
This complex includes special exercises designed for targeted stimulation of specific organs of the genitourinary system. In addition, they contribute to the stimulation of biologically active points, the accumulation of male energy and the production of endorphins - hormones of good mood.
Thanks to these exercises, capillaries are strengthened and the movement of lymphatic fluid in the urinary organs improves. They must be performed every morning and every evening. They are very good for the prevention and treatment of cancers of the male genitourinary system.
This set of exercises also normalizes the motor functions of the pelvic organs, improves blood circulation in the penis, muscles of the perineum and anal area, promotes better voltage penis (erection).
EXERCISE 1Starting position- lying on the right side, legs bent at the knees, the left hand rests on the thigh.
Taking a sharp breath, bend strongly in the lower back, stick out the stomach as much as possible and tighten the anus.
Simultaneously with a long exhalation, straining the buttocks and muscles of the perineum, pull in the lower abdomen and anus as much as possible.
Repeat the exercise 7 times on each side.
This exercise has a massaging effect not only on the prostate gland, but also on all the organs of the small pelvis and the muscles of the perineum. It activates the circulation of energy and blood circulation in the genitals.
EXERCISE 2Starting position- lying on the stomach, hands under the chin, elbows laid to the sides.
Taking a sharp breath, bend your right leg and try to reach your right elbow with your knee (Fig. 177).
With a long exhalation, return to the starting position.
Repeat the exercise 7 times for each leg.
Performing this exercise, you make a good massage of the intestines, bladder, ureters, which normalizes their functions, stimulates increased blood circulation in the pelvic area, and affects the deep meridians of the abdominal cavity.
EXERCISE 3Starting position- lying on your stomach, legs brought together, hands under the chin.
At the same time, tighten the muscles of the buttocks and perineum, pressing the pubis into the mat for 2-3 seconds.
Movements are carried out only by the pelvic area. Breathing is free.
Repeat the exercise 7 times.
EXERCISE 4Starting position- lying on the stomach, hands resting on the palms near the chest, legs brought together (Fig. 178, a).
Taking a deep long breath, slowly raise your chest and head. At the same time, the back must be bent so that the body from the pubis to the chest is pressed tightly against the floor (Fig. 178, b).
Holding your breath for a few seconds, pull your head back as far as possible.
With a long exhalation, lower your chest and head. After exhaling, lie down for a few seconds, relaxing your muscles as much as possible.
Repeat the exercise 7 times.
This exercise regulates the function of the adrenal glands, tones the sympathetic nervous system, stimulates the circulation of energy and blood in the organs of the abdominal cavity and small pelvis.
EXERCISE 5Starting position- kneeling, feet apart - so that you can sit between them.
Performing a long exhalation, raise your hands up (Fig. 179, a).
Sit between your feet and exhale sharply, leaning forward slightly and stretching your arms forward (Fig. 179, b).
Repeat 7-14 times.
This exercise normalizes the circulation of blood and lymph in the muscles of the perineum and penis and, as a result, improves sexual functions.
EXERCISE 6Starting position- sitting on the heels on the rug, the palms of the hands hug the head from the side of the temples, the fingers lie on the top of the head.
Apply to the right and left of the crown of the head light blows with the knuckles for 40-60 seconds.
Breathing is arbitrary, through the nose.
Repeat 7 times.
Exercise relieves constipation, hemorrhage, hemorrhoids, diseases of the prostate gland and kidneys.
EXERCISE 7Starting position- sitting on the mat, hands behind in emphasis, one leg, bent at the knee, stands on the mat.
Simultaneously change the position of the legs: one leg is bent at the knee, the other is straightened (Fig. 180 a, b).
When changing legs, try to strain the muscles of the perineum as much as possible. Breathing is arbitrary.
Repeat 14 times.
Exercise stimulates the circulation of blood and lymph in the muscles of the perineum, cavernous and spongy bodies of the penis and, as a result, promotes a full erection.
EXERCISE 8Starting position- standing on all fours, hands are as close as possible to the knees (Fig. 181, a).
Performing a long exhalation, bend as much as possible in the lower back. Straighten your legs, lift your pelvis as high as possible, while simultaneously pulling in the lower abdomen (Fig. 181, b).
Repeat 7-14 times.
Exercise helps to increase the outflow of blood from the venous plexuses of the pelvic organs: the prostate, penis, testicles, scrotum, bladder and rectum.
EXERCISE 9Starting position- sitting astride a chair facing the back.
Place a loosely inflated volleyball or soccer ball under your buttocks. Holding on to the back of a chair, swing on the ball from left to right, right to left and back and forth for 5-7 minutes.
Then, sitting on the ball, lightly jump so that the groin area comes into contact with the ball first, and then the anus. Perform such jumps for 1-2 minutes. After that, the ball can be removed.
Sit with your back against the back of a chair. Putting your hands on your lower abdomen, do a specific breathing exercise. On a sharp breath, stick out your stomach, slightly bending in the lower back, and on a long exhalation, straining your buttocks and lower abdomen, press on it with your palms.
Repeat 7 times.
Thanks to this exercise, the muscles of the perineum are well massaged, which contributes to the normalization of blood circulation, as well as active biological points on the perineum and around the anus, sexual functions are stimulated, and the energy of the genitourinary organs is activated.
EXERCISE 10Starting position- lying on your back, legs straightened.
Place your right foot on your left knee and take a slow breath (Fig. 182, a).
Then, in the pause between inhalation and exhalation, place the left hand on outside right knee and pull it to the left and down to the floor (Fig. 182, b).
At the same time, vigorously turn your head to the right and, exhaling forcefully, relax all the muscles of the body as much as possible for 3-5 seconds.
Repeat 7-14 times, changing legs.
Thanks to this exercise, the normal functioning of the genitourinary system is restored.
Male self-massage
the best way the fight against impotence and diseases of the genitourinary system is to maintain general health and protect against excessive sexual activity.
You should refrain from sex for a while and provide your body with good sleep and a balanced diet.
A simple but very effective self-massage will help you restore health and potency.
EXERCISE 1Starting position- Sitting on the mat.
Bend comfortably any leg and, grabbing the Achilles tendon with your thumb and forefinger, squeeze it and rub it in the longitudinal direction for 30-60 seconds (Fig. 183). When moving down, the pressure should be increased. Do the same with the other leg, then pinch the Achilles tendon for 30-60 seconds.
Exercise stimulates the kidneys, bladder, sexual function.
EXERCISE 2Starting position- sitting on the mat, legs bent, knees spread apart to the limit, feet moved as close as possible to the crotch, hands on the feet.
Simultaneously with a sharp breath, also sharply retract the anus. Repeat this 7-14 times.
After retracting, straighten your legs and as you exhale, do 7 forward bends.
Thanks to this exercise, the muscles, vessels and vas deferens of the prostate gland are toned, the biological points around the anus are stimulated, which has a positive effect on sexual potency.
EXERCISE 3Starting position- Sitting on the mat.
With circular movements of the hands laid one on top of the other, first massage the front of the left leg from the middle of the gastrocnemius muscle to the foot (Fig. 184), then the same part of the right leg in the same direction. The duration of the massage for each leg is 30–60 seconds.
Such a simple massage helps to relax the prostate and rectum.
EXERCISE 4Starting position- lying on your back, legs bent at the knees.
Massage the superior pubic ligament, located at the edge of the pubic bone, for 30-60 seconds.
After that, proceed to alternate gentle compression of the testicles (the number of compressions should correspond to the number of years of life).
This exercise increases the sensitivity of the testicles and stimulates their work.
EXERCISE 5Starting position- as in the fourth exercise.
Putting one hand on top of the other, place them on the sternum, spreading your fingers like a rake so that they point down.
Take a sharp breath and slow exhale. At the end of the exhalation, with force pressing on the muscles, make stroking movements, while moving the hands from the middle of the body, first to one side, then to the other.
After that, lower your hands 7 centimeters lower and repeat the strokes.
Then place your hands even lower, approximately above the navel, and stroke again.
Finish the massage by going through the entire abdomen.
Make sure that the end of the exhalation coincides with the increased pressure of the massaging fingers.
After that, with the brushes laid on top of each other, make seven full rotational massaging movements clockwise around the navel. Breathing should be frequent and intermittent.
This exercise effectively helps to remove toxins from the body, as well as strengthen the organs of the genitourinary system.
EXERCISE 6Starting position- on my knees. Taking a deep breath, lean forward slightly and during the pause between inhalation and exhalation, pat the hips from the back side, gradually moving your hands higher and higher from the knees to the buttocks (Fig. 185).
Patting should be performed with fingers slightly bent into a fist, moving the hands up and down and covering the entire thigh, while the wrist joints should be free.
You need to pat for 30-60 seconds, then return to the starting position as you exhale.
Repeat at least 7 times.
This exercise provides stimulation of the gonads, bladder and spleen.
EXERCISE 7Starting position- lying on your back, legs apart and slightly bent, a pillow under your head.
Start by massaging the urethra. It is carried out in two ways: by pressing and stroking.
First, find the entrance of the urethra (urethra) to the small pelvis. For reference, remember that it is in front of the anus.
With the pad of your index or middle finger (whichever is more convenient), press firmly on the entry site of the urethra 14–28 times without interruption. After that, with the remaining three fingers (the thumb is not involved), elastically press on the urethra and perineal muscles from the anus to the root of the penis. The root of the penis is also a good idea to massage (the root, not the head!). Repeat these pressing movements 7 times.
Then proceed to the massage by kneading and stroking. Knead the urethra - also from the anus to the root of the penis - at least 7 times in a clockwise circular motion.
Now move on to penis massage. Don't be shy, you're going for a massage, not masturbation. Take it in your hand and knead it from the head to the root for 70-80 seconds.
Testicular massage is also carried out in two ways: shaking and pressing - in the same starting position. First, put the testicles on the palm of your hand and, with alternate raking movements of the hands, toss them from the bottom up (you can’t hit the testicles!) For 40-70 seconds.
After that, proceed to the final stage of the massage. Make alternating movements with your palms along the perineum, starting from the anus. Raising the scrotum with the testicles up, lightly press on them on the pubis. The duration of such a massage is also 40-70 seconds.
Finish the exercise by gently shaking the testicles and scrotum for 14 to 28 seconds.
Be careful - these organs are very sensitive, do not hurt yourself. Massage should bring only pleasure. But at the same time, you should not think about sex, because sexual arousal can only interfere with the correct execution of the exercise.
Exercises to maintain masculine strength
This set of exercises concerns not only physical strength men, but, which is also very important, and sexual. It has long been known that a man stops being a man when he stops looking at women. But just looking at women to confirm male viability, of course, is not enough - something else is needed. So, to save this “something else” and the universal set of exercises for men brought to your attention will help. The versatility of the complex lies in the fact that it can be performed at any time at any age.
EXERCISE 1Starting position- standing, legs apart shoulder-width apart, arms extended forward.
While inhaling, do a deep squat without lifting your heels off the floor. Keep your back straight, slightly arching your lower back (Fig. 186). As you exhale, return to the starting position. You need to perform at least 14-28 squats.
EXERCISE 2Starting position- standing, legs together, arms extended forward or along the body.
Inhale lunge on one knee back (Fig. 187).
As you exhale, return to the starting position.
You need to do at least 14-28 lunges with each leg.
EXERCISE 3Starting position- lying down, resting your elbows and right knee on the floor.
While inhaling, lift the thigh of the left leg up to the level of the buttocks (Fig. 188).
As you exhale, return to the starting position. You need to complete at least 14-28 hip raises of each leg.
EXERCISE 4Starting position- lying on your back, bending your knees, hands resting on the floor.
While inhaling, lift the pelvis, squeezing the buttocks and without bending the lower back.
As you exhale, return to the starting position.
EXERCISE 5Starting position- lying on your back, legs bent at the knees, forming a right angle.
While inhaling, spread your hips to the sides (Fig. 189).
As you exhale forcefully bring them together.
EXERCISE 6Starting position- Lying on your side.
While inhaling, lift your right leg up, holding it with your hand.
Pull your left leg to it and lower it as you exhale, without touching the floor and keeping it on weight (Fig. 190).
You need to perform at least 14-28 repetitions on each side.
EXERCISE 7Starting position- squatting on the floor, resting his hands on the floor (Fig. 191).
As you inhale, bring your knees together, tensing your inner thighs.
As you exhale, spread your knees, continuing to strain your inner thigh.
It is necessary to perform at least 14–28 dilutions-information.
EXERCISE 8Starting position- standing, legs apart shoulder-width apart, arms raised up.
On inspiration, tilt to the right (Fig. 192).
As you exhale, return to the starting position.
You need to perform at least 14-28 tilts in each direction (left, right, forward and backward).
EXERCISE 9Starting position- sitting on the floor, legs as far apart as possible, hands in front of you.
While inhaling, make turns to the right, while trying to twist the lower back as much as possible.
As you exhale, return to the starting position.
You need to complete at least 14-28 turns in each direction.
EXERCISE 10Starting position
While inhaling, lift the body up as much as possible, while the legs lie on the floor.
As you exhale, return to the starting position.
You need to complete at least 14-28 lifts.
EXERCISE 11Starting position- Lying on your side, hands behind your head.
While inhaling, lift your legs up as much as possible, while the body lies on the floor.
As you exhale, return to the starting position.
You need to complete at least 14-28 lifts.
EXERCISE 12Starting position- standing, legs together, palms resting on slightly bent knees. Perform 14–28 rotational movements of the knees to the right and left (Fig. 193).
Repeat the same with legs wide apart. Breathing is arbitrary.
EXERCISE 13Starting position- lying on his stomach, stretched out in a string.
While inhaling, raise straight legs and arms up, bending in the back (Fig. 194).
As you exhale, lower your arms and legs and relax for a few seconds.
You need to complete at least 14-28 lifts.
EXPLANATIONSPerforming all of the above sets of exercises should bring joy. After completing each exercise, take a short rest and do not try to do all the exercises at once.
During the first week of classes, the break between exercises should not be less than 30-60 seconds, then you can gradually reduce it.
During classes, think about victory over the disease, believe in it - and this will undoubtedly come true!
Mentally imagine your body strong, strong and healthy - and it will become so. Faith in success, perseverance and the desire to get rid of diseases significantly accelerate the achievement of success.
Health is in your strong hands You just need to show perseverance and perseverance.
Therapeutic movements for the respiratory system
Only trained muscles are able to provide full breathing and normal gas exchange, therefore, in the treatment of respiratory organs, physical exercises have a special place. They are aimed primarily at training those muscles that are involved in the breathing process: the diaphragm, the external and internal intercostal muscles, the square muscle of the lower back, the rectus and transverse abdominal muscles, the external and internal oblique muscles of the abdomen, etc. In addition, breathing exercises contribute to the creation of a branched circulatory system in the tissues of the bronchi, lungs and entire chest, which significantly improves the blood supply to these organs.
Therapeutic movements for bronchitisDue to their effectiveness, breathing exercises are not only an important therapeutic, but also a preventive measure. People who have ever had acute or chronic bronchitis or other bronchopulmonary diseases should definitely include them in their daily morning exercises.
Below are three sets of exercises for patients with chronic bronchitis who are on different stages diseases.
A complex of therapeutic movements for those who have had an exacerbation of chronic bronchitis
EXERCISE 1Starting position- legs slightly apart, arms bent in front of the chest.
With a springing motion, take your elbows back and inhale, straighten your arms - exhale. Repeat 5-6 times.
EXERCISE 2Starting position
Raise your hands up and take a deep breath; bend sharply to the side - exhale. The same on the other side. Repeat 5-6 times on each side.
EXERCISE 3Starting position- legs slightly apart, arms lowered.
Spread your arms to the sides and take a deep breath; sit down, putting your hands forward - exhale. Repeat 6-10 times.
(For older people, the exercise can be simplified: do incomplete squats 3-5 times, leaning on a chair or bench.)
EXERCISE 4Starting position- standing.
Place your right hand on the back of a chair, your left hand on your belt and take a deep breath; perform a swing movement with your left foot - exhale. The same with the other leg. Repeat 5-6 times with each leg.
EXERCISE 5Starting position- standing, feet shoulder-width apart.
Spread your arms to the sides - inhale. Lean forward, trying to reach the floor with your fingers - exhale. Repeat 5-6 times.
EXERCISE 6Starting position- standing.
Put your left hand on the back of a chair, your right hand on your belt and take a deep breath; make with the right leg, slightly bent at the knee, circular movements in the hip joint (Fig. 195) in one direction and in the other - exhale. Do the same with the other leg. Repeat 5-6 times for each leg.
EXERCISE 7Starting position- standing.
Put your hands on your hips - take a deep breath, make circular movements with your torso to the right - exhale. Do the same to the left. Repeat 4-5 times on each side.
EXERCISE 8Walk for 3 minutes, first at a fast pace and then at a slow pace. Don't hold your breath!
A set of exercises for practically healthy people (prevention of bronchitis)
EXERCISE 1Starting position
At the expense of 1-2, spread your arms to the sides, turning your palms up (Fig. 196), stretch and take a deep breath, at the expense of 3-4, return to the starting position - exhale.
Repeat 3-4 times.
EXERCISE 2Starting position- standing, feet shoulder-width apart, arms lowered.
On count 1, bend your left leg at the knee, put your right hand on your belt, and take your left hand to the side - inhale (Fig. 197); on count 2, return to the starting position - exhale. Perform the same movements with the right leg and right hand for a count of 3-4 (left hand on the belt).
Repeat 3-4 times.
EXERCISE 3Starting position- standing, feet shoulder width apart, hands in front of the chest.
For each count, perform jerks with your hands back, rhythmically combining them with inhalation and exhalation.
Repeat 3-4 times.
EXERCISE 4Starting position- standing, legs together, hands on the belt.
Take a deep breath, at the expense of 1-2, crouching on your toes, stretch your arms forward (Fig. 198) - exhale, at the expense of 3-4 return to the starting position - inhale.
Repeat 3-4 times.
EXERCISE 5Starting position- Feet shoulder-width apart, arms down.
Take a deep breath; at the expense of 1-2, tilt the body to the left (the left hand slides down the leg) - exhale; at the expense of 3-4, return to the starting position - inhale. On the count of 5-8, perform the same movements to the right side.
Repeat 3-4 times.
EXERCISE 6Starting position- standing, feet shoulder-width apart, arms lowered.
At the expense of 1-2, raise your arms bent at the elbows to shoulder level - inhale; at the expense of 3-4, lower your relaxed hands down and shake them several times - exhale.
Repeat 3-4 times.
EXERCISE 7Starting position- Feet wider than shoulders, hands on the belt.
At the expense of 1, take the right leg back, and raise the left arm bent at the elbow to the shoulder (Fig. 199) - inhale, at the expense of 2 return to the starting position - exhale, at the expense of 3-4, perform the same movements with the left leg and right hand. Repeat 3-4 times.
Therapeutic movements for pleurisy
The complex of therapeutic movements prescribed for pleurisy prevents the formation of pleural adhesions, which limit respiratory functions lungs. In addition, the resorption of the inflammatory, effusion fluid, which is located in the pleural cavity with exudative (effusion) pleurisy, is accelerated.
Due to the gradual increase and deepening of breathing during exercise, the affected side of the chest is stretched.
This complex can be assigned to early stages of pneumonia to prevent the formation of adhesions.
EXERCISE 1Starting position- lying on your back, right hand on the chest, left - on the stomach.
Perform a full breath under the control of the hands. Pay attention to the rise of the chest on the affected side as you exhale.
EXERCISE 2Starting position- Lying on your back.
Perform a full breath, as you exhale, pulling the knee to the chest on the affected side.
EXERCISE 3Starting position- standing, hands to shoulders. Raising your arms up, take a deep breath. Return to the starting position - exhale.
EXERCISE 4Starting position- standing, hands down, fingers interlaced.
Raise your arms and turn your palms up. Bend and stretch - inhale. Return to the starting position - exhale.
EXERCISE 5Starting position- standing, hands on the belt. Tilt to the healthy side - a deep breath. Return to the starting position - exhale.
EXERCISE 6Starting position- standing, legs apart, hands in front of the chest. Rotate your torso to the healthy side with a deep breath. Return to the starting position - exhale.
EXERCISE 7Starting position- sitting, hands on the belt. Take a deep breath, spreading your arms to the sides and bending back. Return to the starting position - exhale.
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Ministry of Health of Ukraine
Dnepropetrovsk State Medical Academy
Department of Physical Rehabilitation and Sports Medicine
On the topic: Physiotherapy exercises in obstetrics and gynecology
The work was checked by Cook M.O.
Dnepropetrovsk 2011
Therapeutic exercise in gynecology
gynecological medical physical pregnancy
In chronic inflammatory processes, physiotherapy exercises and massage are indicated. Exercise therapy is used to eliminate adhesions, inflammation, general strengthening organism, rehabilitation. Physical exercises help to accelerate blood and lymph flow, eliminate congestion in the organs of the abdominal and pelvic regions, increase metabolism, and accelerate reparative tissue regeneration. Increased blood and lymph flow during exercise and massage prevents congestion, the formation of adhesions (scars) in the pelvic region.
LH is carried out in the form of morning exercises in a group method or individually in a hospital, and after discharge - in outpatient and home conditions (Fig. 150).
LH is performed in different initial positions (lying, standing, sitting, on the side) with a gradually increasing range of motion, pace and frequency of execution, with the inclusion of special exercises for the muscles of the pelvic floor and abdominal cavity. General developmental exercises must be combined with breathing, relaxation and isometric exercises. After the elimination of congestion, adhesions, pain, exercises with a gymnastic stick, stuffed balls, dumbbells and on simulators are included. In addition to LH, they include dosed walking in combination with running, skiing, rowing, games, swimming and other means of physical education, taking into account the functional state of the woman, her age, nature of work and the course of the disease.
Physical exercises are contraindicated during exacerbations of the inflammatory process, accompanied by an increase in body temperature, erythrocyte sedimentation rate (ESR), bleeding, pain, as well as with encysted purulent processes before surgery (opening and drainage).
In the complex treatment of chronic gynecological diseases, an important place is given to gynecological massage. Its tasks: improving blood and lymph circulation in the pelvic organs, eliminating congestion, increasing the tone of the muscles of the uterus and its contractile function, stretching and eliminating adhesions, connective tissue adhesions of the ligamentous apparatus of the uterus, resorption of infiltrates, eliminating displacement of the uterus and returning it to normal physiological position, improvement of the general condition of the woman's body.
Rice. An approximate complex of LH in gynecological diseases
Mandatory condition for gynecological massage: normal temperature body, biochemical parameters of blood, absence of vaginal discharge, cervical erosion and other inflammatory processes.
Massage technique. The gynecologist spends the toilet of the external genitalia, then washes his hands with soap and brushes, and puts on rubber gloves when performing a massage. The patient should lie still, relaxing the muscles of the abdominal wall as much as possible.
The doctor or masseuse nurse stands between the legs of the patient and gently performs massage techniques. The procedure is performed with both hands. Index and middle finger the left (or right) hand is inserted into the vagina, and the fingers of the right (left) hand are massaged from the side of the abdominal wall (Fig. 151). The fingers that are in the vagina should not touch the clitoris. It is important to spare the urethra, not to cause pain when stretching cicatricial adhesions, moving the uterus and other manipulations.
Rice. Gynecological massage (a, b), b: 1 - pubic bone; 2 - bladder; 3 - rectum; 4 -- uterus
The technique of gynecological massage is strictly differentiated depending on the disease, its course and the age of the patient.
There are five main methods of gynecological massage:
1. Rubbing and stroking the uterus, appendages and other organs of the cavity of the large and small pelvis in order to increase the tone of the tissues.
2. Stretching of pathological formations (scars, adhesions, adhesions, etc.).
3. Rubbing the ligamentous apparatus by shifting the uterus in horizontal and vertical directions to increase its tone and normalize the position of the internal genital organs.
4. Jerky pressure on the abdominal muscles, parietal and pelvic floor muscles.
5. Kneading inside and outside the muscles of the abdominal wall.
Contraindications to gynecological massage: thrombophlebitis of the pelvic veins; menstruation; increase in body temperature, acceleration of ESR; acute inflammatory processes of the pelvic organs; oncological diseases of the pelvic organs; gonorrhea, trichomoniasis, tuberculosis, etc.; cervical erosion; nasal processes in the small pelvis; erosive colitis; pregnancy; lactation; two-three-month postpartum, post-abortion period; girdle pain during the massage.
Amenorrhea
This is the absence of menstruation for 6 months or more. The appearance of menstruation every 2-3 months - oligomenorrhea. The absence of menstruation in a girl over 16 years of age refers to primary amenorrhea, their termination after menstruation has been at least once - secondary.
Psychogenic amenorrhea occurs due to stress. This often occurs in wartime and in female athletes, when excessive ACTH secretion inhibits the production of gonadotropic hormones from the anterior pituitary gland, especially the luteinizing one, as a result of which there is a low excretion of estrogens. The cause may also be underdevelopment of internal organs and past infectious diseases.
The complex rehabilitation shows physio- and hydrotherapy, exercise therapy, massage, physical education (cycling, skiing, swimming, games, etc.). Vibration massage, sauna (bath), hardening procedures, vitaminization, diet therapy, herbal medicine are carried out.
With psychogenic amenorrhea, psychotherapeutic treatment, oxygen therapy (inhalation of humidified oxygen or intake of an oxygen cocktail), and general strengthening therapy are necessary.
Amenorrhea of a functional nature requires different methods of treatment depending on etiological factors, the age of the patient, the duration of the disease, the nature of the involvement in the pathological process of the nervous structures of the hypothalamus and the degree of hypoestrogenism.
With amenorrhea associated with obesity, much attention should be paid to diet therapy, exercise therapy, physical education, massage, sauna (bath), as well as physiotherapy and hydrobalneotherapy.
In case of amenorrhea that has arisen on the basis of debilitating diseases and intoxications, treatment should be carried out aimed at the underlying disease, and general strengthening therapy, diet therapy, vitaminization, hardening procedures, games, walks, etc.
Painful menstruation is a relatively common disorder. Pain usually occurs before the start of the cycle and continues on the first or second day of menstruation. The pains can be dull, pulling or extremely strong, convulsive. Often there are nausea, vomiting, sweating, spastic constipation, headache and other disorders that disrupt the general condition and ability to work of a woman.
Showing massage, LH.
Massage technique. Massage of the back, gluteal muscles, lower extremities and abdominal wall is carried out. Chopping, tapping techniques are excluded. The duration of the massage is 5-10 minutes. Procedures begin 3-5 days before menstruation.
Hypofunction (failure) of the ovaries
The disease is characterized by a violation of the cycle of menstruation, a small amount of lost blood. Pathology is established by determining the hormonal background.
Exercise therapy is used, vibration massage of the lumbosacral region and perineum, mud applications (40-42 ° C) on "panties", general massage, swimming, sauna (bath), ski trips, games, Spa treatment and etc.
uterine fibroids
Uterine fibroids are benign tumors originating from smooth muscle tissue. Tumor development is associated with disorders in the hypothalamic-pituitary region and increased estrogen production.
Exercise therapy, swimming, health path, skiing, vibration massage, games, herbal medicine, hardening procedures, etc. are shown.
Climacteric syndrome (female menopause)
The climacteric syndrome is a weakening of the physiological mechanisms of adaptation associated with the age-related involutional restructuring of the female body.
Comprehensive rehabilitation includes massage, vibration massage, electrosleep, electrophoresis with bromine on the cervicofacial area according to Kellat, baths according to Gauff, coniferous-salt baths, galvanization of the head area, aerotherapy, showers (fan, circular, rain, etc.). hardening procedures, exercise therapy, skiing, games, etc.
Massage technique. Massage of the back, gluteal muscles, lower extremities, abdomen and activation of breathing (rubbing of the intercostal muscles, compression of the lower chest) are performed. Apply stroking, rubbing, kneading and shaking the muscles. The duration of the massage is 8-12 minutes. To normalize sleep, massage is combined with color music, taking an oxygen cocktail. They also include exercise therapy, walks, hardening.
Underdevelopment of the uterus
Genital infantilism occurs when there is a violation of nutrition (in particular, with hypovitaminosis, severe chronic diseases suffered in childhood or during puberty, with intoxication and disorders of the functions of the endocrine glands. The immediate cause of the underdevelopment of the uterus and other parts of the reproductive system is a delay in the development of the ovaries and decrease in their intrasecretory function.
With underdevelopment of the uterus, menstrual, sexual, reproductive and secretory functions are disturbed, functional disorders of the cardiovascular and nervous systems are observed.
Showing massage, LH, tempering procedures, games, ski trips, sauna, hydrocolonotherapy. Gynecological massage is used in combination with exercise therapy, physio- and hydro-procedures. General massage improves blood and lymph circulation, normalizes the psycho-emotional state of the patient, eliminates pain during menstruation, and improves tissue metabolism. The duration of the massage is 10-15 minutes. Course 15-20 procedures. 3-4 courses per year.
Infertility
Infertility - inability to conceive - occurs with the following diseases of the genital organs: inflammation fallopian tubes accompanied by a violation of their patency, complication of peristalsis and damage to the ciliated integumentary epithelium; endometritis, especially in combination with inflammation of the tubes, endocervicitis, colpitis; chronic oophoritis and perioophritis in case of violation of the ovulation process; incorrect position of the uterus, especially in combination with inflammation of the fallopian tubes, ruptures of the cervix and perineum, prolapse and prolapse of the genital organs, cicatricial adhesions (synechia) in the uterine cavity formed after rough curettage, etc.
Infertility can occur due to infantilism, diseases of the endocrine glands, malnutrition, etc.
In the complex treatment of infertility, the following are shown: LH, physical education, sauna, hardening, gynecological massage, segmental reflex massage (impact on paravertebral reflex zones, lumbar region, gluteal and adductor muscles of the thigh). In addition, it is necessary to influence the BAP with an exciting method (see the section “Acupressure massage”). The duration of the massage is 3-10 minutes. Course 20-30 procedures. 2-4 courses per year.
Inflammatory diseasesfemale genital organs
To normalize the ovarian-menstrual and secretory functions, resorption of the inflammatory process, elimination of adhesions and other changes, gynecological massage, therapeutic exercises, physiotherapy, etc. are indicated.
Vulvitis is an inflammation of the vulva, that is, the large and small labia, the clitoris, the vestibule of the vagina with all the glands and ducts opening here. For rehabilitation, they include sitz baths with soda, UV radiation on the vulva area, exercise therapy, walks, hardening procedures, skiing, swimming, etc. In chronic vulvitis, mud applications. In the prevention of recurrence of the disease, air and sunbathing should be used in combination with exercise therapy, skiing, games, etc., wiping and dousing, sauna, swimming, etc.
Endometritis is an inflammation of the lining of the uterus. In chronic endometritis, therapeutic mud, sulfide waters (baths, vaginal irrigation), exercise therapy, massage, walking, skiing, rowing, etc. are used.
Salpingoophoritis - inflammation of the uterine appendages. In a chronic disease, mud applications are used on the solar plexus, sulfide baths, UV irradiation, exercise therapy, massage, walking, cycling, etc.
Parametritis is an acute inflammation of the parauterine tissue. AT acute stage shows cryomassage of the lower abdomen. After the elimination of the inflammatory process, they include exercise therapy, general massage, UV irradiation, herbal medicine, walking, physical education, hardening, etc.
Features of exercise therapy in chronic inflammatory diseases
Exercise therapy is indicated for chronic inflammatory processes: salpingoophoritis, perisalpingoophoritis, parametritis, etc.
Contraindications: severe exacerbations, inflammation, fever, accelerated ESR, peritoneal irritation, bleeding, etc.
A number of patients have persistent lumbosacral pain that limits motor activity. Exercise therapy, massage, physical education lead to an increase in blood and lymph flow, eliminate congestion, improve the flexibility of the spine and joints, and strengthen the muscles. To combat weakness of the abdominal press and atonic constipation, LH is used in the initial prone position and on all fours, exercises with dumbbells, stuffed balls, at the gymnastic wall, and breathing exercises (“belly breathing”).
LH is carried out in the hospital and after discharge at home and sanatorium-resort conditions: they also include walking, skiing, cycling, swimming, playing, running, etc.
When pain syndrome should avoid the use of paraffin (ozokerite), mud, sulfide and chloride sodium water, as they can increase the pain, as the blood flow becomes greater, and the outflow is disturbed. They include gynecological massage, general classical massage, exercise therapy, swimming, sun and air baths, running combined with walking, cycling, gymnastics, water games, etc.
Radon baths are indicated for patients with uterine fibroids, mastopathy, hyperthyroidism, endometriosis.
In case of infertility, ultrasound in a pulsed mode, vibration massage of the lower back, adductor muscles of the thigh and lower abdomen, sulfide baths and vaginal irrigation or electrical stimulation, sauna (bath) and others are indicated.
Incorrect position of the genitals
Incorrect position of the genital organs - their persistent deviations from the normal state, usually accompanied by pathological phenomena. Retroflection - bending the body of the uterus backwards, retroversion - the body of the uterus is tilted backwards, the cervix - anteriorly, retrodeviation of the uterus - a common combination of retroflexion and retroversion. Distinguish mobile and fixed retrodeviation. Movable retrodeviation of the uterus can be a manifestation of anatomical and physiological disorders, fixed - a consequence of the inflammatory process in the pelvis. Inflammatory diseases, injuries of the pelvic organs, anomalies in the development of the uterus, and a decrease in the tone of the ligamentous-muscular apparatus of the uterus contribute to the pathological deviation of the uterus and its bending back. Retroflexion of the uterus can be the result of weakening of the muscles of the abdomen and pelvic floor, which is facilitated by multiple pregnancies, childbirth, surgical interventions during childbirth, perineal ruptures, delayed uterine involution, postpartum infection, etc.
Prolapse and prolapse of the uterus and vagina occur with heavy physical work, constipation, insufficiency of the pelvic floor muscles as a result of trauma to the perineum during childbirth. Predisposing moments: early physical labor in the postpartum period, frequent childbirth, retroversion of the uterus, infantilism, etc. Omission and prolapse of the uterus and vagina are more common in older women with involutional processes in the genitals.
One of the main factors affecting the position of the uterus is intra-abdominal pressure, which is influenced by the position of the body. In the standing position, a negative pressure is created in the epigastric region, which gradually increases downwards and becomes equal to zero near the navel. Below the navel, the pressure continues to increase, and the greatest positive intra-abdominal pressure is noted in the lower abdomen. In the sitting position, the pressure in the abdominal cavity is somewhat less than in the standing position, due to the relaxation of the abdominal wall, and it decreases even more in the supine position. A change in intra-abdominal pressure with a change in body position is determined by a change in the relative position of the internal organs and the degree of tension in the muscles of the abdominal wall.
Intra-abdominal pressure is also regulated by the friendly function of the diaphragm, the anterior abdominal wall and the pelvic floor, which are the supporting apparatus of the intrapelvic organs. With good functional state pelvic floor muscles, they provide sufficient resistance to the abdominal press, as a result of which the uterus and vagina do not fall below normal limits.
With a slight prolapse of the uterus, exercise therapy, diet therapy, vitaminization, transfer from severe physical work to a lighter one. Hydrokinesitherapy (water temperature 27--29°C), swimming with fins, paddles; dumbbell gymnastics (in the prone position), etc. Classes on simulators (in the prone position with a raised pelvis), followed by a contrast shower.
Women who do not complain do not need treatment. During pregnancy, the growing uterus itself assumes the correct position. With severe symptoms of the disease, exercise therapy, diet therapy, fortification, etc. are indicated. Indications for the appointment of exercise therapy are acquired forms of retrodeviation that are not burdened by an exacerbation of the inflammatory process and do not require surgical intervention.
Exercise therapy helps to strengthen the muscles of the abdominal wall and pelvic floor and restore the correct position of the uterus. To achieve these results, the choice of initial body positions and the selection of special exercises are decisive. The starting position promotes the movement of internal organs upward, relaxation of the abdominal wall and changes in intra-abdominal pressure.
The method of exercise therapy depends on the nature of retroflexion of the uterus (mobile, fixed), on the state of the muscles of the abdominal wall, pelvic floor, and cardiac function. vascular system, age, working and living conditions. With fixed retroflexions, exercise therapy is used in combination with physiotherapy and hydrotherapy, gynecological massage.
Methods of gynecological massage. Before the procedure, the patient must empty the bladder and rectum. The body of the uterus is palpable deep in the recto-uterine space. As in a gynecological examination, two fingers of the right hand are inserted into the vagina, index finger they push the cervix backwards, and with the middle one press on the body of the uterus, trying to bring it out of the pelvic cavity, the left hand grabs the bottom of the uterus and puts it in the correct position. Since this does not eliminate the cause that caused the retrodeviation, stable therapeutic success is usually not achieved. In some cases, pessaries are used to hold the uterus in the correct position. With fixed retrodeviation, it is necessary to carry out therapy for the inflammatory process or its consequences.
After surgical treatment include breathing exercises, massage. After removing the stitches, an LH is performed, swimming, skiing, cycling, physiotherapy, etc. are recommended.
Therapeutic exercise in obstetrics
Pregnancy begins from the moment of fertilization. The fertilized egg moves along the tube towards the uterus and reaches its cavity on the sixth-eighth day, there it is immersed in the thickness of the shell and grafted (implanted). By the end of the first month of pregnancy, the fetal egg is surrounded on all sides by chorionic villi; at the third month of pregnancy, the villi remain only on the side of the fetal egg that faces the wall of the uterus. By the fourth month, the villi turn into a placenta.
The placenta secretes a complex set of hormones into the mother's body and biologically active substances, it performs the function of metabolism between mother and fetus. Occurring in the body physiological changes contribute to the proper development of the fetus, prepare the body of the expectant mother for childbirth and feeding the newborn.
From the first months of pregnancy, the woman's body and the fetus's need for oxygen increases, all types of metabolism undergo changes: carbohydrate, fat, protein, water, salt and vitamin. Pregnancy places increased demands on the functions of almost all organs and systems. In this regard, the motor activity of a woman (walking, therapeutic exercises, etc.), hygienic body care, sleep, and many other factors are of great importance for the correct course of pregnancy. Regular physical therapy, massage, etc. are necessary.
Massage technique. The starting position during the massage of the back, lower back - on the side, and the lower extremities - lying on the back (legs slightly raised). The legs are massaged starting from the thighs, then the lower leg. Finish the massage with soft stroking from the fingertips (rear of the foot) to the inguinal region. Chopping, tapping and deep kneading techniques are not used. The duration of the massage is 5-10 minutes several times a day.
Massage promotes the elimination of edema by accelerating blood and lymph flow, improves tissue metabolism, relieves neuro-reflex reactions of the vascular system, and normalizes sleep.
Contraindications to physical education: acute diseases of the cardiovascular system; pulmonary tuberculosis in the acute phase; acute inflammatory diseases (thrombophlebitis, etc.); diseases of the kidneys and bladder (nephritis, pyelonephritis, nephrosis, etc.); toxicosis of pregnant women; bleeding during pregnancy, habitual miscarriages, etc.
Exercise therapy during pregnancy
Exercise therapy is used as a tonic, prophylactic during pregnancy and in the postpartum period.
To improve the functional state of the body of a pregnant woman, systematic physical education (walking, skiing, etc.), exercise therapy, hardening procedures during the entire period of pregnancy and after childbirth are necessary.
Pregnant women have a high standing diaphragm and, as a result, reduced chest excursion, which reduces pulmonary ventilation. Physical education helps to increase oxidative processes, increase oxygen consumption. Walks in the forest, in the park, along the river (or seashore), doing exercises on fresh air increase pulmonary ventilation, reduce hypoxia and enhance metabolic processes, which has a positive effect on the general condition of a pregnant woman.
Breathing exercises help make labor easier. Diaphragmatic breathing enhances venous blood flow in the vessels of the abdominal cavity and thereby eliminates congestion in the organs.
LH and walking contribute to the normalization of peripheral blood flow and facilitate the work of the heart. LH strengthens the pelvic floor muscles, and during childbirth, the risk of perineal ruptures is reduced. Strong muscles the perineum prevents pelvic floor prolapse in the postpartum period, as well as vaginal prolapse, functional urinary incontinence, etc. Bowel functions are also normalized.
Methodology therapeutic gymnastics. General developmental, breathing exercises, relaxation exercises are included, exercises in static tension, with straining, holding the breath and exercises with dumbbells (weights) are excluded. It is preferable to perform exercises in a prone position, on all fours. Of great importance is the emotional factor, so it is advisable to perform exercises to the music.
The first half of pregnancy (up to 16 weeks) is characterized by a complex restructuring of the body, in particular, vegetative nervous system. At this time, there is a danger of miscarriage, therefore, physical education should be carried out carefully, the load should be dosed, and exercises should be selected individually.
Classes are held in the initial position lying, standing, sitting and in the knee-elbow (Fig. 152). The main section includes exercises for training abdominal and chest breathing, pelvic floor muscles, abdominals, etc. The loads increase gradually, as you master the movements, correct breathing. LH can be performed several times a day in combination with walks in the forest, park, etc.
In the second half of pregnancy (17-31 weeks), tachycardia increases, the need for oxygen increases. Due to the increase in the size of the uterus, the lordosis and the angle of the pelvis change, and the woman begins to experience significant static tension in the back muscles in a standing position.
Particular attention should be paid to training the muscles of the abdominal press, pelvic floor, mobility of the joints of the small pelvis, develop the flexibility of the spine, etc. It is necessary to include breathing exercises, relaxation exercises. The woman is taught to relax the pelvic floor muscles while tensing the abdominal muscles.
Rice. Approximate LH complex during pregnancy up to 16 weeks
During this period, venous pressure in the vessels of the lower extremities increases, this is facilitated by a higher pressure in the veins of the uterus compared to the veins of the legs and a gradual compression of the pelvic veins by the growing uterus, which also impedes the outflow of blood from the lower extremities. With the difficulty of the outflow, the appearance of edema on the legs in the later stages of pregnancy is associated. Some women develop varicose veins during this period.
In LH, they include exercises in the initial position lying on your back on a couch with a raised footboard, diploid (suction) massage, moderate walks, after which you need to lie down for 10-15 minutes with your legs raised, then move your feet. Also included cold and hot shower, at night a cool shower for the lower extremities. Limit fluid intake, strictly follow a diet (exclude spicy and salty dishes).
The third period of pregnancy (32-40 weeks) is characterized by rapid growth and development of the fetus. The diaphragm is pushed upward as much as possible, the spleen and liver are pressed against the diaphragm. The cardiovascular and respiratory systems experience great stress, and the respiratory volume decreases.
Rice. Approximate LH complex during pregnancy 17--31 weeks
During this period, the range of motion in the joints of the lower extremities is limited, the possibility of tilting the torso. Initial positions are used that do not cause discomfort in a pregnant woman (Fig. 154).
Much attention is paid to breathing with tense abdominals, relaxation of the pelvic floor muscles with tense abdominals, exercises to relax the abdominal wall, etc.
The postpartum period is characterized by the reverse development of changes associated with pregnancy and childbirth. However, the postpartum period is characterized by progressive processes (lactation).
Adaptation to new conditions after the birth of a child, the restructuring of the body, in particular the reproductive system, are most intensively performed during the first-second weeks of the puerperal period. The most important processes of the postpartum period include the restructuring of the endocrine system. A decrease in the amount of steroid hormones leads to the release of prolactin by the anterior pituitary gland and the onset of lactation. Significant changes also occur in the ovaries.
A woman's adaptation to postpartum stress is facilitated by the creation of a therapeutic and protective regimen. Exercise therapy and massage are extremely important. They raise defensive forces body, improve blood and lymph circulation, being an effective means of preventing thrombosis, pneumonia, thromboembolism, etc., stimulate the reverse development of the uterus, the function of the bladder and intestines.
Rice. Approximate LH complex during pregnancy 32-40 weeks
Gymnastics in the postpartum period. Due to stretching of the ligamentous apparatus of the internal genital organs, relaxation of the abdominal muscles, pelvic floor and vagina, there is a greater mobility of the uterus and vagina.
Getting up too early can interfere with wound healing and cause prolapse of the uterus and vaginal walls. On the other hand, prolonged rest contributes to a slowdown in blood and lymph flow, deterioration in bowel function (atony, constipation, etc.), urinary retention and other adverse events. In itself, hypodynamia (hypokinesia) leads to various changes in functional systems, blood biochemistry, muscles, etc.
Lethargy (flabbiness) of the muscles of the abdominal wall leads to sagging of the abdomen and a change in the position of the internal organs. All this leads to a change in intra-abdominal pressure and an increase in the load on the pelvic organs and the pelvic floor.
In normal labor, LH is started on the second day in the initial supine position. LH is carried out 3-5 times a day for 5--8 minutes, which contributes to the strengthening (improvement) of blood and lymph circulation, metabolic processes, improving the general condition of the woman in labor, accelerating the processes of uterine involution, etc.
The use of exercise therapy in the postpartum period makes it possible to normalize the functional state of a woman at an earlier date, prevent the occurrence of postpartum complications and quickly adapt to living conditions after discharge from the hospital.
Use general developmental, respiratory, special exercises for the muscles of the pelvic floor and abdominal cavity, perineum. Breathing exercises eliminate congestion in the liver, spleen and other organs of the abdominal cavity, and exercises for the abdominal and pelvic floor strengthen the muscles of this area (their tone and strength increase). In addition, LH stimulates the activity of the intestines, bladder, and also increases lactation capacity, etc.
Diseases of the mammary glands
During pregnancy and in the postpartum period, various diseases of the mammary glands can be detected. However, only those pathological processes that are directly related to the lactation function of the mammary glands and are caused by it will be considered here.
Hypogalactia is called insufficient production of milk. The best means for maintaining lactation capacity is the act of suckling the breast of a child. Hypogalactia is primary and secondary. Mental trauma along with the pathological process, malnutrition and other factors can cause a change in the function of the mammary glands from a slight decrease in lactation to the complete and permanent disappearance of milk. Distinguish between relative hypogalactia, when milk is not enough to feed a child, and absolute - when almost no milk is produced.
Rehabilitation. First of all, a young mother must adhere to the correct technique of feeding a child, which contributes to the development of a milk-releasing conditioned reflex to irritation of the nipple; comply with hygiene standards; diet therapy (vegetables, fruits, vitamins with minerals, meat, fish, eggs), drinking regimen(sufficient fluid intake), walks, contrast showers, UVI, massage of the neck, hands, breasts, morning exercises, etc.
Cracks in the nipples, that is, a violation of the surface layer of the skin of the nipple, is accompanied by pain, sometimes so severe that the correct rhythm of feeding the baby is disturbed.
The main causes of nipple cracks are a violation of the technique of feeding a child, inept expression of milk, improper care of the nipples, non-compliance with general hygiene measures. Each of these causes, individually or in combination, can cause a disease. The nipple becomes swollen, hyperemic, sometimes ulcers appear.
Around the affected nipple, more or less pronounced hyperemia of the skin is often noted. Touching the nipple, and even more so sucking, causes pain. Cracks are infected with microbes from the skin of a woman, from her hands, clothes, and finally from the mouth of a child. Feeding maintains a constant maceration of the skin of the nipple, which disrupts the healing process of cracks.
For treatment, along with hygiene of the mammary glands, the following are indicated: UV irradiation of the area of the nipples and mammary gland (2-3 biodoses, every other day), a course of 8-10 procedures; baths with potassium permanganate for nipples (with a water temperature of 38-39 ° C), 3-5 minutes daily; UHF on the nipple area, low thermal dose, 8-10 minutes every other day; massage of the collar area and mammary glands 5--8 min, course 10-12 procedures; ointment dressings (hirudoid, heparin ointment, lazonil, reparil-gel, etc.) on the mammary gland; dressings with 5-10% aqueous solution mumiyo on the mammary gland, a course of 5--7 procedures.
In complex rehabilitation, massage of the neck, collar area, and hands is used. The nipple is treated with a 1% solution of methylene blue in 60% alcohol or ointment bandages are applied. Daily shower and washing of the mammary glands, thorough washing of hands before feeding. It is recommended to express milk and feed the baby through a nipple. Exercise therapy includes breathing and general developmental exercises, tempering procedures (contrast showers), walks, fortification, herbal medicine, UV irradiation.
Massage during breastfeeding is carried out to prevent mastitis, stimulate lactation. First, the reflexogenic zones (cervical-thoracic spine) are massaged, then the mammary glands. Massage is performed before feeding, washing hands with warm water and soap. Nails should be cut short. Stroking and rubbing around the gland is carried out, then it is squeezed with both hands from the base to the nipple, kneaded with both hands from the base to the nipple: with one hand they support the gland from the inside, and with the other they rub it, knead it from the base to the nipple. The duration of the massage is 5-10 minutes.
Lactational mastitis is an inflammatory disease of the mammary gland due to infection of nipple fissures. In primiparas, mastitis is observed 2 times more often than in multiparous. According to localization, mastitis is superficial, deep and very deep, located behind the mammary gland (retromammary infiltrate or abscess).
A woman suddenly has a fever, headache, general malaise, pain in the mammary gland, etc. Lactation is disturbed due to pain and blockage of the milk ducts. In the depths of the gland, a poorly contoured infiltrate is found, which in most cases resolves, but often re-forms in a new area, and the clinical picture of the disease is repeated. With suppuration of the infiltrate, purulent mastitis occurs. Often leads to lactational mastitis and milk stasis.
Rehabilitation includes: massage of the collar zone, hands, sufficient feeding. Gentle decantation and a high position of the gland usually eliminate the congestion. Ointment dressings are applied, antibiotics are administered, sulfal preparations are prescribed. At the beginning of the disease, an ice pack helps, bandaging the gland in an elevated position, the milk is expressed and after 24 hours a child is applied to the chest. Between feedings, the mammary gland is massaged or cryomassage is performed. If there is suppuration, then feeding is not carried out, a puncture is made and antibiotics are administered.
Prevention of mastitis is reduced to the prevention of the appearance of cracks in the nipples and the observance of a hygienic regimen. In addition, UVI, shower, exercise therapy, walks, diet therapy, vitaminization.
Functional urinary incontinence
Functional urinary incontinence may be the result of a deep traumatic effect on the genitourinary system, the result of stretching rear wall urethra, prolapse of the anterior wall of the vagina. Urinary incontinence may occur several months after childbirth. It is observed more often in women with prolapse of the anterior abdominal wall and in those who have given birth a lot.
Of the physical methods of treatment, a contrast shower is prescribed; general massage; electro-gymnastics of the bladder area 10-15 minutes daily. Course 15--20 procedures; vibration massage of the lumbosacral region, perineal muscles, 5-10 minutes daily. Course 10-15 procedures.
Exercise therapy is used to influence the muscular system of the urogenital area. Special exercises are used (Fig. 156) to strengthen the muscles of the abdominal wall, pelvic floor and perineum, contributing to the normalization of blood and lymph flow, and improving tissue metabolism. Swimming, dumbbell gymnastics, cycling, ski trips, games, training on simulators, tempering procedures are shown.
Rice. Approximate LH complex for functional urinary incontinence
Constipation in pregnant women
Constipation in pregnant women occurs with neuro-humoral changes in their body. Long delays stool can be the cause of general malaise, nausea, lack of appetite, hemorrhoids and other phenomena that often complicate the course of pregnancy. Constipation can significantly affect labor activity, so during pregnancy it is necessary to monitor and regulate bowel function. To do this, they prescribe a balanced diet, exercise therapy, walks, a contrast shower, massage the back, lower back (in the position of the pregnant woman on her side) and legs.
Exercise therapy in the postoperative period (abdominal caesarean section)
A caesarean section is an operation in which the fetus and placenta are removed through an artificially made incision in the uterus. Indications for caesarean section: a sharp anatomical narrowing of the pelvis; clinically narrow pelvis; threatening or beginning uterine rupture; complete placenta previa, as well as partial, if it is accompanied by significant bleeding; premature detachment normally located placenta, etc.
Caesarean section requires the same postoperative period like any abdominal operation. Complications are possible, and their prevention should be carried out, including exercise therapy, massage, inhalation, etc. Cesarean section differs from other operations in significant blood loss, postoperative complications that develop against the background of hypervolemia, etc. There is a pain syndrome that causes flatulence, atony of the bladder and other complications.
Postoperative care and timely prevention of complications play an important role. In the first hours, it is recommended to put an ice pack on the seam area, which must be removed for 20–30 minutes every 1–1.5 hours.
After vaginal operations and hysterectomy by the abdominal wall, it is necessary to periodically check the bed sheets so as not to miss the occurrence of bleeding. In the presence of indwelling catheter in the bladder, you need to monitor the excretion of urine, in case of pain, prescribe analgesics. With pronounced signs of acidosis, 150-200 ml of a 5% sodium bicarbonate solution, a 5% glucose solution are injected intravenously.
In the first days, a massage with oxygen therapy is shown, in the following days - breathing exercises (3-5 times a day) and the inclusion of a massage of the intercostal muscles with activation of breathing (chest compression on exhalation) of the patient.
Active management of the postoperative period reduces the risk of developing complications from the lungs (pneumonia, bronchitis, atelectasis, etc.), the cardiovascular system (phlebitis, thrombophlebitis, etc.) and other organs. If there are no contraindications, then on the second or third day after the operation, it is allowed to sit down and get up. Exercise therapy is indicated for all patients, with the exception of those in serious condition.
Patients operated on for vesicovaginal fistulas are allowed to get up on the second or third day after the operation. After plastic surgery on the perineum, patients get up on the seventh-eighth day after the removal of sutures.
With a gradual expansion of the motor regimen, LH is performed while sitting and standing, and the duration of walks is increased.
Diet therapy is carried out depending on the general condition of the patient, the nature of the operation and the course of the postoperative period, as well as the age and type of her professional activity.
The time of discharge depends on the general condition of the woman, the nature of the surgical intervention and the course of the postoperative period. Before discharge, the patient is recommended a complex of exercise therapy, walking, hardening procedures, cycling, skiing, etc.
Therapeutic exercises and massage during adhesions in the pelvis and abdominal cavity are recommended to prevent the formation of adhesions and other postoperative complications. Early general massage is carried out on the operating table and in the next 3-5 days 2-3 times a day in combination with therapeutic exercises and oxygen therapy.
In the first 3--5 days after surgery, LH is performed in the supine position, with the inclusion of respiratory and general developmental exercises, with frequent turns of the patient on her side.
From the fifth to the seventh day, LH is carried out in a sitting position, including walking along the corridor and up the stairs. After removing the stitches, they include exercises for the abdominal muscles, exercises with a gymnastic stick, balls, rubber shock absorbers. You can connect running on a treadmill, swimming, exercising on a bicycle ergometer, etc. After discharge, the patient continues to do LH in the prone and sitting positions, goes skiing or rides a bicycle. Running is combined with walking.
Of the physiotherapeutic procedures in the formation of postoperative adhesions, iodine electrophoresis, hydrocortisone phonophoresis in a pulsed mode are indicated. Effective gynecological massage.
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Physical culture during pregnancy
Method of gymnastics during pregnancy
Gymnastics in childbirth
Gymnastics in the postpartum period
Physical education is a powerful means of strengthening health and increasing the resistance of the human body. Medical and gynecological observations of high-level athletes (S. A. Yagunov and L. N. Startseva) made it possible to establish the positive effect of systematic physical education and sports on the woman's body and to use physical exercises during pregnancy, childbirth and the postpartum period as a therapeutic prophylactic.
The beneficial effect of physical exercises on the course of pregnancy and childbirth is confirmed by numerous observations of domestic and foreign obstetrician-gynecologists (N. M. Kukushkin, S. A. Yagunov, M. V. Elkin, R. G. Lurie, G. K. Zhivatov, K. K. Skrobansky, L. N. Startseva, P. A. Beloshapko, M. A. Petrov-Maslakov, A. A. Lebedev, L. F. Kalinina, Vojta, Noack, Sommer, etc.).
Along with the improvement of the functional state of the cardiovascular, respiratory, muscular systems, the systematic performance of physical exercises creates a positive emotional mood among those involved, as a result of which well-developed women calmly endure pregnancy, are mentally better prepared for childbirth, they have easier childbirth, there are fewer complications. postpartum period.
The development of the musculoskeletal system and the improvement of the circulatory and respiratory apparatus should be given great attention from the first years of a girl's life in order to properly prepare her body for the most crucial period of life - motherhood. Physical education classes should be built taking into account the biological characteristics of the female body. These features require a differentiated approach to the use of various physical exercises, their dosage, accuracy of performance, etc. Particular attention is paid to strengthening the back muscles, abdominal muscles and pelvic floor muscles, the good functional state of which contributes to the correct position of the internal genital organs. Professor V. V. Gorinevsky (1927) wrote: “A long neck, a round back, drooping shoulders, diverging shoulder blades almost always correlate with a sagging abdomen and a soft abdominal wall that barely restrains the pressure of the internal organs. Going further in these comparisons, we can assume that women of this type have weak musculature of the pelvic floor with all possible complications later. local action special gymnastic exercises for the abdominals and pelvic floor are undeniable here ... ".
Closely related to the general physical education physiotherapy exercises, built on a strict scientific basis and being an integral part of the complex rehabilitation activities in the treatment of various patients. In the treatment of a number of gynecological diseases, along with drug treatment and physiotherapy, physical exercises are used as a therapeutic tool that allows solving the problems of pathogenetic and functional therapy.
The need to use physical exercises in gynecological practice is substantiated by the works of O. Brandt, O. D. Ott, M. V. Elkin, S. A. Yagunov, G. K. Zhivatov, D. L. Chernyakhovsky, L. I. Startseva, D. N. Atabekova, K. N. Pribylova, P. I. Belousova and others.
In gynecological diseases, a number of functional disorders are observed. Some of them depend on the pathological process, anomalies in the position and development of the internal genital organs, and some arise due to excessive self-pity and a sedentary lifestyle. It should be noted that negative emotions, depressed mood worsen the course of the underlying disease.
Using physical exercises in the appropriate period of treatment, it is possible, through systematic training, to influence the pathological process, weakened function, strengthen the body of a woman, increase her adaptation to physical activity. Emotionally intense classes, like physical therapy itself, will help distract a woman from thinking about her illness, and increased activity will restore faith in her strength and bring recovery closer.
8.1. THERAPEUTIC PHYSICAL CULTURE IN OBSTETRICS
8.1.1. Therapeutic exercise during pregnancy
The positive effect of physical exercise on the course of pregnancy, childbirth and the postpartum period is a generally recognized fact. Through the use of physical exercises, it is possible to counteract a number of undesirable complications of pregnancy (varicose veins, flat feet, weakness of the abdominal muscles and pelvic floor, pain syndromes of various localization, etc.).
General tasks of physiotherapy exercises during pregnancy are the following:
Strengthening the abdominal muscles, back, pelvic floor, lower extremities;
Increasing the elasticity of the muscles of the perineum, maintaining the mobility of the hip and other joints of the body;
Teaching a pregnant woman proper breathing and voluntary muscle relaxation;
Improving the work of the cardiovascular system, lungs, intestines;
Activation of blood circulation and elimination of congestion in the pelvis and lower extremities;
Ensuring sufficient oxygen saturation arterial blood mother and fetus;
Psychomotor preparation for childbirth.
Data general tasks supplemented and modified by narrower ones related to the peculiarities of the course of pregnancy in certain periods of pregnancy.
Means of exercise therapy.When exercising with pregnant women, almost all means of exercise therapy can be used: physical exercises (gymnastic, sports and applied exercises, games), autogenic training and massage; hardening elements using natural factors(light, air, water); regulation of the day.
Forms of exercise therapy.UGG, LH procedure, aerobics (including dosed walking), physical exercises in water, fitball, self-study for pregnant women.
Selection of pregnant women for classes. All pregnant women are involved in classes, starting from the first days of their visit antenatal clinic and taking them into account until the moment of delivery, but after a mandatory consultation with a doctor to identify possible contraindications and individualize the exercise therapy program. Pregnant women with diseases of the cardiovascular system in the stage of compensation are also involved in the classes.
In the normal course of pregnancy, preference is given to group classes, as more emotional. A group of no more than 6-8 people, approximately the same period of pregnancy and a similar level of physical fitness. Desirable musical accompaniment, quiet and not setting a certain pace. Since at least 10-15 sessions are needed to obtain a sufficiently high effect from LH, it is advisable to start LH no later than 32-34 weeks. In the presence of certain complicating factors that are not a contraindication for exercise therapy (chronic somatic diseases, initial forms of toxicosis, metabolic diseases, pain in the back and lower extremities due to postural disorders, etc.), individual classes are held.
When performing, a variety of starting positions are used - standing, sitting, standing on all fours, lying on your back or on your side.
Contraindications to the appointment of exercise therapy:
Conditions requiring emergency surgical or obstetric care.
Conditions, the clinic of which is mainly determined by inflammatory processes: acute infectious and inflammatory diseases in any organs and tissues; prolonged subfebrile temperature of unknown etiology; rheumatism in the active phase; acute and subacute thrombophlebitis; acute kidney disease and
bladder (nephritis, nephrosis, cystitis); residual effects after suffering inflammation in the pelvis.
Conditions associated with current or previous pregnancies: severe toxicosis of pregnancy (uncontrollable vomiting, nephropathy, pre-eclamptic state and eclampsia); bleeding from the genitals of various origins (placenta previa, premature detachment of a normally located placenta, etc.); threatening abortion; damage to the amniotic membrane; ectopic pregnancy; habitual abortions; pronounced polyhydramnios; a history of stillbirths in mothers with an Rh-negative factor; divergence of the pubic joint; cramping pains in the abdomen.
Conditions associated with somatic burden of a pregnant woman: acute and progressive chronic cardiovascular insufficiency; decompensated diseases of the cardiovascular system, especially in the stage of progression of the process; abdominal aortic aneurysm; actively ongoing diseases of the liver and kidneys; pronounced omission of internal organs with the presence of pain during physical effort; blood diseases; epilepsy; threat of retinal detachment.
Physiotherapy exercises are not contraindicated, but strict individualization of classes is required under the following conditions: past operations in the abdomen and pelvis, including obstetric and gynecological (caesarean section, removal of benign neoplasms, etc.); delayed pregnancy; multiple pregnancy and fetal growth retardation; history of eclampsia; pain syndromes of the musculoskeletal system accompanying pregnancy; syndrome of blocking blood circulation in the wrist; dysfunction of the pubic fusion; toxicosis of pregnancy of mild severity; neurosis of pregnant women; compensated heart defects; initial stages of hypertension, bronchial asthma; mild forms of chronic nonspecific lung diseases; compensated forms of pulmonary tuberculosis in the absence of functional disorders; obesity; diabetes; constipation (atonic or spastic); reflux esophagitis (heartburn); urinary incontinence; expansion of the veins of the lower extremities or hemorrhoidal plexus.
Physiotherapy
When compiling a complex of therapeutic gymnastics procedures, one should take into account both the period of pregnancy in which the woman is located, and her functional capabilities, character related disorders. As a rule, the LH complex during pregnancy includes general strengthening dynamic exercises for the arms, trunk, legs, which improve metabolism, as well as breathing exercises and special ones to strengthen the abdominal muscles, long back muscles and the musculoskeletal apparatus of the lower extremities, increase the elasticity of the muscles of the perineum. Special relaxation exercises are also required.
First trimester (from 1 to 16 weeks). The greatest changes in this period occur in the uterus. The connection of the uterus with the fetal egg in this period is very fragile, its increased excitability is noted, and it is especially sensitive to any physical stress. Therefore, pregnancy can easily be interrupted due to overwork during heavy physical work, body shaking during falls and jumps, exercises that sharply increase intra-abdominal pressure (including during bowel movements). This requires caution and individualization when practicing LH. Intense physical exercise is especially not recommended on days that should have accounted for the first three menstrual cycles.
In the first trimester, with the help of LH, the following tasks are solved:
Activation of the cardiovascular and respiratory systems to improve the overall metabolism and their adaptive capabilities;
Improvement of the psycho-emotional state of the pregnant woman;
Improving blood circulation in the pelvis and lower extremities to prevent venous congestion;
Strengthening the muscles of the back, abdominals and lower extremities for the prevention of pain syndromes of the musculoskeletal system;
Teaching skills of volitional tension and relaxation of muscles and proper breathing;
Preservation and development of mobility of the spine and other joints.
Features of the body of a pregnant woman, characteristic of the first trimester, require the development of individual sets of exercises. It includes dynamic exercises for training the muscles of the arms, legs, muscle corset, relaxation exercises.
Exercises should be simple and cover large muscle groups. Movements are performed in full. Classes in therapeutic exercises during this period also provide for training in the skills of abdominal and chest breathing.
When performing exercises, all the basic starting positions are used. LH procedures are carried out at a moderate, calm pace, avoiding excessive excitation of the nervous system. Breathing should be calm and rhythmic.
The coordinating ease of the exercises performed, their low intensity, gradually adapting the cardiovascular and respiratory systems to physical activity, make it possible to recommend them to all pregnant women, regardless of their general condition.
Second trimester (from 17 to 32 weeks). The increased activity of the placenta in the body of a pregnant woman provides hormonal balance, which is manifested by a decrease in autonomic disorders, an increase in mental stability. Increased tolerance to physical activity. Due to good fixation of the fetus (a placenta has formed) and a decrease in the increased contractility of the uterine muscle, the likelihood of miscarriage is reduced.
In this period of pregnancy, there are significant changes in the musculoskeletal system, creating favorable conditions for childbirth. Ligaments of the pubic and sacroiliac joints, intervertebral cartilages of the lumbar spine are softened. However, due to loosening of the ligaments of the pelvis, their ability to maintain a normal body posture is reduced. This role of the ligaments is taken over by the muscles, which leads to their constant tension and rapid fatigue.
There are changes in the statics of the pregnant woman's body. Body weight increases, and the center of gravity moves forward, which is compensated by the backward deviation of the upper body. This increases the lumbar lordosis of the spine and the angle of the pelvis. At the same time, the muscles of the back and abdomen, being in an ever-increasing static tension, carry a large load. A pregnant woman who does not perform appropriate exercises and does not correct her posture may experience pain in the sacrum and back. Incorrectly selected shoes further worsen posture and increase pain.
The bottom of the uterus at the end of the 2nd trimester is located between the navel and the xiphoid process of the sternum. Compression of the pelvic vessels makes it difficult for the outflow of blood and lymph from the lower half of the body, which is accompanied by
congestion in the legs. There are pastosity of the lower extremities, their edema, vein expansion begins. This limits the use of the initial standing position during the LH. The limited mobility of the diaphragm makes it difficult to breathe. However, some of its increase compensates for the oxygen deficiency.
The volume of the abdominal cavity increases, the lower part of the chest expands. The center of gravity moves forward significantly. As a result, the tension of the muscles of the back and lower extremities increases even more, there is pain in the lower back, spasm of the muscles of the legs. The latter is also promoted by a low content of calcium in the blood of pregnant women. The loosening effect of hormones on the ligamentous apparatus, an increase in body weight lead to the development of flat feet, which intensifies the pain syndromes of the musculoskeletal system. motor functions, including walking, are difficult. Hence the increased fatigue.
In the 2nd trimester, the following tasks are solved:
Improving the adaptation of the cardiovascular and respiratory systems to physical activity;
Improving blood circulation in the pelvis and lower extremities;
Activation of the muscles of the pelvic floor, thighs, buttocks and lower leg;
Strengthening the muscles of the back and abdominals, which carry an increased load due to a shift in the center of gravity, as well as the muscles of the foot due to its possible flattening;
Increased elasticity of the pelvic floor muscles and adductor muscles of the thigh;
Improving the ability to volitional tension and relaxation of the abdominal muscles in combination with chest breathing;
Preservation and development of mobility of the spine and pelvic joints, hip joints.
Procedures are carried out at the usual moderate pace. Assign simple general developmental exercises for all muscle groups. Relaxation and stretching exercises are prescribed in larger quantities than in the first period. Movements for the lower extremities are performed with the greatest possible amplitude in the form of static stretch marks, which increase the mobility of the hip joints and sacroiliac joints of the pelvis and improve the outflow of blood from the lower extremities. Assign relaxation exercises, breathing exercises.
During the period of maximum load on the heart (28-32 weeks), reduce the overall physical load by reducing the repetition
exercises and the introduction of more breathing exercises that improve volitional muscle relaxation. The duration of exercise therapy classes is somewhat reduced to 30 minutes, mainly due to the main part of the LH procedure.
In the final section of the LH classes, with a gradual decrease in the load, walking, dynamic breathing exercises, and relaxation exercises are used.
Third trimester (from 33 to 40 weeks). In this period, there is a significant increase in the size of the uterus, the bottom of which by the end of 35-36 weeks reaches the xiphoid process. Because of this, the mobility of the diaphragm is even more significantly limited, and the heart takes a horizontal position. The displacement of the stomach and intestines contributes to the appearance of reflux esophagitis, heartburn, constipation. The compression of large vessels is accompanied by congestion in the pelvis and further expansion of the venous vessels of the lower extremities, rectum and external genital organs of a woman.
The center of gravity shifts forward even more, increasing the tilt of the pelvis, accompanied by an increase in lordosis and an increase in pain in the muscles of the back and calf muscles. There are restrictions in the movement of the hip joint. This leads to typical changes in gait in pregnant women. It becomes unstable, the stride length is shortened. The hormonal background again causes an increase in the tone and contractility of the muscles of the uterus, accompanied by separate contractions, which requires attention from the instructor during classes.
After the 36th week, the bottom of the uterus begins to descend to the level of the costal arches, which somewhat facilitates breathing and heart function. However, the outflow of blood from the abdominal cavity and lower extremities is difficult, which supports stagnation there. The pressure on the intestines and bladder explains the frequent constipation and dysuric phenomena during this period. Due to hormonal influences, the pubic and sacroiliac joints are weakened, the pelvic bone ring loses its stability, making the pregnant woman's gait even more unstable. The consequence of this is also the appearance of pain syndromes of this localization. Minor physical activity leads to rapid fatigue.
In the third trimester, the following tasks are solved:
Increased elasticity, extensibility of the muscles of the perineum;
Maintaining the tone of the muscles of the back and abdomen;
Increased mobility of the sacroiliac joints, hip joint, spine;
Activation of the activity of the intestine;
Reducing congestion in the lower half of the body;
Increased coordination of relaxation-tension of the muscles involved in attempts, in combination with breathing; activation of the circulatory system.
The above changes in the body, characteristic of this period, require changes in the nature of the exercises. Since this is the most difficult period of pregnancy, the volume and intensity of physical activity is reduced. Procedures are carried out
Rice. 8.1.Sample exercises used in the third trimester
at a slow pace from a position lying on your side or sitting. Light and simple general developmental exercises are used to maintain the skill of correct breathing and, as far as possible, the tone of the abdominal and back muscles. The number of exercises for stretching the muscles of the perineum and the adductor muscles of the legs increases. Continue exercises that increase the range of motion of the spine and hip joints. It is recommended to train relaxation, as well as adjust walking. Walking is recommended.
In the future, against the background of reduced overall physical activity, more attention is paid to the development and consolidation of skills that are important for the normal course of the birth act: arbitrary tension and relaxation of the muscles of the pelvic floor and abdomen, continuous breathing training with simultaneous tension of the trunk muscles and their subsequent complete relaxation. Breathing exercises are changes in the rhythm of breathing, consisting in a gradual increase in the frequency of breathing for 10-20 seconds, followed by a breath hold, which will be used during attempts. Diaphragmatic breathing should be used.
Exercises that imitate postures and actions during attempts are also used, for example, muscle relaxation after the last exhalation (during rapid breathing exercise) or, in cases where uterine contractions are felt, combine them with breathing.
Procedures should be carried out carefully due to the increased excitability of the uterus. Avoid exercises that increase intra-abdominal pressure.
When solving some more local or narrowly focused problems, you can use some of the exercises below.
For back and pelvic pain.
1. I.P. sitting on the edge of a chair. Bend your back at the waist. Then bend it in an arc, pressing it against the back of the chair. After several repetitions, stay in a neutral position for 10-20 seconds.
2. I.P. sitting on the floor, buttocks between the feet, knees apart as wide as possible. Tilt the body forward to the floor. The back is kept straight. Hands lie freely on the floor. Raise the buttocks as high as possible, holding them in this position for several seconds. Repeat 5-6 times. Then slowly return to I.P.
Rice. 8.2.Starting positions of exercises for back pain
3. I.P. On knees. The arms are at right angles to the floor, and the body and head are parallel to the floor. While inhaling, slowly bend your back down, at the same time raise your head and buttocks up. As you exhale, arch your spine (like an angry cat) and lower your head. Repeat the movement several times. This posture increases the flexibility of the spine, strengthens it, and also reduces the pressure of the fetus on the nerves and blood vessels of the pelvis.
4. I.P. lying on your back. Put your legs bent at right angles at the hips and knee joints, on a stool or couch. Stay in this position for several minutes.
The pace of movement in these exercises is slow. The number of repetitions is 3-5 times (with good preparedness, 10 times or more until slight fatigue). In the final phases of movements, it is desirable to fix the posture for 5-10 seconds.
Pain in the calf muscles.
Passive stretching of the calf muscles is used. I.P. - standing, facing the wall or Swedish wall at a distance of a step. Rest your hands on it at shoulder level. Bend your arms and lean forward, as if pressing your chest against the wall. Heels do not come off the floor. Feel the tension in the muscles, without bringing it to a feeling of pain. Stay in this position for 10-20 seconds. Return to I.P. Repeat 3 times.
Varicose veins of the lower extremities, edema.
An exercise is used - legs up with support on the wall. I.P. lying on your side, buttocks pressed against the wall. Roll onto your back, lifting your legs up and pressing them against the wall. Straight arms, palms up, spread apart. After several minutes of this position, spread your legs as wide as possible, until you feel a slight tension in the adductor muscles. Maintain this posture for a few minutes as well. bend
knees, roll onto your side and rest. Repeat 2-3 times. This exercise is also effective for strengthening the muscles of the perineum, which is important in preparation for childbirth.
The procedure of physiotherapy exercises during pregnancy should be stopped in the event of the appearance during classes:
unusual symptoms or phenomena;
Vaginal bleeding, painful uterine contractions;
Feelings of nausea, fainting, shortness of breath, irregular or rapid heartbeat;
Pain in the back and pelvis;
Physically unreasonable, abrupt, frequent fetal movements.
8.1.2. Therapeutic exercise in the postpartum period
The normal course of the postpartum period is very important, since the possibility of the appearance of many diseases in women depends on it. Therapeutic gymnastics allows the body to quickly get out of the postpartum period and cope with the presence of disorders. The role of physical exercises in the prevention of functional inferiority of the muscles and organs of the pelvic floor, abdomen, and posture disorders is especially important. In addition, regular LH classes help to improve lactation.
Physiotherapy exercises in the postpartum period should solve the following tasks:
Improving blood circulation in the small pelvis, abdominal and chest cavity and lower extremities, thereby eliminating congestion and the formation of blood clots in these areas;
To promote active contractions of the uterus, ensuring its correct involution;
Contribute to the regulation of bowel and bladder functions;
Improving the function of the cardiovascular, respiratory and digestive systems;
Strengthening the muscles and ligaments of the abdominal wall and pelvic floor, helping to maintain the correct anatomical position of the internal organs, including the genitals;
Strengthening the muscles of the musculoskeletal system, ensuring the restoration of the normal posture of a woman and the prevention of flat feet;
Improving the emotional state, sleep and appetite;
Activation of metabolism and thereby an increase in the general tone of the puerperal, an increase in lactation capacity;
Restoration of the working capacity of the puerperal in the shortest possible time.
Contraindications to the appointment of exercise therapy after childbirth may be the following conditions:
Body temperature over 37.5?;
Complications of the postpartum period (endometritis, thrombophlebitis, mastitis);
Severe anemia due to large blood loss during childbirth;
Bleeding after childbirth;
Difficult, prolonged, exhausting labor;
Preeclampsia or eclampsia in childbirth;
Severe forms of transferred gestosis;
Progressive insufficiency of blood circulation, kidneys, liver;
Severe subcutaneous emphysema;
Tears of the perineum III degree;
postpartum psychosis.
Means of exercise therapy- exercise and massage.
Forms of exercise therapy.The therapy uses: UGG, LH, self-study of puerperas.
Selection of mothers. Before starting therapeutic exercises, a careful examination of the lower extremities is necessary. The presence of varicose veins, pain, fever require a doctor's consultation for thrombophlebitis. If inflammatory diseases are detected, exercises are prescribed after the condition normalizes (temperature decreases to normal and there is no pain).
With stitches on the perineum after perineotomy or its ruptures, exercises with leg abduction are excluded for 5-6 days. Perineal ruptures of the III degree require therapeutic exercises according to the methods developed for postoperative patients.
In the normal course of the postpartum period, classes are conducted by the group method. The presence of certain complications of the postpartum period involves the use of individual lessons.
Physiotherapy
Physiotherapy exercises should be started as early as possible, since it is in the first days after childbirth, when the restructuring of the body is most active, that physical exercises accelerate and optimize them. With a relatively mild course of childbirth, LT classes can be started from the first day. At severe course when the body of the puerperal requires a longer rest, from the 2nd day after childbirth.
Remedial gymnastics classes begin with general developmental exercises in combination with breathing exercises. Basically, elementary exercises for the upper and lower extremities, pelvic muscles are used. Later, exercises are prescribed to strengthen the muscles of the abdomen and pelvic floor. The load is increased gradually. Exercises are performed at a calm, slow, and then at an average pace. The duration of classes in the first days is 15-20 minutes, in the next days up to 30-35 minutes.
In the first two days, therapeutic exercises are carried out in bed, in the next 2 days - in a sitting position.
On the 1st dayafter childbirth, all physical exercises are performed from the starting position lying on your back:
1. Wiggling fingers and toes.
2. Sipping. Raise your arms above your head and pull your toes - inhale. I.p. - exhale.
3. Bending the fingers into a fist.
4. Pronation and supination of the hands and at the same time rotation of the feet outwards and inwards.
5. Bending of the legs at the knee and hip joints with support on the feet.
6. Lifting the pelvis with support on the feet and shoulder blades.
7. Deep differentiated breathing (thoracic, abdominal, mixed) with self-control.
The whole procedure of postpartum LH consists of 8-10 exercises, performed 3-6 times, and lasts an average of 20 minutes.
On the 2-3rd dayafter childbirth, the exercise therapy complex includes exercises that enhance peripheral blood circulation, diaphragmatic breathing, reducing congestion in the abdominal cavity and in the pelvic cavity, muscle relaxation exercises, exercises for the abdominal muscles. Activation of blood circulation in the pelvic organs helps to reduce the sphincters of the rectum and urethra.
On the 4th-5th dayafter childbirth, the load gradually increases, mainly due to the introduction of new exercises for the abdominal and pelvic floor muscles and an increase in the number of repetitions of previous exercises. Starting positions are added lying on the stomach, on all fours.
In the following days when the uterus decreases in size, most physical exercises are performed from the initial standing position: turns and tilts of the torso to the sides, circular movements of the pelvis, half-squats, movements of the straight leg forward, to the side and back, standing on toes, etc. Postpartum gymnastics procedures are usually carried out through half an hour after feeding the baby.
Restoration of a sufficiently full-fledged working capacity of the muscles of the back and abdomen requires daily systematic training for 2-3 months.
8.1.3. Massage during pregnancy
Massage tasks:
Activation of blood and lymph circulation, eliminating congestion in the pelvis and lower extremities;
Reducing pain, especially in the muscles of the back and lower extremities; strengthening the muscles of the body, increasing the elasticity of the muscular-ligamentous apparatus and maintaining joint mobility;
Improvement of the general metabolism;
Improvement of psycho-emotional status; acceleration of recovery after childbirth.
Indications for massage: pain syndromes in the back, neck, lumbosacral region, sacroiliac joints, lower extremities, calf muscle cramps; mental stress, general fatigue, dizziness, insomnia, headache; signs of toxicosis of mild severity (nausea, increased salivation, swelling of the lower extremities, a slight increase in blood pressure); prevention of the appearance of stretch marks (stretch marks) in the area of the mammary glands, abdomen and thighs; slow generic activity; psycho-emotional and physical stress during childbirth; dysfunction of lactation.
Contraindications: common to massage and the same as for physiotherapy exercises. However, in some cases, even if they are available, acupressure methods can be used.
Disorders of the venous network (varicose veins, phlebitis and thrombophlebitis), acute back pain radiating to the arms or legs require special attention.
Massage position. The position of the pregnant woman during massage should be given great attention. The most important condition while relaxing.
Massage can be performed both lying down (usually on the side) and in a sitting position. Compression occurs in the supine position large vessels and nerve trunks in the abdominal and pelvic cavity, which is difficult for some pregnant women to tolerate.
At the beginning of pregnancy, with an uncomplicated history, massage can be performed with the woman lying on her stomach. If there is soreness in the mammary glands, it is advisable to place small pillows in the subclavian region.
At later stages of pregnancy, massage is carried out in the supine position on the side. In this case, the leg, which is located below, is almost completely straightened, and the upper one is bent at the knee and hip joints. To stabilize the body and its uniform (calm) position, a pillow is placed under the bent knee. Sometimes you need another pillow under the stomach for more relaxation. In this position, you can work on the neck, back, lower back and buttocks, as well as on the upper and lower extremities.
Massage technique.
In the first trimester, massage is aimed more at general strengthening of the body of a pregnant woman. In the second trimester of pregnancy, massage can be more targeted (eliminating back pain, reducing swelling, etc.).
General massage traditionally begins from the back. In the first 3 months of pregnancy, significant pressure in the lumbar region is not recommended. Muscle tension during pregnancy is often concentrated in the collar zone, the area of the shoulder blades, which causes soreness, stiffness of the neck and headache. Therefore, they are worked out more carefully.
The procedure continues with a foot massage. With pain in the legs, their fatigue and swelling, massage is especially effective. When massaging the legs, strong pressure is avoided on the inner surfaces of the thigh, as well as on the inner surfaces of the lower leg in its lower third. A large number of important biologically active points are concentrated here.
Then, in the prone or half-sitting position, the hands are massaged according to the suction technique.
After that, the front surface of the body is massaged. In the first three to four months of pregnancy, abdominal massage can be done lying on your back. As it increases, it becomes difficult to lie on your back, so they move to a semi-sitting position. The abdomen is massaged with very light circular movements in a clockwise direction, with an increasing radius. It is necessary to work on the stomach very softly and rhythmically, mainly with flat stroking techniques.
Massage during pregnancy can be carried out in the form of general and private massage, self-massage.
In the normal course of pregnancy, general massage is possible, with a frequency of about 1-2 times a week and a duration of up to 1 hour. With self-massage, the duration of the procedure usually does not exceed 15-20 minutes and can be performed daily.
Private massage usually includes a local impact on the collar, lumbosacral region, joints and soft tissues of the extremities, especially the lower ones. Such a massage lasting 15-20 minutes can be carried out every other day and even daily.
In the presence of segmental zones, elements of segmental massage are included in a small or moderate dose. The appearance of signs of early and late toxicosis of pregnancy is the basis for the inclusion of acupressure methods.
The course of treatment - 5-10 procedures.
8.2. THERAPEUTIC PHYSICAL CULTURE FOR GYNECOLOGICAL DISEASES
8.2.1. Tasks, indications and contraindications, means and forms of exercise therapy
The use of physiotherapy exercises for organic and functional disorders in the female body has a long history as one of the effective methods of treatment.
Indications for exercise therapy for gynecological diseases:
Residual effects of the inflammatory process;
Salpingo-oophoritis chronic;
Incorrect position of the uterus, ovarian dysfunction due to pelvic peritoneal adhesions after an inflammatory process or surgery on the uterus and appendages;
Genital infantilism, uterine hypoplasia;
Weakness of the pelvic floor muscles;
Stress incontinence;
Concomitant disorders of the function of the large intestine and bladder, pain syndromes;
climacteric disorders;
Decreased physical performance due to physical inactivity;
Reactive neurosis-like states. Contraindications:
Acute and subacute diseases of the female genital organs;
Exacerbation of chronic inflammation with fever, increased ESR, signs of peritoneal irritation;
Malignant neoplasms of the pelvic organs and abdominal cavity;
Encapsulated purulent processes until the opening of the purulent focus and the creation of a good outflow;
Sactosalpinx;
Uterine bleeding;
Vesico-intestinal fistulas. Tasks of exercise therapy with gynecological diseases:
Improvement of blood and lymph circulation in the pelvic organs;
Strengthening the ligamentous apparatus of the uterus, abdominal muscles, lower back, hip joint and pelvic floor;
Contribute to the restoration of mobility and normal ratios of the pelvic organs;
Elimination of residual effects of the inflammatory process;
Optimization of the endocrine system and metabolic processes;
Improving the motor-evacuation function of the intestines and bladder;
Improving the function of the cardiovascular and respiratory systems, increasing physical performance;
Improvement of the psycho-emotional state. The following forms of exercise therapy are used - therapeutic exercises,
morning hygienic gymnastics, hydrocolonotherapy, classes
on simulators, aerobics (dosed walking, step aerobics, etc.). The LH complex includes: general developmental exercises for the muscles of the trunk, upper and lower limbs and special (dynamic and isometric exercises) for the muscles that provide movement in the hip joint, for the muscles of the lower back, abdomen and pelvic floor; breathing exercises - static and dynamic nature, diaphragmatic breathing.
In order to improve blood and lymph circulation in the pelvic organs, dynamic exercises are used that include the muscle groups surrounding the pelvis. They are functionally and reflexively connected with the organs of the female reproductive system. The active work of these muscles improves metabolic and reparative processes in this area, promotes stretching and rupture of adhesions that have arisen as a result of an inflammatory process of an infectious origin or after surgical interventions.
Considerable attention is required to train the abdominal muscles, which strengthens the ligamentous apparatus of the uterus, activating the function of the intestines. In addition, strengthening the abdominal muscles together with the muscles of the lumbar spine reduces the manifestations of pain in the lumbosacral region, which is so common in patients of this group due to muscle hypertonicity, which reflexively occurs in gynecological diseases.
Isometric exercises are usually used to ensure good functional condition of the pelvic floor muscles. With weakness of the pelvic floor muscles, the internal genital organs of a woman fail to maintain their normal position, which disrupts their functions. Strengthening the pelvic diaphragm is an urgent task in almost all pathological conditions in the pelvic area.
The LH complex necessarily includes diaphragmatic breathing, which contributes to the regulation of intra-abdominal pressure and activation of blood circulation in the organs of the abdominal cavity and small pelvis.
When prescribing exercise therapy funds, the following are taken into account:
The nature of the pathological condition;
The presence of adhesive process, its localization;
The period of the disease (acute, chronic, subacute);
The age of the patient;
The state of the cardiovascular system;
The severity of hypodynamic manifestations.
Menstruation without heavy bleeding is not a contraindication for LH, however, the emphasis in the load should be shifted to exercises for the muscles of the upper and lower extremities, stretching, and relaxation. LH is carried out by group (8-10 people), small-group (3-4 people) methods, 2 times a day - once in the exercise therapy room under the guidance of an instructor, then at home or in the ward on their own. With an incorrect position of the uterus, pain syndrome, concomitant pathology of the cardiovascular system, classes are carried out in an individual form.
The choice of the starting position when performing therapeutic exercises is the most important component of successful treatment for gynecological diseases, which depends on the nature of the exercises performed, the relative position of the pelvic organs in a particular patient. In the absence of uterine displacement, LH is performed in any IP: standing, sitting, lying (on the back, on the side, on the stomach), standing on all fours, etc. However, uterine displacements require a differentiated approach to choosing the starting position, which should facilitate the transition uterus in a normal physiological position. With retroflexion (backward bending of the uterus), such a starting position during CG exercises will be: knee-elbow, lying on the stomach, etc.
8.2.2. Therapeutic exercise in chronic inflammatory diseases of the female genital organs
The most common causes of inflammatory diseases of the female reproductive system are sexually transmitted infections, surgical interventions (including abortions), poor personal hygiene, and weakened immunity. Often they occur at a young age and quickly take chronic course. At the same time, the whole organism is involved in the process, metabolism is disturbed, significant deviations occur in the endocrine, nervous, and cardiovascular systems. However, due to the close anatomical location, the unity of innervation, blood supply and lymph circulation with the internal genital organs, the inflammatory process often affects the urinary and digestive systems.
The most common complaint that makes a woman see a doctor is pain of a different nature and intensity, which radiates to the lower abdomen, lower back, leg, rectum, and bladder. Pain, significant during exacerbation of the process,
they force a woman to spare herself, try to exclude stress on the abdominal muscles, pelvic floor and diaphragm, and ultimately lead a sedentary lifestyle. This circumstance, in turn, leads to further deterioration of blood and lymph flow in the pelvic organs and congestion, which contributes to the development of deeper functional and organic disorders in them.
Almost all women are concerned about menstrual irregularities, accompanied by headache syndrome, neurotic manifestations, asthenia and sleep disorders.
The most serious consequences of chronic inflammation are infertility, the risk of ectopic pregnancy.
Tasks of LG:
Reducing the residual effects of the inflammatory process;
Improvement of blood and lymph circulation in the pelvic organs and lower extremities;
Restoration of mobility and normal ratios of the pelvic organs;
Strengthening the ligamentous apparatus of the uterus;
Prevention of adhesion formation;
Stimulation of metabolic processes in the body as a whole, including in the organs and tissues of the small pelvis;
Improving the motor-evacuation function of the intestine;
Prevention of hypotrophy of the abdominal muscles and pelvic floor;
Increasing the body's resistance to infection;
General strengthening of the body, improving the function of the cardiovascular system and increasing physical and mental performance.
Simple gymnastic and respiratory, general strengthening and special exercises are used that correspond to the tasks of exercise therapy for this pathology (Fig. 8.3). Classes include exercises that improve blood circulation in the pelvic region. The acceleration of blood flow leads to a decrease in congestion in the pelvic organs, which, in turn, contributes to the resorption of exudate, the evacuation of decay products from the focus of inflammation. Increased blood circulation during exercise in parallel with increased gas exchange improves trophic processes in tissues, which to a certain extent prevents the occurrence of cicatricial adhesions in the pelvic peritoneum and fiber.
Rice. 8.3.Exercise Options for Women with Chronic Inflammatory Diseases
Exercises to increase the mobility of the spine should be performed with the maximum range of motion in I.P. standing, kneeling, sitting, lying on your back and on your stomach. Exercises to strengthen the thigh muscles include active movements of the lower limbs in the I.P. lying on your back - bending the legs at the knee and hip joints, sliding the feet along the plane of the couch; abduction and adduction of the legs; circular movements with straight legs;
Rice. 8.4.Exercise options to increase blood circulation in the pelvis
imitation of cycling; leg extension (breaststroke swimming); in i.p. sitting - abduction and adduction of the legs; torso to the right and left foot; rotational movements of the legs; movements with straight legs ("scissors"). These exercises are carried out actively, with dosed resistance, weights; exercises at the gymnastic wall are recommended.
In order to improve blood circulation in the pelvic area, classes include dosed complicated walking: with high hips, lifting on toes, with a swing of a straight leg forward, to the side, with a forward lunge in a semi-squat, in a squat, with overcoming obstacles of various heights.
To prevent hypotrophy of the abdominal muscles and pelvic floor, exercises are used for the oblique and rectus abdominal muscles, as well as the muscles of the perineum, which increase blood and lymph circulation in the pelvic organs (Fig. 8.4).
Gain peripheral circulation achieved by exercises for the distal extremities. These exercises are introduced into CG classes when significant physical activity is not yet shown, but the general condition of the patient allows her to expand her motor regimen.
During the period of compaction and delimitation of the infiltrate, rhythmic chest breathing is recommended with its gradual deepening and the transition to mixed and diaphragmatic; exercises for the upper limbs; rotational movements in the hip joints; raising the pelvis with support on the feet and shoulder blades; flexion of the legs at the knee and hip joints (Table 8.1).
Classes can be started when the inflammatory process subsides and the general condition of the woman improves: body temperature is normal or subfebrile; leukocytosis is not higher than 9000; ESR no more than 20-25 mm/h; there is no local increase in temperature; there is no pulsation and sharp pain in the area of the infiltrate.
Exercises are performed from the starting positions while standing, lying on your back, standing on all fours, etc. LH classes should be carried out daily, first individually (for 10-15 minutes), then in a group method (for 20-25 minutes). All exercises are done at a calm pace, combined with deep breathing. When pain the activity must be stopped. With a good functional state of the patient, the session can last up to 40-45 minutes at a submaximal load level.
Table 8.1.LH for patients with chronic inflammatory diseases of the female genital organs (recovery period)
Lesson section | Starting position | Exercises | Continue- validity, min | Guidelines | Purpose of the lesson |
Introductory | sitting and standing | Dynamic breathing exercises. Gymnastic exercises of the distal parts of the arms and legs | 8-10 | The pace is arbitrary with a gradual increase in the amplitude of movement to the maximum and with a gradual deepening of breathing | Increased pulmonary ventilation, increased peripheral blood flow. Gradual increase in total load |
Basic | Lying on your back, on your side, on your stomach; standing, kneeling; sitting on a chair on the floor | Exercises for the body (tilts forward, backward, right, left, turns to the sides, a combination of bends with turns with the participation of arm movements). Gymnastic exercises for the legs in all initial positions, simultaneous and alternate, without weights and with weights. Various walking options, exercises in static breathing. Muscle relaxation exercises | 24-26 | The pace is slow with a gradual increase in the amplitude of movement to full. Perform with the maximum possible range of motion. Relax the muscles involved in the exercise | Increased mobility of the lumbar spine. Increased blood circulation in the pelvic area, reducing congestion. Reducing the load after special exercises |
The end of the table. 8.1
8.2.3. Therapeutic exercise in operative gynecology
Modern operative gynecology has good anesthetic support, perfect surgical technique, new technologies (microsurgery, surgical laparoscopy, seamless tissue connection). However, in today's unfavorable environmental and socio-psychological environment, a negative premorbid background (a sharp increase in extragenital diseases, especially cardiovascular diseases, diseases of the central and peripheral nervous system, and diseases associated with metabolic disorders) can adversely affect the course of the postoperative period. For a complete recovery of the patient, special rehabilitation treatment is necessary, including exercise therapy, aimed at preventing postoperative complications, preventing recurrence of the disease and eliminating functional disorders caused by the pathological process.
Indications:
Extensive adhesive process in the pelvis and abdominal cavity;
Concomitant pathology of the cardiovascular, urinary, digestive and endocrine systems;
Obesity;
The presence of foci of chronic infection;
Large volume and invasiveness of surgical intervention. In malignant neoplasms, exercise therapy is prescribed only
after surgical treatment.
Tasks rehabilitation treatment largely dependent on the size of the operation. Depending on the volume, gynecological operations are divided into radical (extirpation of the uterus, removal of uterine appendages, etc.) and reconstructive-plastic - organ-preserving - (conservative myomectomy, resection of the ovaries, etc.) with the removal of only the pathologically altered part of the organ.
Tasks, means and methods of exercise therapy during operations on the pelvic organs depend on the period of treatment, the age of the patient, comorbidities and the volume of surgical intervention.
There are periods:
Preoperative;
Early postoperative;
late postoperative.
Preoperative period.
Means of exercise therapy are prescribed in the preoperative period to prepare the patient for planned operations. Tasks of exercise therapy:
Restorative, general tonic effect, increased immunity as part of general preparation for surgery;
Feature enhancements critical systems organism (cardiovascular and respiratory);
Preparation of the surgical field for surgical intervention: increasing the elasticity of the skin and muscles; improvement of blood and lymph circulation in the pelvic organs, reduction of congestion in the pelvis;
Improvement of peripheral blood circulation, mainly in the vessels of the lower extremities (prevention of thrombophlebitis);
Teaching exercises for the early postoperative period and self-care, emptying the bladder and intestines in the supine position (subject to bed rest);
Training in controlled localized breathing, painless coughing, relaxation;
Prevention of constipation and urinary retention;
Normalization of the psycho-emotional state. Contraindications to the appointment of exercise therapy:
Severe condition of the patient;
Acute purulent inflammatory process;
Increased body temperature, pronounced symptoms of intoxication;
Severe pain syndrome;
Bleeding or risk of bleeding;
Mobile cyst on a leg;
Ectopic pregnancy;
Malignant neoplasms;
Thrombophlebitis.
Normal menstruation is not a contraindication to therapeutic exercises.
LH includes simple general strengthening and special physical exercises for small and medium muscle groups in combination with breathing exercises. Starting positions depend on the nature of the disease: with prolapse and prolapse of the genital organs in the initial position lying on the back and standing on all fours;
with tumors - in the supine position. It is necessary to avoid starting positions and exercises that increase intra-abdominal pressure, especially when preparing for operations for oncological diseases. Sharp movements and quick change of starting position are excluded.
Particular attention is paid to the exercises that patients will perform in the early postoperative period:
Painless coughing with small cough shocks with fixation of the area postoperative wound;
Correct rise from bed with the exclusion of the muscles of the anterior abdominal wall.
The first classes are held in the antenatal clinic. The LH procedure is carried out at a moderate pace, it is possible to use gymnastic items, the duration is 15-20 minutes. The duration of the course is determined by the duration of the preoperative period.
Early postoperative period.
It starts from the moment the patient wakes up after anesthesia and lasts 1-3 days, depending on the severity of the operation.
Tasks of exercise therapy:
Prevention of early postoperative complications (hypostatic pneumonia, thrombosis, atelectasis, intestinal and bladder atony);
Improvement of peripheral circulation;
Improvement of blood and lymph circulation in the area of the postoperative wound, which contributes to epithelialization and scarring;
Prevention of orthostatic disorders;
Accelerating the elimination of drugs from the body.
Increase in psycho-emotional tone. Contraindications to the appointment of exercise therapy:
Threat of bleeding (when ligating large vessels);
Violations of the blood coagulation system, the threat of thrombosis;
Severe anemia, hypovolemia due to the loss of a large amount of blood during surgery;
Increase in the phenomena of cardiovascular and respiratory insufficiency;
Diffuse peritonitis, septicopyemia;
Acute thrombophlebitis.
LH is prescribed on the 1st day after surgery, already 2-3 hours after waking up, it is advisable for the patient to perform static breathing exercises and repeat them every hour, dynamic exercises for the distal extremities in light conditions (Fig. 8.5.) For the prevention of congestive phenomena in the lungs and improve expectoration, you can apply a vibration massage of the chest: vigorous rubbing of the intercostal spaces and tapping (duration of the procedure 3-5 minutes). The same techniques can be used to activate the actual respiratory muscles (diaphragm and intercostal muscles).
Subsequently, the LH procedure includes: dynamic breathing exercises, breathing exercises with prolonged exhalation, resistance; simple dynamic general strengthening exercises for small and medium muscle groups (multiple rhythmic movements of the feet, bending the legs at the knee joints, etc.); simple exercises for coordination and exercises for
Rice. 8.5.Exercise options in the early postoperative period
workout vestibular apparatus. To prevent thrombosis, it is recommended to bandage the lower extremities with an elastic bandage, which accelerates blood flow through the deep vein system and prevents blood stasis in them. LH is carried out in I.P. lying on your back, at a slow pace, lasting 10-15 minutes, with pauses for rest and relaxation exercises, by an individual method 1-3 times a day.
In acute thrombophlebitis, physical exercises are allowed only for the muscles of the upper shoulder girdle in combination with breathing exercises.
Rice. 8.6.Variants of exercises in free motor mode
In the future, the motor regimen is expanded, in the absence of contraindications, patients can get up and walk around the ward the next day after the operation. In laparoscopic operations, the general motor mode is assigned by the end of the day of the operation. Gradually complicate the LH technique, increase physical activity, add special exercises for the hip joints, large muscle groups, include exercises for the abdominal muscles, pelvic floor, increase the complexity of the exercises, the range of motion, increase the pace of training, add isometric exercises for the muscles of the perineum and abdominal wall (Fig. 8.6)
Late postoperative period.
Tasks of exercise therapy:
Prevention of adhesions;
Strengthening the muscles of the anterior abdominal wall, pelvic floor;
Prevention of recurrence of the disease;
Restoration of organ function (with organ-preserving operations);
Restorative effect, increased physical performance, adaptation to social conditions.
After removing the stitches, patients can exercise in the gym. They use a variety of starting positions, dosed walking at an average pace is recommended, gymnastic objects, medicine balls, expanders can be used. The LH technique with the use of special inflatable gymnastic balls (fit-ball) has proven itself well (Fig. 8.7).
The LH procedure is carried out in small groups and group methods, the duration of the lesson is 30-40 minutes.
After discharge from the hospital, it is desirable to continue exercise therapy in a clinic (antenatal clinic) or at home to achieve a stable clinical and functional effect for at least 4-6 months.
8.2.4. Therapeutic exercises with incorrect positions of the uterus
Normally, the uterus is in the midline of the body and is slightly tilted forward. It is mobile and easily moved. Incorrect positions of the uterus:
Posterior displacement (retroposition), most often due to pathological shortening of the sacro-uterine ligaments under the influence of a long forced supine position, with a complicated course of the postpartum period, as a result of inflammatory processes in the parameter, with anomalies in the development of internal genital organs, etc .;
Rice. 8.7.Exercises to strengthen the abdominal muscles, pelvic muscles, adductor and abductor muscles of the thigh with the use of "fit-ball"
Lateral displacements (to the right - dextroposition, to the left - sinistroposition) due to inflammatory processes in the genital organs or in the adjacent loops of the intestines, followed by the formation of adhesions in the peritoneum and scars in the pelvic tissue, pulling the uterus to the side;
"tilts", in which the body of the uterus is pulled by scars and adhesions in one direction, and the cervix - in the opposite direction (tilt of the body of the uterus backwards - retroversion);
Bends - a change in the angle between the cervix and the body of the uterus; normally this angle is open anteriorly (anteflexio), in pathological cases it is open posteriorly (retroflex); often at the same time there is also a posterior tilt of the uterus (retroversio-flexio).
The changed position of the uterus can be the result of injuries, surgical interventions, perineal ruptures, multiple pregnancies and childbirth, postpartum infection, various neoplasms, prolonged bed rest after childbirth, and many chronic diseases. In addition to the above reasons, irrational physical exercises associated with sharp shaking of the body, especially during puberty, can negatively affect the position of the uterus. It should be noted that long-term unilateral exercises, such as high jumps, always performed with one leg (jogging), can also affect the position of the uterus.
Incorrect positions of the uterus can cause menstrual irregularities, female infertility, and pain syndromes.
Indications.
For PH exercises, cases of mobile acquired uterine deviations are shown, as well as position anomalies complicated by non-rough post-inflammatory adhesions of the genital organs with surrounding tissues. Treatment of anomalies in the position of the uterus, the formation of which is determined birth defects development of the genital apparatus (infantilism, etc.), prognostically less favorable.
When burdening the incorrect position of the uterus with inflammation, neoplasms, etc., therapeutic exercises are prescribed after the elimination of these complications.
Tasks of LH in the wrong position of the uterus:
Strengthening the whole body;
Training of the abdominal muscles, diaphragm and pelvic floor;
Strengthening the muscular-ligamentous apparatus of the uterus;
Bringing the uterus to its normal position and fixing this position.
The most common form of exercise for abnormalities in the position of the uterus is the LH procedure. At the initial stages, to ensure that the features of the anatomical and topographic relationships of the pelvic organs of a particular patient are taken into account, individual lessons are held, lasting 15-25 minutes. Mandatory morning hygienic gymnastics. Practically healthy women can do water aerobics, swimming, with the exception of all types of jumps.
Types of anomalies in the positions of the uterus determine the nature of special physical exercises LH. main role their selection is played by the initial positions, which, by changing the direction of the forces of intra-abdominal pressure and the gravity of the body of the uterus itself, as well as causing the movement of the intestinal loops, create conditions for the transition of the uterus to its normal position.
When the uterus tilts back to optimal starting points include: knee-elbow, knee-carpal, on all fours and lying face down. With this position of the body, the pressure on the uterus from the abdominal organs weakens due to the movement of the intestinal loops to the diaphragm, and the high position of the pelvis is a favorable moment for the return of the uterus, due to its severity, to its normal position. In these initial positions, for example, standing on all fours, the corresponding movements are performed (alternately raising the legs, etc.) (Fig. 8.8).
On the contrary, with hyperanteflexia (excessive bending of the uterus forward), the best starting position is lying on your back, in which the force of abdominal pressure and heaviness neighboring bodies(bladder, intestinal loops) falls on the anterior surface of the uterus, thereby contributing to its deviation back.
When the uterus deviates to the side, exercises are introduced mainly in the I.P. lying on the side opposite to the deviation, which contributes to the stretching of the round ligaments of the uterus due to its movement under its own weight.
Along with special corrective physical exercises, it is necessary to use exercises to activate intestinal motility and eliminate constipation.
When doing most exercises, you need to monitor proper breathing. First of all, it is necessary to achieve
there was no breath holding, straining, so that the movement was always accompanied by an inhalation or exhalation phase.
Special physical exercises that correct the position of the uterus are often performed from uncomfortable positions, such as the knee-chest position, etc. To master them, you need to prepare for several weeks in the form of a variety of general strengthening gymnastic exercises.
Special physical exercises are complemented by gynecological massage.
Rice. 8.8.Special exercises for retrodivations of the uterus
In most cases, the so-called retroflexion of the uterus occurs, so we present special exercises that help position and fix the uterus in the correct position. These exercises should be included in the LH complex, compiled taking into account age, fitness and the functional state of the body. Women who have too much tilt of the uterus back are recommended not only to perform exercises in the I.P. lying on his stomach, but also to rest during the day and even sleep only in this position. Most favorably I.p. standing on all fours, when the uterus, shifting due to gravity, leans forward. I.p. is also useful. sitting on the floor with straight legs, since the center of gravity is transferred forward, the internal organs press on the abdominal wall and contribute to the tilt of the uterus forward.
Active exercises are combined with weight-bearing exercises, with dosed resistance and muscle tension (isometric exercises). The classes use breathing exercises (static and dynamic), pauses for passive rest, walking, elements of sports games, swimming.
Special exercises for tilting the uterus back (according to Vasilyeva E.V., 1970)
I.p. lying on the stomach.
1. Alternately bend your legs at the knee joints.
2. Alternately raise the straight leg back.
3. Simultaneously raise straight legs.
4. Turn on your back, return to I.p. I.p. standing on all fours.
5. Raise the straight leg up, then return to the I.P. The same with the other leg.
6. Simultaneously raise the right arm and left leg and vice versa.
7. Raise your leg, then bend it, trying to touch your knee with your hand. I.p. standing on your knees with support on your elbows.
8. Touch the elbow of the left hand with the knee of the right leg, return to the SP, then with the elbow of the right hand touch the knee of the left leg.
9. Straighten the legs at the knee joints, lifting the pelvis up without lifting the elbows off the floor.
10. Crawling forward and backward (15-30 seconds).
I.p. legs wide apart, palms of hands resting on the floor.
11. Walking in this position for 15-30 seconds. I.p. sitting on the floor.
12. Spread and bring straight legs.
13. Spread your legs as wide as possible to the sides, lean forward to the left and touch your left foot with your hands. The same on the other side.
14. Turns of the torso in one direction or the other, while touching the floor near the pelvis with both hands.
The incorrect position of the uterus also includes its prolapse, which may be the result of malformations and anatomical changes in the pelvic organs, weakness of the muscles of the pelvic floor, weakening and stretching of the ligamentous apparatus of the uterus.
In women who did not strengthen the abdominal muscles during pregnancy and did not engage in health-improving physical culture after childbirth, in the future they often have a “big stomach”, since the abdominal muscles overstretched during pregnancy and not strengthened after childbirth do not hold the pressure of the viscera. This entails the omission of all internal organs, which, of course, can impede their function. Weakening of the pelvic floor muscles may be associated with general weakness muscles and become the result of injury and overstretching during childbirth. The pelvic floor serves as a support for the genital organs, therefore, with weakness of the muscles of the pelvic floor and the ligamentous apparatus of the uterus, prolapse of the uterus and vagina can occur, up to the complete prolapse of these organs.
Exercise therapy for the prolapse of internal organs becomes the main means of treatment, involving the gradual training of weakened muscles with the establishment of internal organs (in particular, the uterus) in the correct anatomical position.
Here is a list of special exercises for the muscles of the pelvic floor and abdominals, which should be included in the exercises of CG (according to Vasilyeva E.V., 1970).
I.p. lying on your back.
1. Alternately move one leg over the straightened other.
2. Alternately bend the legs at the knee joints, sliding the feet along the plane of the couch.
3. Alternately bend your legs, trying to touch your chest with your knee.
4. At the same time, bend your legs at the knee joints, trying to press them to your chest.
5. Alternately raise one or the other straight leg up.
6. Perform leg movements, as when riding a bicycle.
7. Raise straight legs up, hold them (exposure 5-7 sec).
8. Cross and spread straight legs to the sides, raised at an angle of 50-90?.
9. Perform leg movements, as in breaststroke swimming.
10. Legs bent, feet connected. Spread your knees to the sides, bring your knees together, stretch your legs.
11. Move to a sitting position with the help of the hands (without the help of the hands).
12. Legs are fixed, arms along the body. Sit down, bend forward, touching the feet with your hands.
I.p. lying on the stomach.
13. Hands behind the head. Alternately raise the straight leg (right, left) while simultaneously tensing the muscles of the perineum.
14. Arms along the body, legs apart. Raise both straight legs up at the same time and then slowly lower them.
16. Hands under the head, legs apart. Raise the right half of the body up, tensing the muscles of the thigh, buttocks and contracting the muscles of the perineum. The same on the other side.
I.p. sitting on the floor.
17. Emphasis on the back. Spread and bring straight legs without lifting them from the floor.
18. Raise the pelvis off the floor.
19. Tilt the torso to the right, lean with the hands of both hands on the right near the pelvis, moving the hands along the floor, tilt the torso to the left. The same on the other side.
Methodical instructions.
Classes with patients with an incorrect position of the uterus are carried out, as a rule, in the conditions of physiotherapy exercises for women's clinics and in sanatorium-and-spa institutions. It is desirable to have an isolated gym, inaccessible to outsiders. Patients should wear clothing that does not restrict movement. Belts, tight shorts, etc. are not allowed. Before class, the bladder and intestines must be emptied.
It is necessary to focus on the following:
During menstruation, classes do not stop, but the load in general strengthening exercises decreases;
In all exercises, special attention should be paid to breathing, combining it with a rhythm, position and movements favorable for inhalation and exhalation;
The supine position, as well as running and light jumping, for uterine retroflexions can be introduced at the end of the course of treatment in patients with a properly established uterus and dosed carefully.
8.2.5. Massage in gynecology
Massage is an important and effective means of non-drug therapy for various pathological conditions of the female genital area. However, such treatment should be supervised by a gynecologist.
Indications for massage:
Chronic inflammatory diseases of the genital organs;
Adhesive changes in the pelvis;
Menstrual disorders (dysmenorrhea, amenorrhea, etc.);
Hypoplasia of the genital organs;
Hypofunction of the ovaries;
Incorrect position of the uterus, its prolapse;
Infertility without anatomical changes in the internal genital organs;
With weakness, insufficient contractility of the muscles of the uterus and bleeding on this basis;
Urinary incontinence due to physical exertion;
Climacteric phenomena;
Concomitant disorders (pain syndromes, including headaches and lumbosacral pains, neurotic disorders, diseases of the urinary system and intestinal tract);
Surgical interventions. Contraindications:
General contraindications, including tumors of the pelvic and abdominal organs, conditions requiring immediate surgical care;
Acute and subacute forms of inflammatory diseases of the external and internal genital organs;
Purulent processes of the pelvic organs;
Exacerbation of chronic inflammation of the pelvic organs;
III-IV degree of purity of the vaginal flora;
Temperature increase (above 37?), ESR acceleration (above 20 mm per hour);
Endocervicitis and erosion of the cervix;
endometriosis;
Bloody issues;
The presence of menstruation (with oligomenorrhea, massage is possible); the presence of pregnancy or suspicion of it;
Postpartum and post-abortion periods within 1-2 months after the restoration of the normal menstrual cycle;
Venereal diseases;
The appearance of sharp pains during and after the massage. Massage tasks:
Improvement of blood and lymph circulation, metabolic processes and regeneration in the pelvic organs;
Reducing congestion in the circulatory and lymphatic system of the pelvis;
Restoration of the normal physiological position of the uterus;
Normalization of motility, tone of the myometrium and fallopian tubes;
Normalization of ovarian-menstrual function of the ovaries;
Restoration of reproductive function;
Elimination (resorption) of infiltrate in periuterine tissue;
Elimination of adhesions of the ligamentous apparatus of the uterus;
Mitigation of pain syndrome of various localization;
Improvement of the psycho-emotional state. Massage area.
In most diseases of the female genital area, the main areas of massage are: the lower thoracic back, lumbosacral and gluteal regions, lower abdomen, thighs (segments D11-12, L1-5 and S1-2). However, reflex changes are often found in the distal parts of the lower extremities and the collar zone (menstrual irregularities are usually accompanied by headache syndrome, sleep disorders), which should also be subjected to therapeutic effects. With concomitant diseases, the zone of influence of massage can expand significantly.
Massage position: sitting, lying on the stomach or on the side.
Massage technique.
In the treatment of female diseases, any type of therapeutic massage is used. The most common are gynecological, vibrational and classical massage. At present, various reflex types of massage are being actively introduced into practice: segmental, connective tissue, acupressure, etc. However, in a particular pathological condition, in order to achieve the greatest therapeutic effect, preference is given to certain kind massage (Table 8.2)
Table 8.2.The most effective types of massage for various pathological conditions of the female genital area
Pathological conditions | Types of massage |
chronic inflammatory diseases | Classical, segmental, vibratory, point |
Violations of the position of the uterus | Gynecological |
Weakness of the muscles of the uterus, bleeding due to insufficient uterine contractility | Vibrating, point |
Menstrual disorders, ovarian hypofunction, female infertility, uterine hypoplasia | Segmental, vibrational, connective tissue |
Cicatricial adhesive processes | Gynecological |
Pain syndromes | Segmental, vibratory, point |
Gynecological massage has a direct effect on the pelvic organs, their receptor and vascular apparatus. This massage (vaginal) is a medical procedure and is performed only in the conditions of the gynecological department of the hospital or antenatal clinic and is prescribed for violation of the position of the uterus and cicatricial adhesive processes after surgical interventions or inflammatory diseases of the female genital organs.
Vibration massage. Mechanical vibrations cause excitation of receptors located in the skin, mucous membranes, muscles and tendons, walls of blood vessels and internal organs. At the same time, vibration has not only a local, but also a general effect, affecting distant organs and systems, including the central nervous system and the hormonal function of the central structures of the brain. Features of physiological shifts depend primarily on the frequency of vibration, its intensity, duration and localization of exposure, resonant properties of the tissues on which it affects. Massage also has a pronounced analgesic effect. Vibration massage is used to enhance the contractility of the muscles of the uterus, with bleeding due to its weakness, with amenorrhea, to stimulate ovarian function, and thus it is indicated for infertility.
Impact area: sacrum, lower thoracic and upper lumbar vertebrae, lower abdomen, mammary glands, acupuncture points associated with the pelvic organs. The duration of exposure does not exceed 3-10 minutes. Number of procedures 10-12.
Segmental massage uses reflex connections of internal organs with surface tissues - skin, muscles, fascia, periosteum, by influencing which massage techniques can significantly improve the functional state of the relevant organs. Techniques of stroking, rubbing, vibration from the arsenal of classical massage and specific ones are used. The most important and obligatory component of the effective use of this type of massage is the identification of segmental zones - areas of the body, usually of constant localization with reflex changes in tissues. These may be areas of hyperalgesia in the skin and muscles, muscle hypertonicity and myogelosis, areas of swelling or retraction in the connective tissue. As tissue changes are eliminated, there is an improvement in the function of internal organs segmentally associated with these zones. The greatest reflex changes in diseases of the female genital organs are observed in the tissues of the lumbosacral region, pelvis, lower abdomen and thighs. However, attention should also be paid to the zones of the lower cervical and upper thoracic segments, since reflex changes in this area are most often detected in the presence of menopausal disorders.
Segmental massage is highly effective in a wide range of female diseases: menstrual disorders, dysmenorrhea, genital hypoplasia, pain syndromes of various localization, residual effects after surgery and inflammatory diseases of the genital organs. Massage is carried out in a sitting position, lying on the stomach or on the side. The duration of the massage is usually no more than 20 minutes. The duration of the course of treatment is determined by the rate of disappearance of reflex changes, usually 6-10 procedures.
Classic intensive massage (Makarova M.R., Kuznetsov O.F., 1998). This method is based on the use of classical massage techniques, but taking into account reflex changes in the muscles, subcutaneous adipose tissue and skin in the lumbosacral region and abdomen, resulting from irritation of visceroreceptors in inflammatory diseases of the pelvic organs.
Massage begins with the abdomen, subsequently affecting the lumbosacral and gluteal regions. Particular emphasis in massage is given to the impact on areas where there is poor tissue displacement, skin hyperalgesia zones, muscle hypertonicity in order to eliminate them.
Massage of the abdomen begins with a planar superficial stroking turning into a deep one, then rubbing and kneading techniques. The most intensive massage techniques are performed in the iliac regions. The direction of movement is clockwise and towards the regional lymph nodes. Additionally, the iliac crests, the area of the inguinal fold, the pubic joint are worked out by rubbing techniques, and the iliac muscle is worked out by pressing (kneading technique) in the direction from the iliac crest into the depths of the pelvis with a brush clenched into a fist. This technique also affects the colon along its course with pressure in the ileocecal and sigmoid angle with vibration for 2-3 seconds. The massage of the abdominal area ends with vibration (concussion of the pelvis), stroking (planar superficial circular and longitudinal).
Massage of the lumbosacral region: all the techniques of classical massage are used with an emphasis on areas with reflex-changed tissues and exit points of the spinal roots.
Methodical instructions. The construction of an intensive massage technique depends on the course of the underlying disease. In patients with chronic salpingo-oophoritis without exacerbation with rare relapses of the disease, lasting up to 5 years, in the presence of adhesions of the small pelvis of the I-II degree, the massage procedure begins with an intense impact on both areas until a feeling of mild soreness appears. The duration of the procedure is up to 25-30 minutes. The course consists of 4-6 procedures with an interval of 2-3 days.
In patients with a disease duration of more than 5 years, in the presence of frequent recurrences of the development of sactosalpinxes or an extensive cicatricial adhesive process of III-IV degree in the small pelvis, abdominal massage is carried out according to an intensive technique from the first procedures and is combined with a more “sparing” effect on the lumbar sacral area. As you get used to, the effect on the lumbar zone is increased, using all the techniques in the massage procedure, increasing the duration of the procedures up to 25-30 minutes. The course consists of 5-6 procedures with an interval of 2-3 days.
