Repertoire of exercises

During my women’s health practical I taught post natal mothers exercises for their pelvic floor muscles and abdominal muscles. Pelvic tilting was used for both abdominal strengthening and relief of back ache.

I began teaching a post natal woman these post natal exercises. Whilst I was teaching the exercises I realised the lady had limited English so I tried to use simple instructions. She could perform all the exercises well except the pelvic tilt exercise. I explained the exercise and demonstrated the scooping action of the pelvis in standing, but when she practiced it in crook lying she had difficulty tilting her pelvis and instead performed a bridging action. I didn’t want to give up on the exercise, but instead of changing tact I became frustrated and persisted with the same instructions. I started to facilitate with my hands and used simple verbal cues and eventually the lady grasped the aim of the exercise.

I was lucky that this patient was so determined. She didn’t become frustrated at all. I realise, however, that not all patients are this compliant. I learnt that I needed to have alternative ways to describe the exercise to the patient. I had thought about alternative positions such as 4 pt kneeling, however, this position didn’t suit this patient. Other methods of teaching the exercise could have included placing my hand in the patient’s lumbar spine and asking her to bring her back towards the bed, creating posterior pelvic tilt or describing pubic bone movement to the patient.

As physiotherapists we are continually prescribing exercises. It is very important that we can do this in a manner all patients can understand. We therefore need more than one way to teach an exercise or concept. I think watching other therapists teaching exercises and talking to other students is helping to build my repertoire of exercises.