The 5Fs concept for pelvic floor disfunctions

To ensure an adequate sequence in pelvic floor muscle training the concept of the 5 Fs, i.e., Find-Feel-Force-Follow-through-Functional training of pelvic floor muscles was introduced by Bary Berghmans, PhD MSc RPT, associate profesor. Awareness (Find and Feel) of the different muscles involved in maintaining continence is necessary to be sure of avoidance of co-contractions of surrounding muscles (abdominals, buttocks, thighs and back) and activation of the relevant muscles. Sometimes, when patients find and use the relevant muscles at the appropriate time, symptoms can reduce at once. Basic physiological muscle training principles teach us that pelvic floor muscle exercise programs must consist of selective MAXIMAL voluntary contractions with a repetitive character (Force) and sufficient time of relaxation between consecutive pelvic floor muscle contractions. The principles Maintenance and Reversibility (follow-trough) alert the patient to train regularly, sometimes lifelong, but the challenge for the pelvic physiotherapist is to incorporate functional training in such a way that patients will experience progress of their symptoms as soon as possible.