Before embarking on the course please check through this list of precautions and contra-indications to ensure that it will be right for you
There is one huge red flag and if this sounds like you then, really, you need to close your computer and get to your local hospital. Cauda Equina Syndrome is usually caused by a severe herniated disc in the lumbar region. This can cause dysfunction at multiple nerve roots in both the lumbar and sacral regions. These nerves travel to the lower body sending and receiving signals to and from the brain. If these are interrupted, then there are a range of symptoms which may show up as obviously the degree of compression from the disc will vary from person to person.
- Urinary retention – your bladder is filling and you aren’t getting the normal sensation of an urge to urinate. This may lead to a “voiding reflex” whereby the sensors in the bladder just take over and release the urine anyway meaning that there will be sudden and extreme incontinence.
- Faecal incontinence – inability to control the anal sphincter.
- Weakness or paralysis of lower extremities
- Saddle anaesthesia – numbness and loss of sensation in genitals, buttocks or anus
- Pain in the back or legs (like sciatica)
- Sexual dysfunction
I know that sounds pretty scary, but I need to make you aware of that particular condition. Also note that other more minor – if that is a phrase I should use – disc bulges can influence your ability to control bladder and bowel. If this is a concern for you then please contact your GP.
Specifically this could be those with spinal cord injuries which mean that there is insufficient nerve stimulation to the lower part of the body. If you know that you have some form of neurological feedback from below the waist, then absolutely the course is worth a try.
I think the same could be said for those with a neurological condition – including but not limited to Multiple Sclerosis, Parkinsons, Stroke, Muscular Dystrophy and Motor Neuron Disease, etc. Signals can be distorted causing over-active bladder (neurogenic bladder) or there can be limited nerve engagement with the area. For those with an over-active bladder you could try the section on the overly tight (hypertonic) pelvic floor to help relax the muscles. For those with limited nerve engagement - if there is a degree of nerve stimulation to the lower part of the body then I would say use it as much as possible. Keeping those lines of communication open are really useful. There are modifications for all the exercises and many can be done in a seated or lying position to ensure that they are accessible for all abilities.
For those with spinal cord injury or neurological conditions there are many interventions available through your health care providers. Some are surgical and others non-surgical and I am sure that these have been discussed with you in the past. However the “if all else fails” page of this website provides further information.
If you are transgender, non-binary or intersex you may find that surgical interventions have caused changes to the pelvic floor which have then caused subtle shifts in gait and muscle tensions which are now causing incontinence issues. This may need specialist care but, again, feel free to try the section on the hypertonic pelvic floor which will help you find ways to relax it and the surrounding muscles. A couple of things to note - phalloplasty (to construct a neopenis) and surgical procedures which shorten the urethra can increase the risk of urinary tract infections.
Once the pelvic floor is calmer and under less stress then the work to rebuild power begins and that takes you to the re-training exercises section of the course.