Manual therapy technique on the sacrum for people with muscular dysfunction in the pelvic floor, and urinary incontinence

Intervention: - Kegel exercises: at the end of each weekly session supervised by the osteopath and at the participant's home 3 times a week. Slow-Twitch Exercise: the pelvic floor muscle hold for a slow count of 5 seconds, relax 5 seconds, and repeat again for a total of 10 contractions. 3 sets. Fast-Twitch Exercise: Quickly contract the pelvic floor muscle 5 times and relax 5 seconds and repeat again for a total of 10 times. 3 sets. - Global pelvis technique Patient: Right lateral decubitus. Osteopath: at the level of the patient's pelvis. Hands: We place our right knee on the left knee of the patient, for the kick. Left hand controls the patient's pectoralis. Right hand contact on the iliac crest. Technique: Right lower extremity in extension. The lower left limb in flexion. Introduce very little rotation of the spine. Anterior slip of Anterosuperior iliac spine until fold is formed at the waist. We bring the elbow to our hip. We then rotated the patient to open the lumbo sacra veneer. The thrust is performed by simultaneously increasing these three parameters, with kick and joint compression. - Sacrum technique with wedges It is done in two stages: 1. For the previous sacral base: Patient: Prone prone, resting on wedges. Osteopath: Standing at the level of the patient's pelvis. Placement of the wedges: underneath the anterior superior iliac Spines, which makes the two wedges form a V of inferior point, this allows to place the pelvis in retroversion and to correct the relative position for anteriority of the base. Contacts: The correction later consists of taking a pisiform contact or with the heel of the hand on the apex of the sacrum reinforced by the other hand. Technique: The patient is asked to take a deep breath. In inspiration, we are going to push the pelvis in the direction of the floor, in the exhalation the correction is maintained. This correction is performed on about 10 respiratory cycles. 2. For the posterior sacral base: Patient: prone position Osteopath: Standing at the level of the patient's pelvis. Placement of the wedges: The wedge is placed under the greater trochanter, which makes the two wedges now make a V of the upper tip. Contacts: The therapist makes a contact on the sacral base, the position of the wedges makes an anteversion that corrects the relative posterior position of the base of the sacrum. Technique: The patient is asked to take a deep breath. In exhalation, the sacral base is anteriorized, in inspiration, It is maintained. All of the techniques described are performed at each session (25 minutes). Who will deliver the intervention is an osteopath with 6 years experience. The mode of delivery: face to face, manually and individually in a private clinic 3 sessions, once a week for 3 weeks. In addition, patients must do 3 sets of Kegel exercises at home daily.