Recovery exercises for pelvic injury

 Bladder and bowel information and pelvic floor control

The stability of the pelvis is dependent not only on the bones, but also on strong ligaments and muscles.   For this reason, the physiotherapist will teach you some abdominal (tummy) muscle exercises.  These will involve specific exercise training of the stability muscles of the trunk (body), which in turn help to support the pelvis and lower back. 

They will also teach you some exercises to strengthen the muscles that support your bladder and bowel, known as the pelvic floor.  These are important to do, especially if you have any leaking of urine after your operation.

The pelvic floor is a large group of muscles which pass from your pubic bone in the front of your pelvis to your coccyx (tail bone) behind. They create a sling at the base of your pelvis. Their role is to:

  • support the contents of your pelvis and abdomen
  • allow you to control the flow of urine
  • provide strength and support to the pelvis and lower back.

If the pelvic floor muscles become weak due to your fracture pelvis they will not provide the support and control that they should.

Pelvic floor exercises

The following three exercises should be done three times a day once your catheter has been removed. With practice, you should be able to do both exercises in any position. This makes them easier to fit into your daily life. Remember the quality of these exercise is more important than the quantity.

  1. Lie on your back with both knees bent.

Imagine you are trying to stop yourself passing wind and at the same time trying to stop a flow of urine midstream. You can do the exercises by “squeezing and lifting” the muscles to close and draw up the back and front passages.

Hold the squeeze for 5 to 10 seconds

Rest for four seconds

Repeat up to 10 times.

  1. The pelvic floor muscles need to be able to work quickly so that they can react to stresses such as coughing and sneezing. They can be trained to do this by practicing tightening the pelvic floor muscles as quickly as you can, then let go straight away. Wait about one second before repeating; continue until you tire or you can no longer feel the muscles working. As you progress aim to do this up to 20 times.


Before your operation

  • You may be seen before your operation by the physiotherapist who will test the power (strength) and sensation (feeling) in both of your legs.
  • The physiotherapist may listen to your chest and teach you how to clear phlegm if necessary.
  • The physiotherapist will teach you the following exercises which you can start immediately and should continue to do soon as you are able, after the surgery.


  1. Foot pumps

Lying or sitting up in bed, briskly move your feet up and down at the ankles.

Repeat 10-15 times every hour.




  1. Static quads (thigh squeezes)

Tighten your thigh muscles by pushing the back of your knee into the bed (straightening your knee as much as possible)

Hold for a count of five and then relax

Repeat 10 times every hour.

  1. Heel slides

Slide your heel towards your bottom, so your hip and knee bend. Then straighten your leg.

Your physiotherapist may help you move your injured leg at first, until you can manage  exercise on your own.

                                                                 Repeat 10 times, three times a day.

 After your operation

Continue the previous exercises you were shown before the operation.

  • The physiotherapist will move your hip joint:
    • up and down (flexion and extension)
    • out to the side and back (abduction and adduction)
    • turn it in and out (internal and external rotation).

The physiotherapist will show you some additional exercises and advise you when to start them (see below). The following exercise should be done at least four times a day, as you are able. Start with 10 to 15 repetitions for each exercise. You can increase the number of repetitions as your condition improves.

  1. Leg position

 When you are lying down, your leg naturally turns outwards. For this exercise, turn your whole leg inwards so that your foot is facing your other leg.

Hold this position for five seconds, and then relax.

Repeat five times

  1. Hip abduction (leg out to side)


Slide your leg out to the side keeping your knee straight. Then return your leg back to the middle. Your physiotherapist will help you move the injured leg at first, until you can manage the exercise on your own.

Repeat 10 times, three times a day


  1. Inner range quads (leg lifts)

Place a rolled towel under your knee on the operated leg. Tighten your thigh muscles and straighten the knee, lifting your heel off the bed.

Hold your leg straight for a count of five seconds, and then lower it gently.

Repeat 10 times, three times a day

  1. Abdominal exercises

Lie on your back with both knees bent. Tighten your lower stomach muscles and gently flatten the small of your back into the bed (as if you are drawing your belly button towards your back bone).

Hold for a count of 5 to10 seconds.

Repeat 10 times

Getting up

When the surgeon has seen the x-rays after your operation you may be able to start getting up with the physiotherapist, depending on the other injuries you may have.

  • You may feel dizzy or light headed the first few times you get up as your body adjusts to an upright position after a period of bed rest.
  • You will use a frame at first but progress onto elbow crutches. You will not be allowed to put your full body weight on the operated leg for three months (touch weight bearing or non weight bearing) but your physiotherapist will discuss this with you.

Once you have progressed from your frame to getting around with crutches, you will be taught how to climb stairs.

If your fractures involve both sides of the pelvis, you may not be permitted to stand on either leg for three months. In this situation, once you can support yourself sitting over the edge of the bed, the physiotherapist and occupational therapist (OT) will show you how to get into a wheelchair.  The OT will also show you how to get about safely in the wheelchair.

Hospital staff should talk to you and your family or carer about arrangements for your care when you go home. This is so that any necessary plans can be made before you are discharged home.  When you are safely managing the above things on your own and there are no other nursing or medical problems, your discharge or transfer date should be discussed.

Further information

If you live in the UK, you may find it useful to contact the following organisation for more information on bladder and bowel control.

The Bladder and Bowel Foundation


Telephone: General Enquiries: 015 3653 3255

Nurse Helpline (Medical Advice): 0845 345 0165