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contraction and dilation, in the pelvic floor. But here, too,
in order that the levator may fully participate, it is necessary
to concentrate especially on this region of the pelvic floor.
Certain exercises will be mentioned explicitly in the second
section of this book, which treats of physical culture in
pregnancy and the puerperium. They may, with advantage,
be combined with deliberate contraction and relaxation of
the pelvic floor. It should be mentioned that the exercises
there designated semi-active, i.e., those which involve
support by an attendant or some assistant, may also be
carried out actively, that is, without such support. In this
manner, as well as by the modification and/or intensification
of muscular effort, there may be produced a whole register
of semitones between such tempered and careful exertion as
is suitable to pregnancy and after child-birth, and vigorous
action, at full pitch as it were.
The most appropriate exercises in this respect are No. 15
and No. 16 of that group, and especially No. 15, if the feet
are parted and the knees more or less separated. In 15 the
contraction of the pelvic floor naturally accompanies the
lifting of the pelvis, and in 18 the upright movement of the
trunk.
In the case of two more of these exercises, we revert to
the classic exercises described in manuals of obstetrics as
indirectly promoting the strength of the pelvic floor ; they
date from the days of Thure-Brandt, and are generally the
only systematic efforts of a gymnastic kind for their purpose
.which the older books describe. They are No. 17, " Opening
'and Closing of the Knees against Pressure," and No. 27,
" Opening and Closing of the Knees against Pressure while the
Pelvis is raised." And both of these exercises are un-
questionably very important and useful, especially if they
are performed with special conscious attention to the participa-
tion of the muscles of the pelvic floor.
As I have already stated, many exercises in the general
gymnastic repertoire for women are recommended for the
development of the pelvic floor, of course indirectly. But,