How to Recover and Strengthen the Postpartum Pelvic Floor
The pelvic floor is a collection of muscles, nerves, tendons, blood vessels, ligaments and connective tissue that are interwoven within the pelvis and together.
The muscles of the pelvic floor connect to the pubic bone in front, to the tailbone in the back and to the sitz bones at the sides. These muscles provide support and stability to our spine and pelvis, help keep the pelvic organs in place, helps us maintain continence and contribute to our sexual satisfaction (or lack thereof).
They need endurance to work together for long periods of time such as maintaining our continence throughout the day and they need to be able to contract quickly and strongly at various times during the day when we laugh, cough, sneeze, and pick things up.
1. What is Diastasis Recti?
The connective tissue that aligns the rectus abdominis muscles in the midline of the abdomen (think 6-pack) can become stretched and weak during pregnancy and birth but this condition is not exclusive to pregnancy or even to women. When the connective tissue fails to support and align the abdominals there will often be a gap called Diastasis Recti. The key to healing diastasis recti is optimizing the pelvic floor.
Video on what happens when you have DRA
2. How can a pelvic physiotherapist help with my weak tummy and pelvic floor?
Pelvic floor physiotherapists have additional training in the pelvic floor muscles and are licensed to go beyond the labia. They can help us understand what is happening internally such as organ position, scar tissue from surgery and birth, and muscle function. We can go to the gym and see our biceps or hamstrings but we can’t see our pelvic floor muscles. Working with a physio who can evaluate our internal musculature and help us learn to use them appropriately is an amazing experience! Every woman, especially a woman who has been pregnant should see a pelvic floor physiotherapist annually to keep the muscles and all of their important functions in check.
3. How important is pelvic floor exercise?
Pelvic floor exercise is essential to long term maintenance of core function. Just like we brush our teeth twice a day to help maintain dental hygiene, we need to exercise the pelvic floor muscles to ensure they are strong, supple and able to do all of the jobs that it does.
4. What programs are available to strengthen my pelvic floor?
There are kegel exercise devices that many think are needed but good ol' kegels coupled with movement is the best approach. There was a study done that compared regular kegels to kegel exercisers and there was no difference found. I believe it, adding kegels to movement because static kegels, while helpful when learning, do not account for the fact that we move and often times things like leaking or pressure are felt when upright and moving.
The Kegel Mojo program is an education and exercise program that offers workouts for all levels and also has guest experts like a nurse continence advisor, a urogynecologist and a pelvic floor physiotherapist (to name a few) offering advice and tips as well.