Postpartum Care: Mystery of Pelvic Floor

Postpartum Care: Mystery Of The Pelvic Floor

We are blessed to be mothers. BUT, after giving birth to our children, our pelvic floor may not be as blessed. Up to 80% of women who have given birth vaginally cannot effectively contract their pelvic floor muscles. The two most common reasons are damage to soft tissue of the pelvic floor or to the nerve supply of the pelvic floor. The damage to the pelvic floor can also cause a “disconnect” between the mind and body, making it difficult for the brain to isolate and activate the pelvic floor. A common consequence of this is leakage of urine, often when a woman coughs, sneezes, lifts the baby, runs, or other strenuous activity.

Like any other muscle that has been injured, if care is not taken to rehabilitate the area of injury, the muscles involved may not return to their previous level of health.  The primary consequence is pelvic floor weakness, which contributes to incontinence as well as poor muscular support of the pelvic floor organs. Some of the signs and symptoms of pelvic floor weakness or dysfunction include:

·         Incontinence (bladder and/or bowel)

·         A feeling of instability in the pelvis and/or lower back area

·         Hip, pelvis or low back pain, stiffness and/or fatigue

·         Pressure or fatigue in the area of the pelvic floor

·         Decreased sensation 

·         Pain with intercourse as a result of the scar tissue at the site of the tearing or episiotomy

How can Pelvic Floor Physiotherapy Help?

It is recommended that new moms attend for a pelvic floor assessment 6-8 weeks after giving birth. Your pelvic floor physiotherapist will complete a 2-part assessment that includes a global evaluation of your posture, mobility and strength and an internal exam of the pelvic floor muscles. 

After the initial exam, your physiotherapist will develop an individualized treatment plan. Once your ability to isolate and activate the pelvic floor is restored, core-strengthening exercises will be incorporated. Manual therapy techniques are utilized to release tightness or scar tissue, and then facilitation techniques to the muscle are used to help you find and learn how to contract them. 

A pelvic floor home exercise that assists women with pelvic floor weakness is called the elevator.

Visualize the pelvic floor as being on the first floor, which is the normal resting state. Contract the muscles gently thinking of bringing the elevator to the second floor.  Increase the strength of the contraction going to the third floor, then again going to the fourth floor maximally contracting your pelvic floor. Slowly reverse the process going down. Repeat 3 times, rest and repeat 2 times a day.

For further guidance and to arrange a two-part assessment please call Donna Sarna Physiotherapy at 452-2608.