Kegels Just Aren’t Enough! 5 Reasons Why All Pregnant Women Should See A Pelvic Health Physiotherapist
If you just read the words “pelvic health physiotherapy” for the very first time or there is very little that you know about the subject, you are not alone. Although in recent years pelvic health PT has gained some awareness here in Canada, there is still a long way to go.
Pelvic health therapists are registered physiotherapists who specialize in treatment for the pelvic floor. The pelvic floor consists of muscles, ligaments, nerves and connective tissue, and plays an important role in maintaining function of the bladder, uterus and genitals. If you have ever been pregnant, are currently carrying or even thinking about having children, this blog post is for you! We are going to discuss 4 of the most common issues that arise both prenatally and postpartum that can be relieved with the help of pelvic health physiotherapy.
There are a great deal of changes to women’s bodies as they go through pregnancy and then again post partum. It is helpful to understand, especially for new mom’s, what will be your new normal and what things shouldn’t change. Pelvic health therapists can help to make these differentiations. Nowadays, with the amount of accessible information regarding pregnancy, it can be challenging to decipher if particular symptoms of pregnancy are “common” or “normal”. Keep in mind while we discuss the issues below that there is large difference between these two categories.
Did you know that 100% of women in late stages of pregnancy suffer from some form of diastasis recti! While all women are dealing with it, a much smaller number understands what it is and how it can be treated. Diastasis recti is the separation of the abdominus recti muscles due to the expansion of the uterus and increase in the hormone relaxin. This hormone does as the name suggests, it relaxes the muscles and ligaments in the mothers body to allow for all the necessary growing to take place. The downfall being that once these muscles have been stretched as far as they have, they don’t always return to the same place after the baby has been born. If you were to glue two pieces of string side-by-side to a deflated balloon, imagine what would happen when inflating that same balloon. The strings would stretch and pull away from one another. Similar to the muscles in your abdomen, they stretch outward to accommodate the enlarged uterus. Now deflate that balloon once again and consider the changes. Research has found that more than 30% of women continue to experience diastasis recti after 12-month postpartum. AKA, the strings don’t return to their original places on their own.
Diastasis recti is very common but not normal. The new coined term “mommy pooch” does not have to be your new reality because you wanted children. However, do understand that your body does need time to heal postpartum. Pregnancy is very traumatic for the body, you will need time to heal. Mothers should expect that the diastasis recti will heal within the first 12 weeks postpartum, or 4 months after you are finished breastfeeding. One thing to emphasize is that it doesn’t matter how long it has been since you have had your kids, diastasis recti is always treatable.
Incontinence is very common among mothers post-birth, yet it is not normal to have incontinence of any kind either pre or postnatal. Unfortunately 1 in 3 women will have bladder control issues following a pregnancy and less than 20% of those women will seek medical help.
Urinary incontinence is associated with weakness in the pelvic floor muscles. Many women understand that to increase the strength of a muscle, you have to exercise it. This has brought on the fascination of Kegels. But are they right for you?! If you think about the pelvic floor muscles like your upper trap muscles (the one in your upper back that sometimes gets sore if your sitting at the computer for too long). If that upper trap muscle is overactive while sitting at the computer it starts to get tight and sore. The worst thing you could do is go and exercise it. This is the same for the pelvic floor muscles. Some women have very weak pelvic floor muscles, while other have very tight. All body types need different exercise programs, the pelvic floor is no different. So Kegels may not be right for you! And even if they are, most of the time, without proper coaching, Kegels are not executed properly and are ineffective.
There are two different types of incontinence, both a potential reality when having children. Those who have difficulty holding their urine in while jumping, sneezing, coughing or laughing, suffer with stress incontinence. These individuals commonly have a weak pelvic floor and are prescribed strengthening exercises. In opposition, those who struggle when hearing running water or the during anticipation of putting a key in a door, suffer with urge incontinence and have a tight pelvic floor. These individuals will receive a program that encorporated breathing techniques and trigger point release. Gratefully, 80% of women will have full control of their bladder again with pelvic health therapy.
Whether you are feeling pain in your low back or pelvis during the pregnancy or after, this may come as a shock to you but this is also not normal! While it is very common that women experience pain throughout this time, it is definitely something that can be avoided or managed.
Most commonly when women reach their 2nd or 3rd trimester, the weight of the baby bears down on the pelvic bone, compressing the sciatic nerve. This compression radiates pain from the low back, down the bum and continues sometimes to the lower leg. The hormone relaxin that was mentioned earlier is partial to blame for this as well. The increased relaxation of the muscles allows women’s posture to falter and subsequently increases the strain on the lumbar spine. Posture corrective exercises as well as external support systems (such as maternity support belts) can make all the difference for these ladies.
Keep in mind that this does not suggest that there will not be any discomfort following your pregnancy. Regardless if you had a vaginal birth or a caesarean section, your body just went through a great deal of trauma. It will require heeling time and some discomfort will be associated with that.
Consider what happens when you have a shoulder injury that requires surgery. You have the surgery and the doctor says what? “Hope you don’t have any complications, don’t come back”? Not likely! They will ask that you return after a period of time to ensure that you have healed properly and likely encourage you to visit a physiotherapist to rehabilitate the healing muscles. Why would giving birth be any different? Pelvic health therapists suggest that patients return for an assessment roughly 8-weeks postpartum.
Pain with Intercourse
Thankfully, this again is NOT NORMAL! The reality of it though is that 1 in 4 women experience pain during sex even after 18-months of having a child. This discomfort is fortunately treatable as well, through the use of specific exercises and breathing techniques.
Many health care professionals will encourage women to wait 4-6 weeks before engaging in sexual activity. However, it is common for some women to feel ready sooner and others to wait much longer. Many therapists will not encourage women to push through painful postpartum intercourse. Repetitive painful experiences can actually make your body anticipate sex and increase tension of the muscles, leading to increased pain.
Pelvic health therapists report that it is common for women to feel that they are not themselves after giving birth. Some find that they have difficulty returning to activity, sleeping and being sexually active. Understand that your body should heal and return to whatever your previous normal was. These women are almost always right when they sense that “something is off”. Pelvic health therapists find that these patients respond very well to treatment. If you are someone who doesn’t feel like yourself or this sounds like someone you know, be sure to seek medical help.
We are very grateful at Leduc Physio to have the very talented Pelvic Health Physiotherapist, Kalie Carlton, on staff. Kalie received her Masters in Physiotherapy in 2015 and has since completed her level 1 and 2 certifications for Pelvic Health therapy. Although this post talked mainly about the relationship between pelvic health therapy and pregnancy it is a common misconception that pelvic health is entirely for women. This is not true. Both men and women can benefit from seeing a Pelvic Health PT.
To learn more about how Pelvic health therapy can benefit you and to begin your own program, book an assessment with Kailie at www.leducphysio.janeapp.com or call the front desk at (780) 980-5443.