Early Postpartum Tips for Pelvic Floor
Women’s health expert Physiotherapist Jenny Devlin gives insight on what you might expect from your postpartum body and the best approach to begin exercise and optimise your recovery
WRITTEN BY JENNY DEVLIN, MSK PHYSIOTHERAPIST AND SPECIALIST WOMEN’S HEALTH PHYSIOTHERAPIST AT PHYSIO EFFECT
So, you’ve just had a baby… CONGRATULATIONS!!
The first days and weeks postpartum can be a blur and prioritizing pelvic floor exercises might not be at the forefront of everyone’s mind. There are some things you can do, however, throughout the day to start working on your pelvic floor while also enjoying sweet baby cuddles.
BREATHE
Something that we do every day but often don’t do well. Once we have had a baby our breathing is often altered as our baby has been taking up the space in our abdominal cavity and achieving a deep breath might have been tricky for the past few months. Remembering how to take deep breaths can help with the healing process. Our diaphragm and pelvic floor move together and as a result breathing deeply in can help relax and lengthen the pelvic floor muscles and conversely exhaling can help engage the same muscles.
Women’s health Physiotherapist, Mariam Kilpatrick, educating a patient on diaphragmatic breathing.
Getting the muscle pump of the pelvic floor working can aid pelvic congestion and help heal the tissues through lymphatic drainage.
Deep breathing can also help us enter into ‘rest and digest’ mode which can help us feel calm and decrease anxiety and enjoy being present with our baby.
You can practice breathing anywhere but it might be easiest sitting or in a semi-reclined position. Make sure you’re comfortable. Inhale slowly through the nose, feeling the air fill the lungs and the pelvic floor lengthen. Exhale gently through the mouth and feel the recoil of the tissues. Keep your shoulders and jaw relaxed. You can learn more about the structures that make up your abdominal cannister, including your pelvic floor in our recent Blog Post.
Posture
Throughout the day, check in with your posture while sitting, standing and moving around. Has your posture changed since having your baby? Can you find your way back to your previous position?
How we hold ourselves while feeding baby for many hours per day is important. Make sure baby is supported to come up to you, so that you don’t have to hunch over to feed. Try to maintain an upright posture for feeding as much as you can - it has an impact, not only on your back, neck and shoulders, but on your pelvic floor too! This NHS guide has ideas alternative breastfeeding positions from the commonly adopted ‘Cradle Hold.’
Image Credit: Shutterstock. Breastfeeding in a reclined position can ease the tension of a painful back and shoulders.
Have a think when you’re holding baby, are you always holding them on one side? Can you switch? Can you wear them for a while in a carrier instead of carrying them? Try placing your hands on your ribs and stacking them over your pelvis.
There are lots of little ways we can improve postures throughout the day to make our pelvic floor a little happier and function better too!
Pelvic Floor Exercises
Throughout the day try to practice a few pelvic floor muscle contractions. You may find it easier to do it lying down or in sitting. Check in with yourself and see what you can feel. You should be able to feel a gentle lift of the pelvic floor without your pelvis tilting and without your legs or bum muscles working hard. You should also be able to feel it relaxing. Try for some longer contractions and some short, fast ones too.
Women’s health Physiotherapist Mariam Kilpatrick demonstrating the ‘Butterfly’ Technique to connect with your pelvic floor.
Gentle Exercise
In the first days postpartum, take it easy. No matter how your baby was born, the body goes through a lot to bring your little one into the world. You might feel like you can do more exercise wise, but do you really need to? Give your body time to rest and recover and gradually build in your exercises. The first days or weeks might start out just thinking about pelvic floor, core and posture and progress from there. We are all about getting you back to doing the things you LOVE so let’s make sure you’re doing them sequentially in a way that’s right for your body and will allow you to continue doing them long term!
We offer ‘CryBaby Pilates’ classes in our Studio to women and their babies from 6 weeks postpartum.
See a Pelvic Floor Physiotherapist
Pelvic floor symptoms are common, but they are not normal! We hear a lot of people normalizing pain or incontinence. Often ladies don’t know there is help out there but there is level 1, grade A evidence to show that pelvic floor assessment and treatment can improve pelvic floor function. Enjoy baby cuddles and gentle progressive exercises and anywhere from the 6 week mark, come and see us and have a pelvic floor evaluation so we can do an assessment, assist with any symptoms and help you work towards your goals, no matter what they are.
What is Pelvic Floor Physiotherapy?
What is pelvic floor physiotherapy and how can our team help you get back to doing the things you love symptom free?
Written by Jenny Devlin, MSK Physiotherapist and Specialist Women’s Health Physiotherapist at Physio Effect. MCSP & HCPC
What is pelvic floor physiotherapy?
Pelvic floor physiotherapists are musculoskeletal physios who have undergone specialised training in assessing and treating conditions that affect the pelvic area. This can be from pregnancy, childbirth or surgery but it does not have to be!
Some pelvic floor issues that can be treated with pelvic floor physiotherapy include:
Urinary and faecal incontinence
Urinary urgency, retention, frequency
Diastasis rectus abdominus
Pain with bowel movements or urination
Pain in the vulvar area (vestibulodynia, vulvodynia)
Painful intercourse (dyspareunia)
Constipation
Interstitial cystitis
Pudendal neuralgia
Endometriosis
Low back pain
Hip pain
Prenatal care - including pain management, exercise advice, positions for birthing, breathing techniques
Postpartum care - including return to sport
Jenny Devlin, specialist pelvic health Physiotherapist explaining pelvic health assessment
What does a pelvic floor assessment involve?
At your first appointment you will be asked several questions about your current symptoms, past symptoms and other relevant medical and social information.
We will then conduct a physical assessment which will be different for everyone depending on what’s going on with you. It will likely involve postural assessment, checking your pelvic alignment, tummy muscles and how your body moves when you do certain tasks like squat or stand on one leg.
If your pelvic floor seems to be involved then we will recommend an internal assessment. The benefits of a digital vaginal or rectal examination are that the physiotherapist is able to assess tension, strength, prolapse and improve activation of the muscles. The risks are that there may be local discomfort or emotional stress, skin reaction, nausea or bleeding, though we take all measures to minimise these risks.The alternative is doing an external examination and observing the abdomen and giving verbal cues for exercises, however, we will not know exactly what the muscles are doing and often progress is slower with this option. All of this will be discussed with your physiotherapist prior to therapy and throughout treatment. Consent to assessment and treatment can be withdrawn at any time. You are in charge!
Women’s Health Physiotherapist Jenny Devlin conducting a pelvic floor assessment with a female patient.
Does pelvic floor physiotherapy work??
Studies have shown that pelvic floor physiotherapy has Level 1, grade A evidence for treating urinary incontinence and pelvic organ prolapse. Clinical guidelines (2008) on the conservative management of urinary incontinence by the Society of Obstetricians and Gynaecologists of Canada recommend “proper performance of Kegel exercises should be confirmed by digital vaginal examination or biofeedback”. This is crucial because a high percentage of women can not contract their pelvic floor correctly. Further to that, performing more kegel exercises may not be what you need and an assessment with a trained pelvic floor physiotherapist can help guide you as to what treatment is most effective for your body.
Often people are prescribed pelvic floor physiotherapy in their postpartum period or when they are older but physiotherapy should be routine for pregnant people too. Research shows that pelvic floor muscle training between 20-36 weeks of pregnancy had a shorter second stage of labour, less urinary incontinence and less pregnancy related low back pain compared to people who did not perform pelvic floor exercises. This is an essential time to have your pelvic floor evaluated, learn optimal positions and breathing for labour and delivery and to set yourself up for a more successful postpartum recovery.
Make sure you align yourself with a pelvic floor physiotherapist who understands that not all pelvic pain is tissue based. Pain, especially chronic pain, is multifactorial and therefore it is so important that you find a physio who understands the relationship between pain, biological factors, the nervous system, psychological and social factors so that you can have the best outcome!
How do I know if pelvic floor physiotherapy is for me?
Do you have a pelvis? Then the answer is YES, pelvic physio is for you! Joking aside, there are so many reasons that might bring you to a pelvic physiotherapist. If you have pain or discomfort in your pelvis area; heaviness or pressure at the vulva, vagina or rectum; leaking of urine or stool; need to go to the toilet often or experience urgency or have pain with intercourse. If you have uncontrolled doming of your tummy muscles when you move or have noticed a gap between your tummy muscles. If you have issues with constipation, hip pain or low back pain. If you are pregnant and in pain, or are looking for exercise guidance or tips and tricks for labour and delivery. If you are postpartum (6 weeks after childbirth for a vaginal exam, though physiotherapy can start before that). If you want to make a plan for returning to running or working out or to make day to day tasks feel easier on your body.
Still can’t decide? Call us on 01412304766 to discuss or use the link below and book your initial assessment, we will figure out what is best for you.