Q&A: How to treat common pelvic floor issues women experience after pregnancy
Two of the most common issues are urinary incontinence and pelvic pain. Unfortunately, women who have both natural and Cesarean births struggle with these issues, but there is hope.
Q: What are the most common pelvic problems that women experience after pregnancy and how do you treat them?
A: New moms are often surprised with the many issues that they experience after giving birth. Two of the most common issues are urinary incontinence and pelvic pain. During pregnancy and the birthing process, many of the pelvic muscles, ligaments and support structures get injured or stretched out, and getting things back to normal, or at least back to a manageable place, can be complicated or difficult.
Women who have both natural and Cesarean births struggle with these issues. But there is hope. Knowing the responsibilities of the pelvic and core muscles can help you regain some of your pre-pregnancy body. Getting the assistance of a professional to properly diagnose the problematic musculature can be a real game changer.
In my practice, I am lucky to work with Michelle Fritz, a physical therapist who is an expert in women’s pelvic health. She explained what you can expect from a pelvic floor physical therapy examination postpartum (usually after six weeks). First, she talks with the patient about the details of the birth as well as any relevant past gynecologic and medical history. She also discusses the patient’s primary complaints and functional limitations, then she examines the patient’s core strength, breathing mechanics, posture, lumbar/lower extremity strength and flexibility as well as gait and balance.
In addition, a pelvic floor examination to assess the flexibility and strength of the main pelvic floor muscles may be needed. Finally, she develops a plan with appropriate exercise and manual techniques to reduce pelvic pain, increase strength, and improve function.
A common exercise prescribed postpartum is diaphragmatic breathing with transverse abdominis contraction. Many women who experience a Cesarean delivery are often cut at the transverse abdominis (TA) muscle and may have difficulty activating their core properly. Women who have had a vaginal delivery may also have difficulty activating the TA because of diastasis recti, a separation of the rectus abdominis muscles. This is very common with pregnancy as these muscles separate to make room for the growing fetus. Sometimes, the muscles do not come back together after delivery, and this can contribute to core and pelvic floor weakness.
To perform the exercise, take a deep inhalation through your nose, allowing your belly to fill. As you exhale through your mouth slowly, lightly tuck your belly button toward your spine without moving your pelvis to activate the TA muscle. This exercise can be performed lying, sitting, and standing as well as with functional activities such as getting up from a chair or lifting the baby.
Hopefully, this basic exercise can start the ball rolling to get your body back. As always, seek the opinion of a medical professional before beginning any therapy program.
Marc Legere is a chiropractor specializing in myofascial release in Blue Bell and Cherry Hill. He can be reached at mlegere@patchtechnique.com.