Sometimes your body does not just, “bounce back” from growing a baby inside and pushing a melon size head out of a lemon size hole! Muscles, ligaments and tissues are stretched and sometimes torn and this is especially true for our good ol’ pelvic floor.
Our pelvic floor stretches from the pubic bone at the front to the tailbone at the back. It can be likened to a trampoline in that it stretches in response to weight (like it does with a growing baby sitting on it) and can bounce back up again once the weight has gone. However, if it has been bearing a weight for a long time (third trimester with a big baby) the muscles can become over stretched and weak. This is why even mothers who have had cesareans may have pelvic floor dysfunction or abdominal pain from scars after giving birth.
During a natural birth, the pelvic floor is put through the wringer. Muscles can be weakened, over stretched, or torn if the pushing part of labor takes a long time – even worse if there are forceps used. In the few days after giving birth this area can often feel swollen, bruised and down right sore! And for some, leaking or pain can be a real issue (your pelvic floor also supports your bladder and bowel).
At the 6 weeks postnatal OB/GYN consultation they will check if everything looks O.K. before clearing you to resume sex and exercise. They will probably mention the word “kegels” as well. Kegel exercises help strengthen the pelvic floor by squeezing the pelvic muscle to build up endurance and power. (For example: you pull the pelvic muscle up as through you are trying not to pee, hold for 5 seconds, while you continue to breath normally, and then release. Then repeat).
Leaking after giving birth is normal. According to a 2001 to 2008 National Health and Nutrition Examination Survey, more than half of women more than 20 years old in the United States experience some type of incontinence. Crossing your legs when you sneeze or cough, and going to the bathroom before running/jumping can definitely help avoid embarrassing accidents, but are not the answers to the problem. If you still need to do this months or even years after giving birth it might be time to see a Physical Therapist. It can be fixed!
Angie Peters MPT, who has an office in Kihei and Makawao, explained that the first thing that would happen is a pelvic floor muscle evaluation, which includes an assessment of muscle strength and flexibility of the pelvic floor, hips, abdominals, and back. She would also look at the joint alignment of the pelvis and spine, your posture, body mechanics, and discuss behavioral patterns and current bladder habits too.
Physical Therapy treatments may include: pelvic floor and core strengthening exercises, pelvic girdle strengthening, postural correction, specialized massage techniques and myofascial release, and biofeedback to assist pelvic floor muscle training and/or pain control along with ergonomics training for infant care and work/ home activities. Just know that with the right therapy it can be corrected and our pelvic floors can be rehabilitated!
Image Credit: Jan Fransisco