PELVIC FLOOR EXERCISES FOR POSTPARTUM RECOVERY

Mom with kid and Perifit

 

One of the most beautiful, complex, miraculous journeys of a woman’s or birthing person’s life can be pregnancy. Over 9 months, our bodies experience so many amazing changes. In addition to our bellies growing, our hearts expand forever to welcome our new babies. Pregnancy and birth is an athletic event, stretched out over a long period time, and sometimes our bodies need a little bit of help recovering after the physical changes and demands of having a baby.

What happens to the pelvic floor during delivery?

Let’s talk about the pelvic floor and what really happens during and after a vaginal birth. The muscles have to relax, stretch, and open to allow the baby to move down the birth canal and be born. Sometimes the muscle may tear, or become strained. This demand, or load, on these muscles can lead to pelvic floor muscle dysfunction after baby, as they are healing from a repair or a tear. The muscles can be weakened, overstretched, or too tight, which means they have a hard time contracting, relaxing, doing their job, and this may cause pain. There are ways to help you heal, recover, and regain strength in the pelvic floor muscles after having a baby, and most women and birthing persons are very successful with rehabbing those muscles, if they have the right program in place.

There are so many things to do to help! Pelvic floor rehab and proper pelvic floor exercises as part of your postpartum recovery plan are shown to help decrease pain, increase pelvic floor function, and improve overall pelvic health. This can help prevent future issues with leaking, prolapse, and pain, if you’re planning for more children or while you travel through your motherhood journey.

What are pelvic floor exercises? 

Pelvic floor rehab is used to improve strength and control of the pelvic floor muscles, so they can function as close to their prior level of function as possible. To really make this effective, your training and exercises should have 3 main components: Overload, Specificity, & Reversibility.

  • “Overloading” is when we stress and “load” the muscles: in a good way. We want to actually make them work hard, so they can get stronger and work more effectively. It’s the same idea of increasing weight when you work out at the gym: if you stayed at the same weight all the time, you’d never see any improvements in strength.
  • “Specificity” is really about making this habit. It’s specialized, focused exercises and movements that you need during a specific exercise or activity (like coughing or lifting) that help train the muscles to do that movement on it’s own, without having us to think about it. Kegel exercises are one way to do this, and they help the pelvic floor contract when it should, and helps train both types of muscle fibers that are found in the pelvic floor. It’s important, however, that Kegels are properly performed, prescribed, and monitored
  • “Reversibility” means that it’s important to maintain your strength and function, and that if we don’t use our new found strength in our pelvic floor muscles, it’s easily lost, or “reversed”. This is very similar to running or other exercises you may do for your arms: If you stop running for a few weeks, that endurance, strength, and cardiovascular fitness decreases and it feels hard!

Do I have to practice pelvic floor rehabilitation after childbirth? 

Let’s say this: it would help you SO much! Proper pelvic floor exercises and rehab can help with pain, speed up recovery, and possibly prevent further issues (like leaking urine and pelvic organ prolapse) down the road. Stress incontinence (leaking urine with laughing, coughing, sneezing, or jumping), leaking bowel movements, pain in the vagina and perineum, and prolapse (where your organs sit lower in the vaginal canal) can be from pelvic floor dysfunction, and many women will experience this up to a year after birth or even longer.

When can I start postpartum pelvic floor training?

This varies for everyone, but the general rule is around the 6-8 week mark after baby (c-section or vaginal birth), when your doctor or midwife clears you for safe exercise and sex. It takes about that long for tissue and wound healing, and we don’t want to rush anything. We want to make sure your program is successful and consistent, and that you are ready and feeling good to start your recovery right!

How Perifit can help strengthen your pelvic floor after birth

Kegels can be one of the best ways to prevent, help heal, and decrease symptoms of pelvic floor muscle dysfunction, but it’s actually quite hard to make sure you’re doing them correctly and to measure your improvement. This is where Perifit can help! Perifit gives you instant feedback about your pelvic floor contraction, and actually makes doing your program fun! The app uses games to help you train your pelvic floor successfully, and it also provides you with statistics and real time facts about progress and muscle activity. You don’t have to guess! You can be confident that you’re doing the right exercises for you, and that you are maintaining your strength gains and working towards a better, healthy, pelvic floor.

 

Article written by
Marcy Crouch, PT, DPT, WCS
Board Certified in Women's Health Physical Therapy
Creator and founder of The DT Method™️: The Standard for Birth Prep & PostPartum Recovery
@thedowntheredoc

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References:

Durnea CM, Khashan AS, Kenny LC, Durnea UA, Dornan JC, O'Sullivan SM, et al. What is to blame for postnatal pelvic floor dysfunction in primiparous women-Pre-pregnancy or intrapartum risk factors? European journal of obstetrics, gynecology, and reproductive biology. 2017;214:36-43. 

Kapoor, D.S., Freeman, R.M. Pregnancy, childbirth and urinary incontinence. In: Haslam, J., Laycock, J. (eds)Therapeutic Management of Incontinence and Pelvic Pain.London: Springer-Verlag. 2008. 

Hall B, Woodward S. Pelvic floor muscle training for urinary incontinence postpartum. British journal of nursing (Mark Allen Publishing). 2015;24(11):576-9. 

Elenskaia K, Thakar R, Sultan A, Scheer I, Beggs A. The effect of pregnancy and childbirth on pelvic floor muscle function2011. 1421-7 p.

Laycock J. Concepts of Neuromuscular Rehabilitation and Pelvic Floor Muscle Training. In: Baussler K, Shussler B, Burgio KL, Moore KH, Norton PA, Stanton S, editors. Pelvic Floor Re-education. 2nd edition. London: Springer; 2008. 

Deffieux X, Vieillefosse S, Billecocq S, Battut A, Nizard J, Coulm B, et al. [Postpartum pelvic floor muscle training and abdominal rehabilitation: Guidelines]. Journal de gynecologie, obstetrique et biologie de la reproduction. 2015;44(10):1141-6.

Women’s and Men’s Health Physiotherapy Team. Your recovery after childbirth. Physiotherapy, exercises and advice. 2016. Version 2. 

Kegel exercises: A how-to guide for women. (2018). Retrieved from https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/kegel-exercises/art-20045283