I have been encountering some great questions about the postnatal pelvic floor. Below is a list of the most common questions.
Q: How long after delivery should I wait to see a pelvic floor physiotherapist?
I generally recommend waiting 6 weeks before having an internal vaginal examination; your body requires time to heal. However if you are experiencing low back or pelvic pain, seeing a physiotherapist sooner will be beneficial.
Q: I have Diastasis Recti, can pelvic floor physiotherapy help?
Diastasis Recti (or DRA for short) is a separation of the connective tissue that joins on the abdominal muscles. It typically occurs along the linea alba (connective tissue line attaching the ribs to the pubic bone). It is due to stretching of the abdominal tissue to accommodate your growing baby, however the tissue can remain stretched well after delivery.
The goal is support the connective tissue through control of transversus abdominus (deep abs). The transversus abdominus is part of the deep core system along with the diaphragm, pelvic floor and multifidus (deep back muscles); the whole system must work together to be functional.
Until you have been evaluated by a trained professional and it is determined that you have adequate deep core control, avoid abdominal exercises including planks, crunches and double leg lifts.
Q: Which exercises are best during the early postpartum period?
Everybody will respond differently in the early postpartum period (first 6-8 weeks) and you should return to physical activity at a pace that is right for your body. It is advisable to have an evaluation with a pelvic floor physiotherapist to ensure it is safe to return to activity, together you will discuss your goals and develop a plan that is right for you.
Generally low impact activities like walking and swimming are safe for the body in the early postpartum period.
Q: I had a Cesarean Section, yet I am still experiencing urinary leakage when I cough, I thought my pelvic floor would be okay?
During a cesarean section, the abdominal muscles, including transversus abdominus are cut to allow access to the uterus. Our deep core system must work together to be functional, therefore a dysfunction in one area can lead to a dysfunction in another, in this case in the pelvic floor.
Secondly, following a cesarean section, scar tissue is created as the incision heals. This may create restrictions in the deep core system, creating dysfunction to the system as a whole.
Q: When will I feel like myself again?
The immediate post partum period is considered to be 6-8 weeks. However, keep in mind that your body underwent a beautiful change over a 9-10 month period where your abdominal and pelvic floor organs shifted to accommodate your growing baby. It can take at least as long for you body to make the transition back.
Be patient, it’s hard work to grow and nurture a child. Working with a pelvic floor physiotherapist in your area that you connect with will help you reach your goals.
Stay tuned for part 2……