WHAT IS THE PELVIC FLOOR?

If you would have asked me 4 years ago what the pelvic floor is, I probably would have told you it’s the back room in a club where shady dancing happens. After my first child, I remember peeing myself a little when I was working out, and honestly, I just thought that was my forever because #motherhood.

During my second pregnancy, I started working with a trainer who specialized in pregnancy and postpartum and she started teaching me about the muscles that hold everything together. Little did I know, it is so much more than kegels.According to the Continence Foundation of Australia, “The floor of the pelvis is made up of layers of muscle and other tissues. These layers stretch like a hammock from the tailbone at the back, to the pubic bone in front. A woman’s pelvic floor muscles support her bladder, womb (uterus) and bowel (colon). The urine tube (front passage), the vagina and the back passage all pass through the pelvic floor muscles. Your pelvic floor muscles help you to control your bladder and bowel. They also help sexual function. It is vital to keep your pelvic floor muscles strong.”

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Supporting my bladder, womb, and bowel?

Helping sexual function?

Sounds like an important part of the body. It’s kind of a disgrace that we don’t learn about this in sex ed. Or anatomy. Or the OB office or… anywhere unless we actively seek it out.

BODY CHANGES IN PREGNANCY AND BIRTH

During pregnancy and childbirth, a baby is bearing down on your pelvis which impacts the tissue and muscles. Whether you deliver vaginally or have a cesarean birth, you experience a change. This function is also closely tied to your abdomen which often experiences separation during pregnancy and postpartum, adding to issues such as incontinence. As you carry and deliver a baby, there are several shifts- these shifts cause the muscles and tissue to adapt to the changes.

WHEN DO YOU NEED PELVIC FLOOR THERAPY?

If you’re experiencing painful sex, a heavyweight feeling in your pelvic area, or are experiencing urinary or bowel incontinence, it’s a good idea to seek out physical or occupational therapy. If you’re feeling out of touch with your body after giving birth, you may benefit from pelvic floor PT. Many professionals recommend that all mothers get some level of PT after giving birth, regardless of red flags, because of all of the changes and impacts on that area during pregnancy and childbirth. In countries such as France, this therapy is standard care after birth for every mother. While many women are thinking about weight loss and outward appearance after a baby, there is much more, and by actually addressing the internal, you set yourself up for a stronger, connected body.

ARE KEGELS ENOUGH TO FIX MY PELVIC FLOOR?

The pelvic floor is so much more than kegels. I’ve been doing kegels for as long as I can remember and when I went to PT, she told me I needed to RELAX my pelvic muscles. Everything was holding tension and not being able to relax my floor muscles was contributing to painful sex and bladder issues. Come to find out, I hold stress in my shoulders, hips, and my pelvic floor. Kegels can be a great part of strengthening and healing IF that is what you need. Seeing a pelvic floor therapist allows them to examine your muscles and tissue and give you insight as to what will help it best function.

After seeing my therapist for 3 months, I “graduated” with exercises to do at home and then started using the Perefit Kegel exerciser to gamify my exercises- it helps you to both contract and relax the muscles and helps you to build endurance. And honestly, kegels are more fun when you’re collecting stars.

Are you looking for a virtual way to learn about proper postpartum exercise? Check out the 6 week course from Strong Body Strong Mama Fourth Trimester Restore (and tell her Chelsea sent you!)

WHAT DO THEY DO IN PELVIC FLOOR THERAPY?

Does the idea of having someone “evaluate” and help you “repair” that whole area, “down there” feel a little intimidating? I know. But let’s face it, if you’ve given birth you’ve already had someone else “down there” so giving it attention to improve its function doesn't have to be scary.

There are different approaches to pelvic floor therapy. To get an accurate understanding of your function and needs, your therapist will most likely want to do an internal exam. (If you’re uncomfortable with this, there are ways to talk about your pain/function and provide ideas without an internal exam, however, your assessment may not be as accurate and therefore your treatment may not be as effective.)

BIOFEEDBACK

Some pelvic floor therapists use biofeedback to gauge your function. With biofeedback, sensors and a computer monitor are used to show muscle activity and allow you to see what areas need attention.

DRY NEEDLING

Dry needling is a method of relieving tension that involves inserting a thin needle into the muscle tissue.

MANUAL MANIPULATION

Similar to dry needling, manual manipulation targets the release of muscle tissue but the therapist will use hands or another tool as opposed to needles.

STRENGTHENING EXERCISES

Your therapist will teach you exercises you can do in your therapy as well as at home to exercise your pelvic floor. This may emphasize contraction strengthening and endurance or relaxation of the pelvic floor muscles (or a combination.) While I highly recommend seeing a therapist who can help you with an individualized plan, you can also find resources online. Please find exercises from someone specifically trained in prenatal and postpartum care such as Strong Body Strong Mama.

CHAT WITH A PELVIC FLOOR EXPERT

Sarah from Pelvic Floor and More answers questions just like yours so that moms can understand their pelvic floor and be empowered to take care of it- from understanding to advocacy to practice. Listen in and learn- because you deserve to!

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