Pregnancy and birth are amazing experiences but they can certainly take a toll on your body.
AusHealth physiotherapist Jenni Davies offers invaluable insight on how to get back to full health and great shape.
The changes your body goes through to accommodate the growing baby, over approximately nine months, are phenomenal. During a vaginal birth, the pelvic floor muscles stretch up to five times their original length.
In approximately 50% of women, these changes reverse naturally and completely. In the rest, the residual changes can present in the following ways:
■ Weak/lengthened, or weak/tight pelvic floor muscles (PFM)
■ Prolapse of the bladder, uterus or bowel (symptoms of dragging/heaviness/pain in the lower abdomen or back/ feeling of vaginal fullness/bulging/lump)
■ Painful intercourse
■ Inhibition of the PFM
■ Abdominal separation
■ Urinary(bladder), faecal (bowel) or fl atus (wind) leakage
■ Increased urgency and/or frequency to get to the toilet
■ Pelvic, hip or low back pain
■ Difficulty passing bowel motions or using tampons
Typically, once your baby is born, the focus shifts to the health of the baby, You have your six-week check with your Doctor and unless you have major pain or incontinence symptoms, it is assumed that you, as the Mum, are fine. Cultural expectation is that we should regain our pre-baby body within weeks so we return to exercise quickly.
However, the research is telling us that approximately 50% of us will have long standing physical changes. This partly explains why the long-term statistics are so high for incontinence and prolapse (50% of 40-49 year-old women have incontinence, 70% of 40-60 year-old women have prolapse). This is the guilty secret of our society.
The great news is that specific treatment with a Pelvic Health Physio is effective in up to 90% of people. The soft tissue softening hormones that occur during pregnancy, don’t fully return to normal until after you finish breastfeeding and have 2-3 normal menstrual cycles, this
gives us a wonderful window of opportunity in the first few months after birth to maximize improvement.
The down side of this “slow” hormonal change is that you are also at a much greater risk of causing more damage during this period if you return to intense sport or exercise with an underlying problem.
So, if you have any of the symptoms listed above, or have any of the risk factors listed in the box, or don’t have any symptoms but want to check that you are not at risk of causing more damage, especially pre-sport and exercise participation, I recommend that you get a full pelvic health assessment. This can be done at any time post-birth (even years after), but, if there are no severe symptoms, come in at six-weeks or before you return to sport.
The assessment involves:
■ A detailed conversation about your symptoms, birth/pregnancy history, relevant medical/injury history, current level of activity and goals
■ An external physical assessment – looking at spine, pelvis, hips, abdominals, overall muscle function
■ An internal assessment - looking at scarring, pelvic floor muscles, function of the deep core stability unit, position of the pelvic organs and specific measurements to identify your risk factors for future pelvic organ prolaps
This information is analysed and together we create a treatment/rehabilitation plan to enable you to reduce your symptoms and reach your goals. Alternatively, if there are no issues that need addressing, you are given the all clear to continue as normal.
Please note: You will see post-natal checks advertised using real-time ultrasound (RTUS) for diagnosis of pelvic floor issues. Unfortunately, the RTUS is a great tool to assist with assessment and treatment, however it really does not give sufficient information to diagnose pelvic floor dysfunctions.
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