What is the pelvic floor?
The pelvic floor is a collection of muscles, nerves, tendons, blood vessels, ligaments and connective tissues interwoven in the pelvis. These attach to your pubic bone in the front, the tailbone in the back and your sitz bones on either side.
The pelvic floor is also part of the core with includes the diaphragm, transversus abdominals and the multifidus. The pelvic floor has a role in breathing, stabilizes the spin and creates tension in the abdominal wall.
Function of the pelvic floor
The function of the pelvic floor is to support the pelvic organs: bladder, rectum and uterus. The pelvic floor plays a role in urinary continence – controlling when you need to pee.
During childbirth, the pelvic floor muscles must yield to allow for baby to pass through the birth canal and to help push your baby out for a vaginal birth.
Pelvic Floor Dysfunction
Pregnancy and birth do put a strain on the pelvic floor and challenges women face postpartum are often blamed on it.
Challenges after childbirth are common but they are not normal.
Incontinence is any unwanted loss of urine at any time. It is not normal to leak after having children. There are two main types of incontinence: stress urinary incontinence and urge urinary incontinence.
Stress urinary incontinence occurs when there is an increase in intra-abdominal pressure that the pelvic floor can’t manage, resulting in a leak of urine. Small amounts of urine may leak when laughing, coughing, sneezing or running.
Urge urinary incontinence is sudden and an uncontrollable urge to find a bathroom. This can be the result of scar tissue or nerve damage.
Pelvic Organ Prolapse
Pelvic organ prolapse is the descent f the pelvic organs including bladder, uterus or rectum, into the vaginal canal. A cystocele is when the bladder bulges into the vaginal wall. A uterine prolapse is when the uterus descends into the vagina and a rectocele is when the rectum bulges into the vagina. There are different stages of prolapse and not everyone experiences symptoms.
Pelvic pain can be the result of the pelvic floor being too tight (hypertonic) or lax (hypotonic). There may be discomfort in the lower back, pain during intercourse and pelvis.
Pelvic Floor Physiotherapist
You do not need to suffer. A pelvic floor physiotherapist is someone trained in physiotherapy and has additional training in the pelvic floor. An initial assessment may include an internal exam, where they can assess the function of these muscles and position of your organs.
A pelvic floor physiotherapist will help balance the pelvis and also recommend exercises to regain strength to this area.
Seeing one during your pregnancy will have many benefits as they understand what the female body does when pushing a baby out and can help prepare you for that day. After pregnancy, it is great to see one at 6 to 8 weeks for an assessment. It is the pelvic floor physiotherapist who should give you the green light to return to exercise activities.
You may already be familiar with Kegel exercises but not all women should perform them. If the pelvic floor is tight or hypertonic, Kegels will worsen any pain you may have. Kegels contract the pelvic floor muscles and making them tighter, when it is already too tight.
Seeing a pelvic floor physiotherapist will help determine if you are hypertonic.
To do a proper Kegel sit on an exercise ball or a firm chair. On an exhale breathe, imagine yourself picking up a blueberry or coin with your vagina and try to draw it upwards into the body. As you inhale, lower the blueberry or coin down. Once you have mastered the exercise sitting, you can try them lying down or upright.
Pelvic Floor Recovery
Every week we run a pelvic floor and core recovery class. This class is open to all postpartum women and your baby is welcome to attend with you.
We will learn how to breathe with the core and work on exercises that are safe for both vaginal and caesarean delivery. We focus on poses that retrain the pelvic floor and prepare your body for more high impact activities.