Pelvic floor physiotherapy (PT) is a specialized type of physiotherapy that has been growing in popularity over the last number of years. In fact, in France, Belgium, and many other countries, pelvic floor rehabilitation is a typical component of postpartum care, for every women that has a baby.
We are joined by Melissa Wong, owner and pelvic floor physiotherapist at Markham Pelvic Health to answer your questions regarding pelvic floor physiotherapy and how it might benefit our pre and post-natal clients.
How is pelvic floor physio different than a regular physio?
Pelvic floor physiotherapy is just like regular physiotherapy except that there is specialized post-graduate training to address issues affecting the pelvis and surrounding structures.
What is the pelvic floor and how do you assess it?
The pelvic floor is a group of muscles that sit inside the pelvis. Imagine them arranged like a wide hammock running from the front of our bodies to our tailbone, and side to side towards each hip. The pelvic floor is responsible for bladder and bowel control, sexual function, pumping of blood through the body, supporting our internal organs, and stability to help hold us upright. Because the muscles sit inside your body, the best way to truly assess the muscles is to do an internal examination, either rectally or vaginally. We typically use a finger to feel the strength, endurance, and state of the muscles. Just like your neck muscles can be tight, weak, or painful, your pelvic floor muscles can do the same.
What are common reasons a pregnant woman would see you in her pregnancy?
The most common reasons a pregnant woman would come see a pelvic floor
- Urine leakage (with sneezing, coughing, or exercise)
- Pain or discomfort in the low back, hips, pelvic bone, or vagina
- Ensure she is doing kegel exercises properly (50% of people do them incorrectly!)
- Help a woman get ready physically for labour and delivery, including teaching how to relax the pelvic floor, how to “push” without over-straining the pelvic floor, and teaching perineal stretching
Do kegels really work? And how can a mom-to- be prevent tearing?
International guidelines state that kegel exercises must be considered the first line of defense to help with bladder or bowel leakage. The problem is that up to 50% of people who perform kegel exercise actually do them incorrectly! Research also shows that performing perineal massage can help reduce the risk of tearing during delivery and the need for an episiotomy. Learning how to do both can greatly assist in both the delivery and postpartum periods.
What are some symptoms a postpartum mom might experience that you would recommend them see a pelvic floor physio?
The body does a lot of natural healing postpartum. If you are experiencing any of the following symptoms after your baby, especially after 6 weeks, we recommend coming in for an assessment sooner rather than later.
Issues a new mom might experience include:
- Persistent abdominal bulging
- Neck, back, or pelvic pain
- Vaginal, perineal, or rectal pressure or bulging sensation
- Bowel or bladder leakage
- Difficulty returning to exercise
- Pain attempting to return to intercourse
- Pain around stitches, whether you had a vaginal or cesarean delivery
How does a C-section affect the pelvic floor?
Many people think that although they had a Cesarean birth, their pelvic floors have been spared the “trauma” that might have occurred with a vaginal delivery. Unfortunately, this is not true! Although a baby did not travel through the birth canal, the pelvic floor muscles and the pelvic ligaments were under the same amount of pressure over the previous 9 months of pregnancy. A woman’s posture
still changes in the same fashion to adapt to a growing baby, and unfortunately, women are at risk of experiencing the same difficulties postpartum as a woman who had a vaginal birth.