We have put together a few tips and exercises to help you recover after having your baby.
It is important for everyone to do some pelvic floor strengthening after they have had a baby.
The pelvic floor muscles are a ‘hammock’ of muscles underneath your pelvis. They attached at the front of the pelvis to the pubic bone and span backwards to attach at the base of the spine around the sacrum and coccyx (tailbone). The opening of the bladder, birth canal (vagina) and the bowel all pass through the pelvic floor.
1. The pelvic floor muscles are continually working to help support your pelvic organs and abdominal content (bladder, uterus in women and bowel) from underneath and stop them dropping down.
2. The pelvic floor muscles help with bladder and bowel control. The pelvic floor muscles circle around the opening for the urethra, vagina and back passage and stop you leaking urine, wind or faeces. The muscles need to work harder when you cough or sneeze or on exertion to avoid leaking.
3. The pelvic floor muscles have an important sexual function, helping to increased sexual awareness for you and your partner during sexual intercourse.
Common disorders of the pelvic floor include urinary incontinence (leaking) or prolapse of the vaginal walls or the uterus. Like other muscles in the body, ‘if you don’t use then, you lose them’. They weaken and are no longer efficient at doing their job. The pelvic floor muscles are affected and can weaken for a variety of reasons:
Pelvic floor muscles need to be exercised like any other weak muscles.
A pelvic floor muscle contraction is performed by closing and drawing up your front and back passage. Imagine you are trying to stop yourself from passing wind and at the same time trying to stop your flow of urine. The feeling is one of ‘’squeeze and lift’. In the beginning it may be easier to do the exercises lying, but you can progress them to sitting or standing. You can feel the correct muscles by placing your index finger or thumb into the vagina.
There are two types of pelvic floor exercises you should do;
1. Quick and strong
Squeeze as hard as you can and then let go completely. Rest a second and then repeat. Aim to build up to 10 in a row. This exercise will help you to contract your muscles quickly when you laugh, cough etc.
Perform a pelvic floor contraction and try to hold it for as long as possible. Try to build up to holding for 10 seconds. You must feel the muscle relax at the end of the contraction. Aim to repeat it as many times as you can, building up to a maximum of 10 times.
You must aim to do these exercises at least 3 times a day. Generally, it takes 3-6 months to get a muscle really strong again. Do not do so many that the muscle begins to ache remember it is quality not quantity!
Urinary incontinence can occur after having a baby or for other reasons throughout life. Doing pelvic floor muscle exercises may help to prevent this. If you are struggling with any urinary incontinence you can chat to the GP or refer into physiotherapy.
Types of urinary incontinence:
The muscles that control your bowel can also be affected after child birth. During child birth the sphincter muscles at the bottom of the rectum can be stretched or damaged. This can mean it is difficult to control wind or bowel movements. If you have any concerns about this, you can chat with your GP or refer in for physiotherapy for advice.
The pelvic organs in a woman’s pelvis (uterus, bladder and rectum) are normally held well in place by ligaments, muscles and connective tissue. If the supporting structures are weakened or become overstretched, with the help of gravity, the pelvic organs can bulge (prolapse) from their natural position into the vagina. This is known as a pelvic organ prolapse (POP). Pelvic organ prolapses are common in women. For the majority of women prolapses are mild and do not cause any problems. However it may cause a heavy, dragging sensation and you may be aware of a bulge in the vagina. This can affect bladder, bowel and sexual function. If you have any concerns chat with your GP or make a referral to physiotherapy.
If you are having back or pelvic pain you can refer in for advice from physiotherapy. Here are a few tips and exercises to help get you started.
Top Tips to ease pain
Sometimes your tummy muscles can separate during pregnancy.
It’s common for the two muscles that run down the middle of your stomach to separate during pregnancy. This is sometimes called diastasis recti, or divarication. Normally the muscles will start to close in the few weeks after you have had your baby. You can self-refer in if you feel that the muscles are not coming together as they should.
You can start gentle exercises when you feel up to it. Anything higher impact it may be better to wait until your 6 week check up with the GP. You may wish to wait longer if you feel any signs of incontinence or prolapse as it takes time for your body to strengthen up again as it takes time for your muscles to strengthen up again.
Remember it will take many months for your body to recover fully! These are just some tips and exercises to help you on your way but if you have any concerns we are here to help.
Post Partum Exercise and AdvicePelvic Health
GP Debenham Group Practice, IES CCG Prescribing and Diagnostics Lead
We are experts in musculoskeletal and pelvic health physiotherapy, providing specialist assessments, management and self-management to our communities, helping them to return to optimal health and stay healthy.