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Postpartum pelvic floor exercises


5 Exercises That Helped Improve My Postpartum Bladder Leakage

Oh motherhood. You bring so much joy and happiness to my life and I often forget what life consisted of before having babies….until I sneeze and pee my pants. Oh yes, I remember what it was like to be able to run, jump, sneeze, cough and not worry about the chance of urine spilling down my legs.

The love we have for our babies is indescribable. There is absolutely nothing we wouldn’t do for them. However, that being said, this does not mean we have to love every battle wound pregnancy and childbirth leaves behind. The female body’s ability to create human life is amazing. However, most of us are left with unpleasant side effects that can not only be embarrassing but actually cause chronic pain if left untreated.

Have you ever heard of Pelvic Organ Prolapse?

I had not. Pelvic Organ Prolapse is an incredibly common health condition for women yet it is often overlooked and not discussed. Despite not being able to do much to prevent it, it would have been nice to have a little warning that my bladder, or other organs, could actually fall out of place during delivery.

So here I am, sharing my own personal experience with Pelvic Organ Prolapse. At first, this felt like an extremely embarassing topic to write about. However, I truly think others need to be informed and aware. Let’s face the facts, I birthed an 8.5 pound baby. Things definitely do not go back to normal very quickly after something like that!

Again, this is my own personal experience with Pelvic Organ Prolapse.  If this is something you think you may be suffering from, I encourage you to see your doctor.
How I Discovered My Prolapse

About two weeks after my daughter was born, I felt a small “bulge” in my pelvis. Because I had no knowledge of pelvic organ prolapse, I was TERRIFIED! Long story short, I was referred to a Pelvic Floor Physical Therapist. The exercises that I share below are the ones I learned from my sessions.

Having an exercise science background, I understand the importance of physical therapy to help the body function more optimally without pain or discomfort. I believe that EVERYONE who has a baby should do some kind of pelvic floor physical therapy or be given exercises to help strengthen the muscles after childbirth. Even though our bodies are designed to have babies, this does not mean that we don’t suffer from injury as a result of childbirth.

Take This Example

If you were to rupture your bicep muscle lifting something heavy, you would be sent to physical therapy to rehab your arm. We need to think of it the same way for childbirth. Muscles, tendons and ligaments can get very stretched and even torn during labor and delivery. Living with pain, incontinence, or discomfort is not normal.

During delivery, my daughter had gotten stuck in the birth canal. In a rush to get her out because she was not breathing, the doctors had to aggressively wiggle and pry her out. This caused a great deal of trauma to my pelvis. Miraculously, there was no tearing however my bladder had prolapsed. The prolapse was minor however it still causes discomfort and could worsen without awareness and caution.

How I Recovered From My Traumatic Birth Experience

These exercises are from my own experience with a Pelvic Floor Physical Therapist. These were the exercises I was given to strengthen my pelvic floor. They are not meant to cure prolapse but I encourage EVERYONE to do them either during pregnancy or postpartum. It doesnt matter if you are 5 weeks, months or years postpartum, keeping our pelvic floor strong is very important. I also strongly encourage these exercises during pregnancy as well.What is Pelvic Organ Prolapse?

Medical Definition

Pelvic organ prolapse is a disorder in which one or more of the pelvic organs drop from their normal position. It is caused by injury to the muscles or tissues that support the pelvic organs.- ACOG The American Congress of Obstetricians and Gynecologists About one third of women are affected by prolapse or similar conditions over their lifetime.

This refers to the prolapsing or drooping of any of the pelvic organs, including:
Bladder
Uterus
Vagina
Small Bowel
Rectum
These organs are said to prolapse if they descend into or outside of the vaginal canal or anus. WebMD

My Definition:

The feeling of my organs falling out of my body. Okay, an exaggeration but it is not comfortable.

What are the causes?

The main cause of this injury is pregnancy and childbirth, especially vaginal childbirth. ACOG

What are the symptoms of Pelvic Organ Prolapse?

From personal experience, I felt a “bulge” in my pelvic area.

Symptoms vary somewhat depending on which organ has prolapsed:

  • A feeling of pressure or fullness in the pelvic area
  • Feeling of something actually falling out of the vagina
  • A pulling or stretching in the groin area or a low back pain
  • Painful intercourse
  • Spotting or bleeding from the vagina
  • Urinary problems such as incontinence or a frequent or urgent need to urinate
  • Problems with bowel movements, such as constipation or needing to support the back (posterior) of the vaginal wall to have a bowel movement.

Symptoms are typically worsened by standing, jumping or lifting. They are usually relieved by lying down.

How is it Diagnosed:

Pelvic Organ Prolapse is diagnosed during a pelvic exam. It is classified using the location (bladder, rectum, or uterus) and the degree or grade of prolapse. There are five degrees and is graded from 0 (no prolapse) to 4 (maximum prolapse)

What is Pelvic Floor Dysfunction?

Pelvic floor Dysfunction is a disorder that affects the muscles and or nerves in the pelvic floor or the surrounding structres. The pelvic floor muscles surround the urethra, rectum, vagina and prostate. If there is dysfunction in these muscles, it can cause urinary, bowel or sexual dysfunction in women and men.

How can a Pelvic Floor Physical Therapist Help?

Pelvic floor physical therapists specialize in the muscles, nerves and connective tissues that live between your legs, also known as the pelvic floor. They gain their expertise through a series of post-graduate continuing education classes, certifications, and training. Their training allows them to perform both internal and external pelvic exams, and broadens their knowledge of conditions which affect the pelvic floor.

Physical therapy is a practice of healing that restores function and reduces pain through the use of techniques to improve bony alignment, reduce trigger points, and improve muscle coordination and strength. Pelvic floor physical therapy is a branch of physical therapy and is built upon these same principles.-CMTMEDICAL

How can strengthening the pelvic floor help?

During pregnancy, our bodies release a hormone called relaxin which increases laxity in our joints. This increase in laxity can cause injury to the pelvic floor. A pelvic floor physical therapist can help expecting women prevent or recover from pregnancy related pain or dysfunction.

They can teach women how to coordinate their abdominal and pelvic floor muscles properly. It is very important to re-learn how to coordinate the pelvic floor muscles to prevent or worsen incontinence or pelvic organ prolapse.

5 Exercises that Helped My Bladder Prolapse and Prevent Me from Peeing My Pants

Below are the exercises that I was given during my Pelvic Floor Physical Therapy Sessions. The muscles in my pelvis were so damaged and weak that I was unable to hold a proper Kagel during my first visit. Pretty embarrassing!

And in case you are asking yourself how you’ll know if you are doing them incorectly, the physical therapist will either use their fingers or a device inserted into the vagina to feel for the strength of the muscles and to ensure they are being done properly.

Before you begin, locate your pelvic floor muscles.

Lie down with your knees bent. To do this imagine you are trying to stop your urine. Squeeze and lift the vaginal area without tightening your buttocks or abdominal muscles. Do not actually attempt to stop the flow of urine. This can lead to infection.

Next, imagine you are squeezing someone’s fingers and lifting at the same time. This is a little awkward but that’s how I figured it out! You should have a sense of pulling or squeezing.

The Exercises

Pelvic Floor Contractions or holds:

This works the muscles ability to hold.

  1. Slowly tighten and hold using the technique above. Imagine squeezing and drawing up without using your abdominals or clenching your buttocks.
  2. Hold for 5 Seconds
  3. Relax 10 seconds
  4. Start with 5-10 reps 2-3 times per day.
    *Gradually work your way up to 10 seconds per rep.

*I could not hold this for 5 seconds when I first started. It takes a great deal of concentration. I was very embarassed and discourgaed but it got much better!

Start these next two exercises lying down. When you get stronger, they can be done ANYTIME, ANYWHERE because no one can see you doing them!

Quick Flicks

A series of rapid contractions and releases.
Quickly tighten, lift up and release.
Start with 5 reps, 2-3 times per day and work up to 10 reps.

Roll Ins

Lay on your back, knees bent
Place a small ball between your knees
Squeeze the ball as you perform your contraction exercises above
Start with 5 reps 2-3 times per day.
Gradually work your way up to 10 seconds per rep
Repeat for flicks

Kegal exercises to help prevent postpartum bladder leakage

Roll Outs
  1. Lay on your back, knees bent
  2. Place a loop band around your knees.
  3. Separate your knees, pushing against the band as you perform the contraction exercise above
  4. Start with 5 reps 2-3 times per day.
    Gradually work your way up to 10 seconds per rep
    Repeat for flicks.

Kegal exercises to help prevent postpartum bladder leakage

Bridging
  1. Lie on your back
  2. Engage your pelvic floor (think kegals) and draw in your core (think pelvis to ribcage)
  3. Push through your heels and squeeze your bottom to push your hips off the ground
  4. Contract pelvic floor while holding the bridge position.
    The goal is to maintain a straight line from your shoulders to your knees and hold
    Avoid hyperextending your hips by lifting too high and keep abs engaged.

Hold 5-10 seconds
Relax and repeat 10 times

Kegal exercises to help prevent postpartum bladder leakage

Standing Pelvic Floor Contraction
  1. Hold pelvic floor contraction for 5 seconds working your way up to 10-15 second holds
  2. Relax 5 seconds
  3. Repeat 10 Reps 2-3 times a day

 

Standing Plies
  1. Place Feet shoulder width apart, toes turned out
  2. Slowly bend your knees while contracting your pelvic floor over 5 seconds
  3. Slowly stand back up, relaxing your pelvic floor over 5 seconds.
  4. Perform 10 reps, 2 times per dayKegal exercises to help prevent postpartum bladder leakage

My hope is that more women start talking about this issue because chances are that you, family or friends are dealing with this and may not know there is help available.The more awareness that is brought to this silent epidemic, the more women who will be spared from feeling alone, helpless and too embarassesd to help improve their symptoms.

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