And will it stop?
You’ve done ‘being pregnant’, you’ve done the birth, there were no major complications and you’ve done your 6-8 weeks of ‘confinement’.
And then you go back to your pre pregnancy exercise routine – well the GP did sign you off – and you wet yourself.
When you have been used to being fit, strong and active, pregnancy and the weird stuff that happens to your body can throw up some even weirder complications.
I can remember having done all the right stuff post baby number one and heading to my first Body Attack class, for fun! It was fun until I realised I could no longer do jumping jacks.
Why do you get pelvic floor weakness after birth?
The first thing to say is, ‘DON’T PANIC!” In the early days it is quite normal. Stress incontinence is something to be aware of (and definitely not to be ignored or put up with) but not something to feel you’re going to be burdened with in its present form forever.Jumping on a trampoline, plyometric work (like jumping jacks) and sneezing are probably the biggest stressors on your pelvic floor unless you are an international ski competitor. To have a little problem when you jump with your legs wide apart is like going in at the deep end.
Bear in mind that during pregnancy your body will have adapted massively. Organs move and a large baby with its first home are carried around daily by your body, putting downwards pressure on your bladder and pelvic floor. Do you remember all those times you needed the loo?
Birth will also have contributed to stress. If you have a straightforward vaginal birth those pelvic floor muscles are streeee-e-e-e-e-e-eeeetched – phew – and may need a little time to feel more like themselves again. Like an overstretched elastic band. That’s without considering deliveries which require cuts, Ventouse or forceps where there’s intervention or dare I say it, nasty tears that damage your area. If that’s you – book an appointment with a women’s health physiotherapist to get the best advice.
If you are approaching your 40s, those muscles aren’t as supple or pliable as they were when you were a teenager. They’re going to take a little longer to repair and probably a little more work to help them get there.
And of course during pregnancy your body was flooded with extra hormones like progesterone and relaxin causing the ligaments to be more lax. In fact, let’s face it, making every thing more jelly like. From your eye muscles to blood vessels, little escapes the effects of your hormones. Your body stays like this for roughly four months post birth or after you have finished breast feeding but can vary from woman to woman as can its effects on your body.
On this last point, it’s worth knowing that your urinary function isn’t just about voluntary muscles. There are involuntary muscles that you can’t control up there too. So if you are still swimming in jelly hormones it’s possible your peeing is partly a result of your involuntary muscles still being pregnant too.
What can you do now to build your strength up?
Kegels are a good place to start but they aren’t the full picture and whilst the jury is still out in some circles on their effectiveness, to my mind they are still a great foundation for getting your pelvic floor fit for purpose. Do bear in mind if you want to get back to ‘action mama’ mode they aren’t enough for you.
Get squatting! Squats are brilliant pelvic floor exercises without the kegels and will get your legs and bottom strong again post baby. Muscle strength and condition is vital for improving pelvic floor strength and condition. They are connected. When you squat your pelvic floor works. Add an out breath and a kegel on the way back up and you have yourself a great little conditioning exercise. If you’re after a great ‘at home’ conditioning programme, we’ve recently launched the Fit School Hub which will take you through conditioning and mobility work to do at home.Breathe! Your out breath has a brilliant, natural relationship with your pelvic floor so use it. Exhale and lift those pelvic floor muscles. Breathe out on the way up from a squat. Focus on your out breath in your Pilates class. Blow out when you’re boiling a kettle and add a lift.
Find an excellent Pilates class. One which focuses on post natal work. Regular Pilates is great if you know what you are doing but I’d recommend starting with at least one course of post natal Pilates, if only to give you an opportunity to ask questions.
Get specialist help. Consider asking a post natal exercise expert for a personalised programme. I’ve had great results working with post natal women with just three sessions and homework over a two month period. If you need more expert help then book in with a women’s health physiotherapist. We recommend Zoë Eggleton at Holly House.*
Build up slowly. Nine months pregnant; nine months recovering although I’d suggest more like 12. Your GP sign off is not carte blanche to run a marathon. It means you have recovered from birth! Slow and steady wins the race and if you focus on repair and rehabilitation now you’ll save yourself in years to come.
*Zoë Eggleton is running an evening workshop ‘Kegels and Cake‘ on 3rd October. A great opportunity to ask questions.
For more information on the Hub or pelvic floor rehab please don’t hesitate to email us on firstname.lastname@example.org.