Pregnancy and post-natal (post-baby) issues commonly include pain in the low back, hips, groin and hands, as well as pelvic floor problems such as incontinence and prolapse. Pelvic floor muscle exercises are often an important part in helping many of these issues. Every person is different so finding out why you have a problem is essential to proper recovery.
What are some common changes I can expect to happen to my body when I am pregnant?
As the baby grows inside your tummy, your hormones, posture and balance change and 50 per cent of women experience low back pain. As the baby grows and gets heavier, the pressure inside your tummy and down onto your pelvic floor increases. This pressure means your pelvic floor muscles need to stay strong to support the weight from above. Up to 67 per cent of women will leak urine (incontinence) when they laugh, sneeze, cough or exercise during pregnancy but those with stronger pelvic floor muscles are less likely to leak during pregnancy and after the baby is born.
By the third trimester 66-100 per cent of women will experience widening of their abdominal muscles, noticing a gap down the centre of their tummy when they do things like get up from lying down. This widening is normal to make room for the growing baby and usually goes away 8 weeks after the baby is born.
How effective is physiotherapy for my recovery pre and post childbirth?
Research shows that pregnant women doing an intensive, supervised pelvic floor muscle exercise program were 56 per cent less likely to leak urine in pregnancy and 30 per cent less likely to leak up to 6 months after giving birth. More importantly, up to 10 per cent of women after having babies will leak faeces. Women who did pelvic floor exercises were half as likely to report this.
Women’s health encompasses a huge variety of conditions that may affect women throughout their life. Such conditions include incontinence or leakage of the bladder or bowel; chronic pelvic pain that could include endometriosis (where tissue that normally lines the uterus grows outside the uterus) or muscle spasm; conditions associated with pregnancy and early parenthood such as back or sacroiliac joint pain in pregnancy, carpal tunnel syndrome and mastitis (inflammation of breast tissue usually due to infection).
How do I know if my condition requires physiotherapy or other medical attention?
Physiotherapists with expertise in women’s health can tailor exercise programs for you to improve many things:
Pelvic floor muscle overactivity and chronic pelvic pain are gaining increasing awareness among doctors and fitness coaches, and the role of women’s health physiotherapists has never been more important.
If you’ve had a history of endometriosis or painful periods, you may have difficulty inserting a tampon or experience pain with intercourse. Some people who have suffered a back injury are told they have weak core muscles and are encouraged to do a lot of ‘stability’ training. However, in some situations it may not be weak muscles causing your pain, but actually overactivity as a method of protection for those muscles. The signs of overactivity are difficulty fully emptying your bladder or bowel, pain with intercourse, and sometimes incontinence.
Women’s health physiotherapists are highly skilled at taking a very complete history and thorough assessment. This may involve a vaginal examination, with your consent, to manually palpate (examine by touch) the pelvic floor muscles and locate the cause of the pain. Accurate diagnosis can then be made. Usually, your physiotherapist will work closely with your GP and may seek to include a psychologist, gynaecologist or a sexual health physician to best help you.
How can physiotherapy help women’s health conditions?
Physiotherapy treatment may include some of the following: pelvic floor muscle down training, relaxation and mindfulness training, stretching exercises, general exercise advice and a pelvic floor exercise program to restore normal coordination, endurance and strength to the muscles.
Pregnancy and the early years of motherhood is a time of enormous physical and emotional change. Women’s health physiotherapists assess, diagnose and treat many conditions that are commonly associated with pregnancy including musculoskeletal conditions such as pelvic girdle, low back or rib pain and carpal tunnel syndrome (de Quervain’s syndrome). They assist with optimal positioning for breast-feeding and baby holding, and can manage mastitis alongside medical doctors.
Incontinence and prolapse can be a problem for women soon after their babies are born, so a return to safe exercise that allows your pelvic floor muscles to return to optimal function is critical. Pelvic Floor First guidelines are a useful resource to help guide safe exercise after birth.