By Cathy Rogers, B.Sc. (PT)
Does the idea of jumping on a trampoline with your kids make you cringe? Do you have to run to the bathroom when the trainer at the gym pulls out the skipping rope? Are you barely able to make it to the bathroom on time? Is intercourse painful? Does your belly still look and feel like you are pregnant?
Have you heard these comments before or have you found yourself thinking these thoughts? Childbirth is a life-changing experience but many moms find themselves dealing with the physical effects in the early postpartum period or maybe even years after giving birth. So many times we are told that “leaking or pain is normal” after having children or that it comes with aging. If you experience any of these issues, you are not alone. Research shows that 44.6% of women have some degree of urinary incontinence (leaking) 5-7 years after delivery 1. Ninety-two percent of new moms who are incontinent at 12 weeks post-delivery will still be incontinent 5 years later 2. There also exists a strong correlation with those who are experiencing incontinence and low back or pelvic girdle pain. Busy moms just deal with it and are frequently unaware that treatment for these issues is available.
Regardless of whether you have a vaginal delivery or deliver via Caesarean-section, many moms experience pelvic floor related symptoms that can persist for many years if left untreated. After the first 8 weeks following delivery in which the body and tissues are healing from the birth experience, new moms should be recovering all their pelvic floor related functions. It is not normal to experience any of the following:
- Urinary symptoms including leaking with exertion, increased urge
- Any form of loss of bowel control (e.g. increased urgency, streaking in the underwear)
- Bulging or pressure between the legs (perineum) when exerting (e.g. cough/sneeze, lifting)
- Pain with intercourse
- Inability to fully empty the bladder so you may feel like you still need to pee even after recently relieving
- Any pain, including the back, pelvic girdle, hip, perineum, etc.
- Feeling really weak in tummy muscles or noticing a bulge in the belly when sitting up
If a new mom is experiencing any of the symptoms it is important to follow-up with a physiotherapist who has expertise in prenatal/postpartum and/or pelvic floor issues. A thorough postpartum assessment should not just involve assessment (either externally or internally) of the pelvic floor and its muscles but should include a comprehensive assessment of the entire body to find the cause or “driver” of your symptoms. Too many new moms are told to just do “Kegels” to address any issues with leaking but frequently Kegels alone will not solve the problem, and in some cases, these exercises can make it worse! A comprehensive assessment by an experienced physiotherapist will help figure out the cause of why the symptoms, either pain or pelvic floor, are happening and what the best course of treatment will be. This should also include a thorough evaluation of the core muscles and abdominal wall via real-time ultrasound imaging as it is very common to develop poor or altered recruitment patterns for core muscles after pregnancy and delivery. This can result in a tummy muscle separation (Diastasis Rectus Abdominis) and/or back and pelvic girdle pain.
Every mom’s birth experience is unique and as such a thorough postpartum assessment is important to help address symptoms and recover function. If left untreated, some of these symptoms can persist for years. A physiotherapist with experience in pre/postnatal and/or pelvic floor can help put together an individualized treatment plan.
If this sounds familiar to you and you are looking to start the journey to recovery, regardless of how old your kids are, find a local experienced physiotherapist to help guide you in the right and healthy direction. For those of you who are local, many of the physiotherapists at Diane Lee & Associates – Consultants in Physiotherapy can help guide you through this rehab; call the clinic to book a postpartum assessment!
1 Wilson et al., 2002
2 Viktrup et al., 2000