Essential checks after birth
by Shira Kramer and Elizabeth Burke (Women’s Health physiotherapists)
There are a few essential checks that we recommend new mums undergo before commencing exercise and normal daily activities after delivery. These checks can be made as soon as you give birth, and should be monitored over the first few months. The Pelvic Floor Muscles are strongly affected during pregnancy and labour and need to recover as well as rehabilitate. 1 in 3 women will suffer from pelvic floor dysfunction at some stage after having a baby. These issues include inability to control your bowel and bladder (ie when and where you go to the toilet), pelvic organ prolapse, sexual dysfunction and pelvic or low back pain.
Pelvic Floor Muscle activation
One of the most important checks we recommend is your pelvic floor muscle activation. Post birth, it is important for you to ensure you are getting the correct activation and progressively improving your strength and endurance of this important muscle group. You also need to ensure you are able to coordinate this group of muscles, with your Transverse Abdominis Muscle (Deep abdominal muscle) and Diaphragm (breathing muscle). By seeing a Pelvic Floor Physiotherapist, you will have these muscles assessed ensuring you are doing the correct activation. This may be done by either real time ultrasound or digital examination. Following an assessment your Physio will give you a specific program to ensure that the muscles get stronger and are able to hold as you progress back into exercise. A combination of a specific exercise program and appropriate support garments will ensure you return to pelvic floor fitness as soon as possible.
The abdominals are also an area that is affected. More specifically, the most superficial muscle, the Rectus Abdominis Muscle or the famous ‘six-pack’ muscle should be checked postnatally. This muscle has a ligamentous divider along the midline, which can often pull apart during the pregnancy. This is called a Diastasis of the Rectus Abdominis Muscle or DRAM. There is an ongoing possibility of it remaining apart postnatally, if you are doing strenuous type activities such as heavy lifting or abdominal exercise that require the trunk to flex or bend forward, such as crunches. Having a DRAM may be asymptomatic, but in most cases can lead to low back pain, pelvic girdle pain, pelvic floor dysfunction, poor posture and in severe cases hernias. It is important to have this checked to prevent long term issues. Your abdominal muscles will be assessed by gentle palpation along with real time ultrasound. For optimal recovery of the abdominal muscles we recommend a specific physiotherapy exercise program, some lifestyle modifications to avoid straining and appropriate compression garments. For more information about Pelvic Floor issues or Abdominal separation follow the links.[block id=”love-stuff-share”]