Updated: Jul 3, 2022
Written by physiotherapist Amanda McDonald.
At Body Align Physio we are dedicated to helping women of all ages achieve their optimum physical function and improve their quality of life. We see many women, in all shapes and forms, and we strongly believe that seeing a pelvic physiotherapist at pregnancy and postpartum should be standard care.
Pregnancy and delivery (vaginal or caesarean section) bring about huge changes to your body and life. Your muscles and ligaments of your abdomen and pelvic floor go through significant changes. The ligaments become more flexible in pregnancy and the pelvic floor muscles stretch significantly (almost 200% of their normal length!) during vaginal delivery. Along with this, the nerves that tell your pelvic floor muscles how to contract and relax can also be stretched during a vaginal delivery which may affect the coordination of your pelvic floor muscles.
Whether it be starting with a pregnancy or postnatal assessment you are already on the right path for optimal pelvic health now and for the future. And remember, it doesn't matter how long it has been since you had your baby, it is never too late to start your postnatal rehabilitation.
Our Postnatal Assessment:
It is very common for postnatal women to experience pelvic conditions during pregnancy and postnatally. With a thorough assessment, treatment and exercise rehabilitation plan you can address many of these changes and return to your pre-pregnancy state. When returning to more demanding exercise it is even more important to have a specific treatment and exercise plan. That is where we can help!
From 4-6 weeks following either a caesarean or vaginal birth, our specialised pelvic physiotherapists can work with you to understand your postnatal journey, rehabilitate your pelvic floor and abdominal muscles, and guide you back into a safe and specific exercise routine. And remember after your first pregnancy you are forever postnatal, so it is never too late to start!⠀⠀⠀⠀
WHAT TO EXPECT AT YOUR FIRST PELVIC PHYSIO APPOINTMENT.⠀⠀⠀
Our overall aim is to empower self-management and self confidence in your body and in your mind. No one knows what to expect from their first pelvic physio appointment, but everyone is nervous!
Here is a guide on what to expect;⠀⠀⠀⠀⠀⠀⠀⠀
History - At the start of the appointment you will talk about what has brought you to pelvic physiotherapy. We want to know what your symptoms are, and how they are affecting your life. As your pelvic physio we may ask more specific questions about your lower back and pelvis, bladder and bowel, sexual function, exercise and general health. We will talk about exercise and life goals with you.
Assessment – Following our chat a physical assessment will take place with your consent. Specifically we will look at the pelvis, spine, and pelvic floor muscles and pelvic organs commonly via an internal vaginal examination. This will help us determine if your symptoms are coming from muscles, joints, nerves, the pelvic organs, or a combination of these things.⠀
Education – We will provide you with some education on the anatomy and some possible reasons of why this may be happening.
Treatment – Following this we will develop the best treatment plan to help manage and achieve your goals. This may include manual therapy, pessary fitting, an individualised exercise program, advice and education on diet, lifestyle, movement and exercise.
WHAT DOES A POSTNATAL ASSESSMENT AND REHABILITATION PROGRAM INCLUDE?
Pelvic Floor Muscle Assessment: Your pelvic floor muscles are integral for continence, sexual function, and stability of the pelvis. An internal vaginal examination assists us to check pelvic floor muscle tone, activation, strength and coordination.
Abdominal Separation (Rectus Diastasis) Assessment: We assess for any abdominal separation particularly looking at the depth and width of the diastasis, how you are breathing, and check any scars or tenderness. We also use Real-Time Ultrasound to look at core activation.
Pelvic Organ Prolapse (POP) Assessment: Prolapse is recognised as a lowering of either the front wall (bladder), back wall (rectum) and/or the uterus downwards into the vagina. Many women experience prolapse as a result of a vaginal delivery. We assess if there has been any change to your pelvic organs following delivery, and identify if you are at risk of a prolapse occurring in the future.
Lower Back And Pelvis Assessment: The lumbar spine and structure of the pelvis are significantly impacted by pregnancy and childbirth. We look specifically at how these joints and muscles move, and how specific movements aggravate your symptoms. We can then give you specific exercises to help rehabilitate the condition.
We understand that these are very sensitive topics and as always we treat every case with the utmost privacy and respect.
We look forward to meeting you and helping you with your pelvic health journey.