pelvic floor Archives - GV Sportscare

Congrats! You’ve had a baby and want to get your body moving again. Here are some of the things you need to know before getting back into running, sport or high-intensity exercise after pregnancy.

The demands of pregnancy, birth and the postpartum period involves big changes to the musculoskeletal system. The body needs time to recover and this will impact readiness to return to high-intensity or high-impact activity safely. This would be no different for a runner sustaining a non-pregnancy related injury – our advice would be to commence running again only after appropriate progression through rehab and ticking off key strength and loading criteria!

Can I get back to running/sport/HIIT straight away?

Current guidelines recommend waiting at least 12-16 weeks before returning to running or high-impact exercise. This is to prevent injury to the pelvic floor, abdominal muscles and other joints and muscles.

But this doesn’t mean you can’t be exercising earlier! Low impact or low intensity exercise is safe in the postpartum period from as early as 3 weeks postpartum when directed by a health professional such as a physiotherapist.

Our Shepparton physiotherapists can assess you in the postpartum period, and get you started with your return to exercise at home or the gym, a walking program, or discuss with you our Mums & Bubs Clinical Exercise classes. We recommend a postnatal assessment at the 3-4 week mark to make an individualised plan for returning to exercise.

What about my pelvic floor?

The pelvic floor undergoes many changes during pregnancy, childbirth and postnatally. Read our blog to learn more about the pelvic floor. The pelvic floor can become weak, which means that it doesn’t function as well as it should – this can lead to pelvic floor symptoms like bladder or bowel leakage, urgency or prolapse.

Running, sport and/or high-intensity exercise are high impact activities that increase pressure in the abdomen, which in turn places more pressure and demand on the pelvic floor.

Symptoms to look out for that may indicate your pelvic floor or core isn’t coping with exercise:

Bladder or bowel leakage (even just a little!) or difficulty emptying bowels
Urinary urgency (rushing to the toilet)
Heaviness/bulge/dragging sensation in the vaginal area
Bulging/doming in the abdomen through an abdominal separation

Image source: https://www.continence.org.au/about-continence/continence-health/pelvic-floor

Return to running or high-intensity training checklist:

✓ Have already completed at least 6 weeks of low impact cardio exercise, such as walking or swimming

✓ You will have done at least 6 weeks of strength and conditioning in the postpartum period prior to running, to get your muscles strong enough for running/sport/HIIT

✓ Timeline wise, at least 12 weeks postpartum (and even up to 6 months), to allow your body time to heal, improve your strength and prevent pelvic floor dysfunction

✓ A pelvic floor assessment and run/sport/HIIT clearance from a pelvic floor physio

✓ Able to pass a series of pelvic floor loading tests without pelvic floor symptoms above

✓ Able to pass general lower body strength tests – this is the benchmark for all runners/athletes to prevent other non-pregnancy related joint/soft tissue injuries!

How can our Shepparton based Physiotherapists help with your postnatal return to running?

– Complete a post-natal musculoskeletal assessment and pelvic floor screening (as early as 3-4 weeks postpartum), and refer you onto a local pelvic floor physio if indicated

– Develop an individualised exercise program including general strength, mobility, pelvic floor and core exercises

– Facilitate safe return to running, HIIT or your chosen sport by testing you against the criteria above to ensure you are ready to return to this level of exercise

– Work with you to set some short and long term goals!

– Emily Wiedemann
Physiotherapist Shepparton

First of all, what is the pelvic floor?

You’ve probably heard the term ‘pelvic floor’ thrown around here and there, but what actually is the pelvic floor and why is it important?

The pelvic floor is a group of muscles located in our pelvis that stretch like a sling from the pubic bone at the front of your pelvis to the tailbone at the back of your pelvis, and side to side to each ischial bone (sitting bones).

In the simplest terms, the pelvic floor supports the pelvic organs that sit above it and prevents the pelvic organs from falling through. Above your pelvic floor sits your important organs including the bladder, bowel and the uterus, and the pelvic floor muscles help to control release of urine and faeces from these organs by relaxing and contracting muscles around the openings of these organs (sphincters). The pelvic floor also plays an important role in sexual function in both males and females.

Image source: https://www.continence.org.au/about-continence/continence-health/pelvic-floor

Just like any other muscle in your body, the pelvic floor muscles can become weak. This can happen in both females and males! This means that they are unable to support the pressure coming from your abdomen, or cannot control the flow of urine or faeces out of the bladder or bowel.

Some of the signs of this include bladder leakage with coughing, sneezing, laughing, running, jumping, urgency to use your bladder or bowels, or in females, signs of a prolapse including heaviness or pressure or the feeling as though something is coming out of your vagina.

Who is at risk of pelvic floor issues?

Some people have a higher risk of developing pelvic floor problems:

Women who are pregnant, recently given birth (regardless of the birth type) or who have ever been pregnant
Women who are going through menopause or women post-menopause
People who have had surgery on the pelvis e.g. women who have had gynaecological surgery, men who have had prostate surgery, or following pelvic radiotherapy
People who participate in high-impact exercise e.g. running, jumping sports or high intensity cardio; or heavy lifting e.g. at work or at the gym
People who have a chronic cough or sneeze e.g. due to asthma or smoking
People who suffer from chronic constipation

So, what can physiotherapists do about it?

If you can relate to any of these symptoms, just remember you are not alone. 1 in 4 people (males and females) will experience bladder leakage, 1 in 4 women will experience a prolapse in their life, and 1 in 10 young women will experience bladder leakage during sport – but just because this is common doesn’t mean it is normal!

Physiotherapists are experts in managing musculoskeletal problems, and the pelvic floor muscles are no exception! The research suggests that exercises for your pelvic floor which are done for a minimum of 12 weeks can significantly reduce symptoms of pelvic floor dysfunction, and if started during pregnancy can prevent pelvic floor issues after pregnancy!

Our Shepparton physiotherapists are trained in delivering these exercise programs which we can design for you to complete at home and can make sure that you are completing the exercises correctly. Alternatively, our Clinical Exercise (formerly Clinical Pilates) classes are also designed to target the pelvic floor muscles if this is an issue for you.

I want to exercise – how can I modify my exercise to take care of my pelvic floor?

If you are worried about your pelvic floor during your regular exercise routine, here are some tips that you can start with to reduce strain on your pelvic floor:

Engage the pelvic floor before performing an exercise, if you’re unsure how seek help from your Shepparton physiotherapist
Perform exercises in sitting or lying down, rather than in standing
Increase the number of repetitions (10-15) or sets (3-4) but reduce the weight you are lifting
Avoid holding your breath while completing an exercise
Switch from higher impact to lower impact cardio exercise e.g. walking or swimming rather than running
Switch from single leg to double leg exercise e.g. skipping on two feet rather than one

Unsure where to start?

Our Shepparton physiotherapists can assist you to form an exercise regime that is safe for your pelvic floor based on your individual needs. We can also help guide if you need to see a specialist women’s health physiotherapist.

Helpful Websites:

Continence Foundation of Australia

Pelvic Floor First, Pelvic Floor Safe Exercises

Go Against The Flow (support for young women with incontinence)

–Emily Wiedemann

Physiotherapist Shepparton

GV Sportscare

Tag Archive for: pelvic floor

Getting back to running, sport or HIIT after pregnancy, where should you start?