Pelvic floor friendly postnatal exercise: A case study
Making pelvic floor friendly modifications to an exercise program can have long-lasting – and sometimes fast – results. Physiotherapist and Pelvic Floor First ambassador Dianne Edmonds shares a client’s story of pelvic floor improvement with specialised physiotherapy.
Mrs J was eight weeks postnatal and decided that it was time to do some exercises to tone her abdominal muscle wall. She also wanted to lose weight and thought running would help her. So she started running, doing sit ups, and planks, as these were the exercises that she knew. A few weeks later she visited the physiotherapist to check her pelvic floor and found that her program was not the best option for her recovering pelvic floor. This was her second baby, and she had experienced leaking of urine with a deep belly laugh in the last two months of her pregnancy. She had also felt strong pressure in her pelvic floor and felt “looser” with intercourse. This had occurred at the end of her first pregnancy too, but this time it was feeling worse.
Taking into account her level of abdominal muscle wall stretch and her pelvic floor history, the physiotherapist modified her program, removing planks and sit ups due to the pressure these place on the recovering postnatal pelvic floor. Instead of running, walking was recommended for another month.
Mrs J was taught to activate her abdominal wall to ensure her pelvic floor was lifting and not dropping, and taught some introductory level postnatal abdominal exercises, including single-leg roll outs and four-point kneeling exercises. With a more accurate focus on drawing in her abdominal wall during lower level core exercises, Mrs J was now able to feel the recruitment of her lower abdominal wall.
She went home to practice these exercises, and reported that within one week her husband had noticed an improvement in her pelvic floor tone! No longer were the exercises pushing down on her pelvic floor and with correct technique and focus, her combined pelvic floor and lower abdominal exercise program was resulting in toning both of these areas, which had been affected by two pregnancies and childbirth. Mrs J was later able to return to running, commencing with a walk/jog. With continued good recovery to her pelvic floor, she was able to progress her level of postnatal abdominal muscle exercises, while protecting her pelvic floor.
Australian Fitness Network offers a range of online courses for fitness professionals to ensure postnatal clients protect their pelvic floor when returning to exercise.