This guest post was written by Alina Horrocks who holds a Doctor of Physical Therapy.
I am a mother of 3. I am also a physical therapist. My background is mostly acute (hospital) care. I’ve shifted from working full-time as a PT, to being a stay at home mom. When I became fully immersed in the “mom world” and was meeting other fairly new mothers, I was surprised at how many of these women were having pelvic floor issues (mainly incontinence).
In my experience as an OB/GYN patient, none of my providers really took any time to explain the importance strengthening the pelvic floor or the correct way to do it. In talking to several friends, that has been their experience as well. Many ended up seeing a Women’s Health specialist PT for incontinence issues postpartum, and they were very surprised at what they didn’t know about their own body and how simple the treatments are.
Women’s Health & Physical Therapy
Having had the advantage of going to PT school, I at least knew a little about my pelvic floor and the Women’s Health specialty within the world of physical therapy. It is a fairly new but growing specialty. But even in school, the amount of curriculum dedicated to Women’s Health and/or pelvic floor issues was minimal. I’ve had to really do a lot of my own research and take some extra courses to learn more.
A systematic review published in 2014 found that “PFMT (pelvic floor muscle training) during pregnancy and after delivery can prevent and treat UI (Urinary Incontinence)”. This research shows the benefit of exercising the pelvic floor, but the problem is that our current healthcare culture doesn’t promote much preventative education in this arena.
What I want all mothers and mothers-to-be to know
I think many women just accept the fact that some urine leakage after having a baby is expected. Many women do experience this, yes….BUT that doesn’t have to be the case. Urine leakage is a dysfunction of the pelvic floor and there is treatment available!
There are physical therapists that specialize in Women’s Health that can help with all kinds of things (urinary and bowel incontinence, breast cancer, lymphedema, pelvic girdle pain, pediatric pelvic health, male incontinence and pelvic health, sexual dysfunction, pregnancy and postpartum, to name a few…). However, you may have to seek them out. The American Physical Therapy Association (APTA) has a Section on Women’s Health (SOWH) where you can look up therapists who’ve been specially trained and certified – look for someone with a WCS after their name (Women’s Health Clinical Specialist). For more info, go here.
Performing a pelvic floor contraction
Think about pulling the whole area from your pubic bone to your tail bone “up and in”. Another description I’ve heard is to “stop the flow of urine”, but actually I think a more accurate description is to “stop the passing of gas”. The contraction needs to include the muscles around the vagina as well as around the anus. You should not be holding your breath or contracting the abs. If you have difficulty doing this or are unsure if you are doing this correctly, you may want to seek out a Women’s Health specialist.
Exercise your pelvic floor
- Quick flicks – contract your pelvic floor as hard as you can.
- Sustained contraction – contract your pelvic floor and hold the tension starting for 5 seconds and working up to 10+ seconds.
- Elevator – contract and lift up your pelvic floor little by little, like you’re going up floor by floor in an elevator. When you get to the top, or your maximal contraction, don’t just completely release the tension. Instead, control and let down the contraction little by little (or floor by floor) until you are completely relaxed.
You can perform these exercises sitting, standing, or lying down. Like any exercise, start small and build up. I recommend 2-3 sets of 5-15 reps of these exercises a day. Perform these consistently, maybe there is something already in your daily routine where you could incorporate your pelvic floor exercises. For example, when you brush your teeth, take a shower, cool down from a workout, nurse your baby, or watch commercials during your favorite TV show. Practice these both during pregnancy and after.
Once you are confident you are correctly contracting the pelvic floor, try doing it while pulling your belly button into the spine (contracting the transverse abdominis). Also, try contracting your pelvic floor while walking or going up and down steps.
Find a Physical Therapist
Try doing these simple exercises on your own and if more help is needed or other issues arise, a physical therapist can really help. Most states these days don’t require a prescription from a doctor to see a physical therapist so you can go directly to a specialist for an evaluation.
Our bodies go through so much during pregnancy! And we give so much to be mothers! My hope is that we can create more awareness in our communities on ways women and mothers can take care of themselves and also to let them know there are people to help.
This guest post was written by Alina Horrocks. Alina graduated from Texas Woman’s University in Houston, TX with a Doctor of Physical Therapy in 2010. She has worked primarily in the hospital setting, helping inpatients regain and improve functional mobility. She welcomed her third child last year and is now using her professional and personal experience to help other moms take care of their bodies during pregnancy and beyond.