The experience of bringing a new baby home is exciting and wonderful. But this period can also be terrifying for a new mother, and at times, isolating. It’s a word we have been hearing so much of lately, but for other reasons – “Stay at home. Self-isolate. Social distance”. The concept of this is hard for anyone, more so for a new mother. As new mothers, we rely on getting out of the house and being social with our family, close friends and mother’s groups for support. We rely on access to our medical and allied health professionals so that we can look after ourselves and in doing so, care for the new baby we have brought into this world. Even though Covid restrictions are now easing, it can still be challenging to leave the house with a new baby in those first weeks or months, for reasons other than the essentials. Looking after yourself and getting into some regular exercise might be low on your list of priorities.
Exercising from home
While the recent Covid crisis has been challenging, especially for new mums, this crisis has produced a tremendous surge in online exercises and exercise programs. We are lucky to have technology and the online platform to access exercise programs from home, however new mothers wanting to start exercising need to be cautious in selecting exercises. Some exercises place extra load on the abdominal muscles or pelvic floor which new mums need to avoid soon after having a baby, as these can have adverse results. Getting professional guidance before embarking on an online exercise program is vital.
At PhysioTec, we have two Women’s Health physiotherapists, Megan Power and Irene Li, who can assist you through this uncertain time. If you can’t make it to the clinic in person, we are able to provide an online ‘Telehealth’ video consultation. We will take a thorough history inclusive of your pregnancy and birth experience. We will also look at your posture and a variety of movements. From this we will give evidence-based advice and, if appropriate, recommend a personalised exercise program you can do safely at home.
We can address any of the following during a consultation:
- Pelvic floor muscle and function
- Abdominal separation
- Safe exercise options/exercises to avoid
- Pelvic pain
We also offer an App for your exercise program and this includes video, audio and text description. It also allows in-app messaging to stay in touch with your physiotherapist.
The Importance of the Pelvic Floor Muscles
Like any other muscle in our body, the pelvic floor muscles may be weak, too active, a source of pain and can also be different side to side. These muscles, along with connective tissue, support the pelvic organs. In women, these are the bladder, uterus and bowel. The pelvic floor is important for prevention and management of prolapse, management of urinary incontinence and also for its role in sexual function. Following childbirth, the pelvic floor needs time to recover and then we can start to gradually build up strength and coordination of these muscles again.
The main recommendation of the most current guidelines state that pelvic floor muscle training is associated with a reduction in prenatal and postnatal urinary incontinence (Mottola MF, et al., 2018). These exercises can be performed daily HOWEVER, it is crucial that women seek instruction from a knowledgeable health professional to ensure proper technique in order to obtain the best outcomes/benefits from performing these exercises. This is especially the case for women who have never trained these muscles.
What about running?
In March 2019, three highly experienced physiotherapists – Tom Goom, Gráinne Donnelly & Emma Brockwell combined their areas of expertise to release a paper on returning to running after childbirth and the guidelines for this population. The main findings were that women in the post-natal period benefit from an individualised assessment and guided pelvic floor rehabilitation in order to prevent and manage pelvic organ prolapse (Hagen, S et al., 2014), manage urinary continence (Bø, 2003) (Dumoulin, C et al., 2018) (Price, N et al., 2010) and improve sexual function.
Based on expert opinion, the following suggestions were made:
- Return to running is NOT recommended at all prior to 3 months post-childbirth OR beyond this time point if any symptoms of pelvic floor dysfunction are identified before or after attempting a return to running
- Pelvic health, load management and strength testing should be assessed in order to establish if a patient is ready to return to running in the post-natal period
- Additional factors that should be considered in the postnatal evaluation are weight, fitness, breathing, psychological wellbeing/status, abdominal separation, breast support and feeding, running with a buggy and relative energy deficiency in sport (RED-S)
How can a Physiotherapist help me?
At PhysioTec, our physiotherapists who specialise in Women’s Health can address your postnatal concerns and advise you on the safest exercises, individually tailored to your symptoms and current capacity. If you are wishing to return to a level of activity similar to pre pregnancy, your physiotherapist is able to guide you on load and intensity and how to graduate safely back to full activity. We are passionate about what we do and our continuity of care. We are here (in person at Tarragindi or online via TeleHealth) to help and provide you with the best advice and support!
Book Online or call us on 3342 4284 to speak to us today!
References
Bø, K. (2003). Is there still a place for physiotherapy in the treatment of female incontinence? EAU , 145-153.
Dumoulin, C et al. (2018). Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database of Systematic Reviews(10).
Hagen, S et al. (2014). Individualised pelvic floor muscle training in women with pelvic organ prolapse: a multicenter randomised controlled trial. 282(9919), 796-806.
Mottola MF, et al. (2018). 2019 Canadian guideline for physical activity throughout pregnancy. British Journal of Sports Medicine, 52, 1339-1346.
Price, N et al. (2010). Pelvic floor exercise for urinary incontinence: A systematic literature review. Maturitas, 67(4), 309-315.
