How and why you should do pelvic floor exercises in pregnancy!
So you probably heard lots of people talk about doing kegels in pregnancy but what does this actually mean and why should you care?
The pelvic floor is a group of muscle and connective tissue running from the pubic bone at the front to the tailbone at the back. It’s not the inner thighs, it’s not the lower tummy muscles and it’s not the bottom muscles. It’s not just a clever name…it’s quite literally the floor of your pelvis.
The pelvic floor plays some EXTREMELY important roles. These include:
- Preventing leakage of urine and feaces
- Allowing you to eliminate your bladder and bowels when it’s convenient
- Supports and holds up the internal pelvic organs (Bladder, bowel and uterus for women)
- It also has a large role in sexual pleasure and orgasm!
Poo’s wee’s and sex are three things we don’t like talking about when they’re going well let alone when they are going badly!
During pregnancy the weight of your baby places large amounts of pressure and extra stress down on your pelvic floor. This is said to be the equivalent of a 100kg man standing on a trampoline!
Learning how to properly contract and relax your pelvic floor is so important in pregnancy and here’s why:
- Prevents urinary incontinence in pregnancy
- Prevents pelvic organ prolapse (a bulge in the vagina due to one of the pelvic organs dropping down) which affects up to 1 in 3 women! Take it from me as a pelvic floor physio nobody wants this!
- Prevents tearing in birth: having an understanding of what your baseline pelvic floor tone is give us an understanding of your risk for pelvic floor and perineal tears in birth. It will guide your exercise program and you may need to focus more on releasing the pelvic floor and learning how to relax it properly if it is overactive!
- Improves your ability to properly relax the pelvic floor during labour
- Improves postpartum recovery time: this is due to blood supply to the pelvic floor increasing with exercise, much like your muscles get bigger when you go to the gym and your recovery time improves! Remember the first time you went to the gym or lifted weights, you probably felt really sore the next day but after a while your body adapts and the blood supply to the muscle improves recovery time! The pelvic floor is no exception!
- Reduces risk of postpartum pelvic floor dysfunction
It is common for the pelvic floor to be both under-active and over-active.
Signs of an overactive pelvic floor include
- Pain with intercourse history of pain with tampon insertion or pap smear
- Pain or difficulty urinating or chronic constipation. Women with a history of recurrent yeast infections, endometriosis or a history of sexual trauma have a slightly higher risk of pelvic floor over-activity
Signs of an under active pelvic floor include
- Leakage with coughing or sneezing, leakage with jumping or running
- Inability to make it to the toilet on time
It is important to understand that an over-active pelvic floor does not mean a strong pelvic floor, quite the opposite in fact. Imagine carrying around a 5 kg weight all day long and then being asked to lift a bag of shopping… when the pelvic floor is overused the muscles becomes fatigued and then may not be able to keep up with regular demands.
Okay but how do I know what my pelvic floor is doing?
My advice is if any of the signs listed above resonate with you then seek proper advice and assessment from a Women’s health Physiotherapist. If not, ensure that when training your pelvic floor muscles that you practice turning these muscles on as well as turning them off.
Much like any other muscle in the body, to be strong means to you have power, endurance, speed AND functionality. In order for the pelvic floor to be strong and work optimally I suggest training the pelvic floor in each of these categories.
- Short quick contractions will train the pelvic floor speed.
- Long slow holds will train endurance.
- I suggest training at different intensities. it’s no use owning a brand new car that only drives well at 100 km/h when you live in the city. In the same way it’s no use if the pelvic floor can only function in one way. Try training at different intensities, start with 10%, 25%, 50% and 100%
- Maximum Pelvic Floor contractions will improve its overall power.
- Last but certainly not least is functionality. It’s no good only being able to do your pelvic floor exercises when laying down when we spend most of our day walking around. Practice in sitting standing, and when moving.