Why Haven’t I heard of Pelvic Floor Physiotherapy Before?
This specialized type of physiotherapy is relatively new in Canada; however, over the past five years, this essential form of rehabilitation has certainly picked up momentum. In other countries such as France, every post-partum woman that delivered vaginally is assessed by a Pelvic Floor Physiotherapist and is taught how to do a kegel correctly. The French government even covers up to ten sessions with the physiotherapist for post-partum pelvic floor strengthening and core muscle retraining! The reason is that the pelvic floor plays an integral role in preventing leaking, supporting your pelvic organs, providing back stability, and sexual health; hence, rehabilitating the pelvic floor after having children is not only restorative, but preventative against these things as well. Today, more and more women are learning about the effective health practices that they benefit them for the rest of their lives.
Why is it important to have my pelvic floor checked before I return to exercising post-partum?
Your pelvic floor muscles are part of your inner core muscle group. They work together with three other muscles (the Transverse Abdominis, the Multifidus, and the Diaphragm) to provide the foundation for core stability. After giving birth, your body, including all of its core muscles, will need time to recover. Starting an exercise program that involves running, jumping, kickboxing, boot-camp, and “core strengthening,” before your inner core muscles have regained their function, places you at risk of developing/worsening a pelvic organ prolapse, developing/worsening urinary incontinence, and straining your back.
Hence, having your core and pelvic floor muscles assessed by a specially trained physiotherapist will let you know how strong or weak your core is and, subsequently, what level of exercise may be appropriate for you. Your physiotherapist will let you know what precautions you may need to take when starting your exercise routine. You will also learn how to do a proper kegel and how to re-train your core so that you can confidently activate your core while exercising.
Another added benefit is that the assessment will make light of any pre-existing injuries or areas of pain, and will be able to make specific exercise recommendations for you.
Pelvic Health Physiotherapy is also covered under Extended Health Care plans as Physiotherapy.
Isn’t leaking a normal part of aging?
This is a misconception. It is NOT normal to leak with age. If you are leaking, even if it is just a little, your pelvic floor muscles are likely weak. A correct pelvic floor contraction can help improve urethral closure to prevent leakage. The stronger the muscles, the better they are at providing tight closure. There is a substantial level of research that states pelvic floor strengthening should be considered the first line of treatment for incontinence.
Important point to remember: Leaking is COMMON with aging but NOT NORMAL. Starting today, let’s change our perception of what’s normal.
I’ve had 3 kids, isn’t leaking normal after having kids?
This is yet another misconception. It is NOT normal to leak. If you are leaking, even if it is just a little, your pelvic floor muscles are likely weak. With the incredible amount of stretching that occurs during a vaginal delivery, in many cases, the muscles do not return to optimal status. Like any other muscle that has had an injury, the pelvic floor muscles need to be rehabilitated to their optimal state. If you are leaking, there is likely some (or a lot of) residual weakness from the delivery and your pelvic floor muscles need some help. The reason why this is so important, is that the pelvic floor plays an integral role in maintaining continence, supporting your pelvic organs, providing back stability, and improving sexual health. Hence, rehabilitating the pelvic floor after having children is not only restorative, but preventative as well!
I had my kids over 10 years ago. Is there a point to begin kegels at this stage of my life?
Yes of course! It is never too late to strengthen your pelvic floor and core. Over time, lack of adequate contractions cause your pelvic floor muscles to lose their tone. Add to that, hormonal changes that occur with menopause, and now you’re left with pelvic floor muscles that struggle to do their job. However, this muscle group can be strengthened, just like any other voluntary muscle in our body.
Interesting fact: In France, any woman that has had a vaginal delivery, is directed to see a pelvic floor physiotherapist post-partum for pelvic floor strengthening and core muscle retraining, and their government health plan covers it!
If I think I have a problem with my pelvic floor muscles, should I start doing kegels right away?
There are two important points to consider when answering this question:
- Research has shown that at least 50% of women do not contract their pelvic floor muscles with just verbal instructions or a written handout. Hence, you might decide to start strengthening your pelvic floor, but there is a good chance you are doing your kegels incorrectly. Learning how to perform a kegel through an internal assessment is the “gold standard.”
- Kegels aren’t for everyone. A large number of women actually have pelvic floor muscles that are too tight. Imagine what it may be like to have tight neck muscles. They may be sore, you may have difficulty turning your head, or you may even experience headaches. The treatment in this case wouldn’t involve strengthening the neck to tone the muscles up even more. The treatment would be focused on releasing and relaxing them. The same goes for the pelvic floor. If your pelvic floor muscles are being held tight, doing kegels can actually make your symptoms worse! If you think you might have some issues with your pelvic floor, have them assessed by a Pelvic Floor Physiotherapist.
You will find a list of Pelvic Floor Physiotherapists online at: www.pelvichealthsolutions.ca