You’re fresh into postpartum either for the first time or again, and you’re wondering if you might have a pelvic floor dysfunction? It may not be the best situation to find yourself in but there is a light at the end of the tunnel.
There are many ways to tackle this topic and quite a few physical therapists are starting to thoroughly address this on social media, which is so important. While I believe you need to make sure you give the right attention to these situations, I do have a couple tips that can help you right off the bat (especially if you’re waiting to get into physical therapy.)
Whether it be during exercise, physical therapy, etc. you’ll see a lot of the same muscles being worked for pelvic floor dysfunction. Ultimately, we want to strengthen not just these affected muscles, but also others around it. This includes the transverse abdominis, diaphragm, and multifidus to name a few.
All that said, I strongly recommend seeking a professional opinion to help you formulate a plan on how to heal both of these issues. In the meantime, here are a couple exercises you can do to help your recovery right now!
360˚ Breathing
Breathing is one of the first (and most important in my opinion) aspects of our body to regain a mind/muscle connection with postpartum. The diaphragm specifically, is impacted by carrying a child and ultimately needs a little help once that baby is earth side. Wondering how pelvic floor dysfunction is impacted by breathing? Your diaphragm is the muscle located just below your lungs and impacts respiration.
Our rib cage is affected during pregnancy, along with the muscles leading downward to the pelvic region. These areas all work together (or don’t in this case) which can cause pelvic floor dysfunction. Learning or re-learning how to breath properly is imperative for the overall function of your abdominal and pelvic muscles (your core.)
Note: If you have trouble feeling your abs contract, you can use a towel or long shirt to guide the muscles in the torso area to close and contract on the exhale for these movements. Wrap the towel or shirt around your back with the two ends in both of your hands. On the exhales, pull the two ends closer together forming tension around your sides.
Here’s how to practice reconnecting with your breathing and pelvic floor muscles:
1.Hands To Ribs To start, take your hands and place (cup) them around your ribs. (Think, hands on the hips and then move them up to your ribs.)
2.Expand Side Then Back On the inhale, first feel the rib cage expand into your hands then breathe into your back. You should feel a stretch in your back as the pressure expands this area (focusing on your diaphragm.)
3. Pull The Zipper In This is often referred to as “sucking up the blueberry” into your vagina. We want to pull the zipper up the hole(s) which forces a contraction (hello, pelvic floor) during the exhale. (Remember to engage the other hole too.) This is also where you’d start pulling on the towel/shirt ends closer together to reinforce this exhale and support the contraction of the muscles.
4. Pull the Zipper Up As we’re sucking the zipper in (on the exhale), we need to continue zipping it up. This focuses engagement at the deepest abdominal muscle, the transverse abdominis (not your 6-pack), which is responsible for holding everything in and wraps like a corset. Slowly pull the zipper up until you’ve completely exhaled (and keep pulling on the towel/shirt if you’re using one.)
Remember, you may not have full function of all of these areas yet. If you are not able to feel your pelvic floor at all, I recommend you mention it to your health care provider as they can best help you with next steps (or a script to physical therapy.)
Having trouble with these movements? See below on some pelvic floor dysfunction exercises you can do to help at each of these steps.
Can’t Feel Your Back When Breathing In:
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- Deep Squat Chair Stretch – Grab the back of a chair with both hands and while holding it, perform a squat. Hold your position at the bottom of the squat and attempt to breathe into your back. You do not need to see or feel large amounts of movement however, you should feel/see some expansion. Keep breathing in and out slowing for the entire duration.
Perform this movement 2-4 times for 30 seconds (start counting at the bottom of the squat.)
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- Rock Back Breathing – Lay in a kneeling position with your glutes on the heels of your feet. Hunch forward (almost like child pose). Inhale, expanding your breath into the back. Then, pull your belt buckle to your back (activating your core muscles) on the exhale.
Perform this movement 2-4 times for 10-30 seconds.
Can’t Feel My Pelvic Floor:
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- Swiss Ball Kegels – Grab a small towel and roll it up. Sit on the swiss ball (also called exercise ball/stability ball), placing the small towel directly under your vagina. This allows your body to sense something down there to provide feedback/feeling. (tactile) Inhale through your mouth and on the exhale, try to lift the pelvic floor off the towel. (you should not be engaging other muscles like your abdomen or glutes.)
Perform this movement 3-4 times, attempting to hold the contract for 5-10 seconds.
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- Quick Flicks – Sitting or standing, breathing in through the mouth and on the exhale, attempt to “pull the zipper” quickly and drop it. Or, “suck the blueberry” up quickly and let it go. You can use the towel/shirt method here too.
Perform this movement 2 times with 3-4 flicks as quickly as the flip of a switch.
Can’t Feel My Transverse Abdominis:
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- Abdominal Bracing – Lie on your back with both knees bent and feet flat on the ground. Make sure your rib cage is as closed as possible (should not be flaring). Place your hands on the sides of your torso (think – hands on your hips but move them to your abdomen.) On the inhale, breathe through your stomach (and back if possible) and on the exhale push air through your mouth like you’re blowing out candles. As you’re exhaling, pull the zipper in and up which should cause your belly button to go up while pulling toward your back. You want it to look like the air leaving is deflating your stomach. At this point you should feel the abs push into your hands if you are contracting correctly. You can also place an item with a little weight (i.e. a basketball) on your stomach and as you exhale you should see this drop slightly rather than bounce or fall off.
Perform this movement 2 times for 20 seconds.
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- Deadbug – Lie on your back with both knees bent at a 90˚ angle (feet dangling in the air.) Make sure you do not have an arch in your back (you should not be able to stick your hand all the way through to the other side.) Inhale through your nose and on the exhale pull the zipper in and up while simultaneously lowering the right leg and tapping your right heel AND extending your left arm up and overhead, lowering it towards the ground above your head.
Perform this movement for 8-10 reps on both sides.
NOTE: To increase the difficulty, move the working leg farther away from the body when lowering until it is straight. I suggest looking at videos to make sure you are performing this correctly. Do not allow the lower back to lift off the ground.
But most importantly, remember that each person’s journey is so different. Pelvic floor dysfunction is no different! It may take a while to get to a point where you can feel muscles again but just know there are plenty of resources to help you improve.
And while some of these may feel difficult to do, the more you practice you will regain this strength. There are various pelvic floor strategies to use which is why I do recommend asking your health care provider about the strength and/or the severity. Knowing this information about your pelvic floor dysfunction can help you determine where to start in your recovery journey.
