If I could time travel back 5 years ago, I often think about all the real bits of knowledge I would share with that new excited mom. I would tell her to pack lots of extra baby clothes in the diaper bag for those emergency blowouts, how it’s ok to feel like you don’t have everything together, and I would tell her about pelvic floor considerations – the what, the how, and why all of this matters.
Instead I often say…
“I wish I would have known”
I wish I would have known more information about postpartum issues, what a pelvic floor was, and that pelvic-floor physical therapists existed! Instead, I was caught up in having the perfect birth experience and didn’t think much beyond the big day! (This is a different story, but birth did not go according to any plan I had designed on my laptop. Birth apparently doesn’t work that way no matter how much you will it!)
I wish I would have known HOW to listen to my body, what questions to ask, and most importantly, advocate for myself when I wasn’t sure what was happening to me. These past eighteen months, I have educated myself by working with pre- & post-natal fitness specialists, health professionals, and pelvic-floor therapists. I do this so that I can provide women in communities near and far with the resources they need to thrive.
I wish I would have known there was more to the bigger postpartum picture than sleepless nights, diapers, and cute baby clothes. Preparing MY body, mind, or emotions for the postpartum period was something that never came up in conversation. By the way mamas, postpartum isn’t just the 4th trimester (considered the first 3 months after delivery), POSTPARTUM is forever! Our bodies, regardless of our birth experience, are forever changed. It’s not something to fear, but it is something to learn and gain strength from.
I wish I would have known that while common, that it wasn’t normal to experience the symptoms of leaking, pain, and weakness that I was having.
YET, in a way I am GRATEFUL that I didn’t know. It took me down a path I never imagined traveling. This path has taken me to a place where I speak up for those around me and provide them strength, power, and knowledge. I don’t want my friends, my family, my community of amazing women saying, “I wish I would have known…”
We do not need to keep quiet about these issues. We can and should share our experiences. In our sharing, we lift one another up to become stronger, more powerful, and more aware in how to keep improving the lives of those that we love.
The Road to Empowerment
While it can be scary navigating this journey, you do not have to travel alone. Often times, there are ways to treat and manage pelvic-floor issues to get you back to being you.
This means not running to the bathroom because you’re afraid you won’t make it. It means being able to jump on the trampoline, run, and laugh with your kids; shoot, even sneeze or cough without leaking! It means having a truly STRONG core that gives you balance while living the FUNCTIONAL life you deserve.
There are different strategies within breathing, alignment, physical therapy, progressive movement, and much more, that can assist in the healing or managing of pelvic-floor dysfunction. The fix is often not surgery, but individualized strategies that you can learn with the help of a trained professional. If you have any symptoms mentioned in Part 1 of this blog series, it’s important to advocate for yourself, in any stage of your life!
Ask for a referral to see a pelvic-floor physical therapist who can collaborate with a specialized fitness professional who understands how to help you move. As a team, a plan can be collectively built with intentional movement and strategy that is right for YOU based on YOUR own unique goals. We need to open up this conversation for our friends, our daughters, and OURSELVES.
Now we understand why we need to care about the core and pelvic floor, but what exactly are they? Below is a brief anatomy lesson on the core and pelvic-floor basics!
The core is made up of the diaphragm, the transverse abdominis (TA), the multifidus, and the pelvic floor. Typically, we often think of just the six pack (rectus abdominis) muscles or obliques, and while important, they do not make up the primary components of the core system. We need to utilize all parts of the core for not only our favorite exercise, but our daily activities like carrying kids, grocery shopping, or picking up legos for the 8 millionth time. The core is the foundation for strength and the center for all movement. (1)
The Pelvic Floor
The pelvic floor is not just your vagina. Raise your hand if you knew that? I didn’t!
The pelvic floor is a group of muscles that essentially acts as a bowl, working together holding in the contents and structure of your body. The job of the pelvic floor includes dynamically responding to changes in pressure and load, as well as maintaining continence (no leaking!) (2)
In addition, the pelvic floor:
- Supports organs/structure at rest and during exertion
- Facilitates sexual pleasure
- Initiates and completes toileting activities
The pelvic-floor muscles perform in conjunction with your inner core helping you create/maintain stability, balance, support, pleasure, plus keep you dry!
See, talking about your pelvic floor isn’t so bad!
Coordinating the Core Canister
Utilizing the core canister as a coordinated unit helps provide stability, manage pressure, and ultimately provides strength to our bodies. Normally, these muscles work in anticipation to automatically accomplish these important tasks. During pregnancy, postpartum, or menopause, the body undergoes many changes which can cause this system to sometimes (not always) become out of sync. As a result of these muscles not working together, dysfunctions such as incontinence, diastasis recti (that does not regain function), and pelvic-organ prolapse can occur.
The below diagram shows the core working together as a coordinated unit. On inhale, the diaphragm contracts and descends, with the belly and pelvic floor relaxing to make room for everything in our bodies. On the exhale, the diaphragm relaxes with the pelvic floor rebounding, gently lifting upwards and in with your deep abdominal muscles (TVA) working together.
Often times, moms think they have a weak pelvic floor that results in leaks. However, this may not always be the case and the opposite can be true!
Pelvic-floor muscles should be flexible so they can relax as well as support and hold. (3) After my second baby, I was diagnosed with a hypertonic pelvic floor, which meant that I could not fully relax my pelvic-floor muscles. When these muscles cannot fully relax and lengthen, the muscle can fatigue thus resulting in leaks. A common example is this: think about your biceps for a minute. We don’t walk around constantly performing a bicep curl (well most of us don’t!). If we constantly flexed, the bicep would fatigue and eventually give out. Same can happen with our friend the pelvic floor.
Remember my Kegel marathon? Instead of always focusing on tightening my pelvic floor through Kegels, I needed to learn how to relax my pelvic floor and coordinate them with my whole core system. Learning this was the difference maker for me and why I no longer pee when I jump. In addition, coordinating my system allowed me to regain balance and strength. By learning to use the core and pelvic floor together, it can help manage the pressure within our system which may reduce leaks, help improve diastasis, and regain overall function.
My personal experiences will not be your experiences or situation. We are all different. I recommend that any pregnant or postpartum woman (any age!) visit with a women’s health physical therapist to discuss more how your core and pelvic floor are working together based on your own unique considerations.
Click here to find a PT near you!
Time to Speak Up
I speak up about this because I remember my first jump-rope workout after having my son and the feeling of embarrassment and sadness when I leaked everywhere! It doesn’t take having kids to have stress or urge incontinence, but it can be a major reason why, regardless of the type of delivery you experienced. Incontinence is an issue that affects both men and women, young and old.
I speak up about this because I remember seeing my stomach make a tent shape down the middle of my abdomen. I felt so weak through my core and back that I regularly lost my balance while lunging down to the ground. Diastasis recti (DR) is still a condition that is being widely researched. However, in many cases – not all – through work with a pelvic-floor physical therapist, you can regain optimal function of your core without undergoing surgery. If you have DR please consider following my friend Lisa Ryan’s journey here – it’s absolutely incredible!
I speak up about this because pelvic-organ prolapse (POP) is common among many women or only thought to be an issue for postmenopausal women. POP is the descent of the pelvic organs from their original position into and sometimes outside of the vagina. However, many women don’t know they have prolapse or ignore the symptoms until it’s too big of an issue to ignore. Symptoms can often be managed by learning strategies and movements that work with their bodies – allowing moms to return back to running, lifting, and living!
I speak up about this because I didn’t know I needed to massage and watch for scar tissue on my c-section scar. Many friends and clients didn’t know that after experiencing a perineum tear that therapy work with a trained pelvic-floor physical therapist could help them manage pain. Scar tissue can build up adhesions which can cause problems that lead to nerve and muscle pain, as well as attach to organs causing issues such as incontinence.
I speak up about this because many women who have low back, hip, or chronic pelvic pain are often told it’s part of motherhood and the “gift” of having babies.
I speak up about this because no matter how “fit” we are, how much we ignore signs or symptoms, or keep these things to ourselves – these issues matter. Our FUNCTIONING bodies matter. This should be the message we hear. Not a bounce back message, not how to lose the baby fat as quickly as possible, not “I wish I would have known…”
Be the Change
Prior to motherhood I didn’t know that many of these issues existed and now I do. So, Moms, allow our bodies to heal, repair, recover, and let’s open up about the process. These common dysfunctions span far beyond motherhood. Our young daughters, sisters, mothers, friends, grandmothers are dealing with these problems or might have them in the future, not realizing there is help and hope available to them.
The women we love are counting on US.
Let’s speak up and start having the conversation about “down there” – a conversation that educates, empowers, inspires, and supports women to lead the lives they deserve.
I hope you’ll join me in speaking up, building awareness, and supporting our community of strong, inspiring, and amazing women!
Stay tuned for upcoming posts on how and when to return to exercise, the role of a pelvic-floor therpist, and some of my favorite functional movements!
1. Snatch Kettlebells Course, Haley Shevener
2. Antony Lo, The Female Athlete Course