Pelvic Organ Prolapse: 50% of Women Who Have Had Children May Have This

Pelvic Organ Prolapse (POP) is a diagnosis women can get postpartum and after childbirth.  Statistically, 50% of women are at risk for POP after pregnancy, but you can develop POP prior to pregnancy.  I ended up having a little pelvic organ prolapse during my "training for half marathon" days, which then worsened postpartum (with each of my pregnancies).  Know this though, having prolapse does not mean you have to stop exercising. I certainly have not and I am pregnant with my third! :)    

Picture from Google Images

Picture from Google Images

Prolapse can tend to be a scary word, so let's go over what it is.  Pelvic Organ Prolapse (we will discuss female anatomy) is when the pelvic organs are pushing against weakened pelvic floor muscles that are not functioning to support the organs within the pelvis (bladder, uterus, rectum, urethra) and women can begin to feel pressure in vagina (sometimes women feel like an old tampon is coming out) from the organs starting to come down into the vagina.   

3 Most Common Types of POP:

Picture from Google Images

Picture from Google Images

1: Cystocele: bladder prolapse.  Women may complain of feeling pressure in vaginal canal.  Sometimes the pressure is felt when the rectum is filling with stool and pushing in on cystocele.  Other times it is felt after lifting or carrying weight (same with all 3 types), such as babywearing.

2. Uterine: The uterus can lower post pregnancy and delivery.  Sometimes it is difficult to keep a tampon in due to a lower uterus or some women find intercourse uncomfortable because their partner may be hitting their cervix during deep penetration.  Do keep in mind, the uterus does move during our cycles (higher and lower) and this is why some women may feel this during their days 14-21 of their cycle (different for everyone). 

Picture from Google Images

Picture from Google Images

3. Rectocele: Rectum prolapse:  Some women may complain of feeling a bulge in vagina when the rectum is full of stool.  Some women have to "splint" or insert their fingers vaginally to push back on the rectum to void during a bowel movement. 

Prolapses are measured by grades of 0-4.  "0" meaning no degree of prolapse and "4" meaning the prolapse is bulging outside of the vaginal opening.  Your doctor can give you your grade of pelvic organ prolapse in their office.  I like to look at my patients' prolapase in the clinic in a few different positions and let the patients see what they are feeling in their vaginal canal. Remember, 50% or more of women can have some kind of degree of POP after baby and some can be asymptomatic and manageable. Some POPs cause more issues so it's important to seek proper postpartum exercises and the help of a pelvic floor physical therapist to assess what exercises would benefit you and help you get back to certain exercises that interest you.  

With being early postpartum, and/ or if you are experiencing "feeling of pressure in your pelvis" or "pressure down there", it is important to avoid certain activities and exercises:

  • Avoid standing for prolonged periods of time: this could be household work, baby wearing through the grocery store,  carrying toddler, lifting heavy weight (moving furniture) etc 
  • Avoid wide leg squats and lifting from a deep squat, especially while holding your breath may increase your prolapse
  • Avoid abdominal exercises: such as crunches, sit ups, planks and push ups (not saying avoid forever)
  • Avoid running, jumping, HITT workouts, plyometrics and burpees etc ( I like to avoid these until 4-6 months postpartum AT LEAST to help the pelvic floor muscles heal properly after delivery). 

What you can do while exercising in early postpartum:

  • Pay attention to what you are feeling in your vagina while exercising and afterwards.  Increased bulging and pressure are bad.  If you feel this, you may have increased your exercise time or intensity too soon. 
  • Focus on your posture and alignment while exercising.  Remember to keep ribs stacked over pelvis.
  • Watch your breathing with exercises.  EXHALE during exertion and avoid holding your breath with exercises.
  • Focus on core and pelvic floor strengthening and retraining to get the muscles on the right tract to support you and your organs again
  • Do exercises in different positions: lying on your back, back and hips elevated, sidelying, sitting, standing (avoid too much of this one due to gravity)

I like to suggest to new moms to seek the help and guidance of a pelvic floor physical therapist before getting back into running or plyometric exercises to avoid POP and other pelvic floor dysfunctions in the future (especially if they are having signs of pelvic floor dysfunction: urinary incontinence, pelvic pain, feeling of pressure, diastasis recti, low back pain, hip pain etc).   . 

Pregnancy Journal: 27 Weeks!

On the hayride to go find our pumpkins!

On the hayride to go find our pumpkins!

I am closer to 28 weeks than 27 weeks while posting this, but our house was hit with the stomach bug this weekend and life got away from me.  

Landon doesn't like sitting on the hay.  Jackson was so excited to sit by the pumpkins!

Landon doesn't like sitting on the hay.  Jackson was so excited to sit by the pumpkins!

So #27weekspregnant and continuing to feel great!  This is my favorite time of year.  I love the fall, Midwest weather, the clothes, the smells, the food (but really, who doesn't love food while pregnant?!), and the outside activities.  My boys and I went to a local Pumpkin Patch this weekend (prior to getting sick), and had a blast. 

I am feeling baby move more and more each day.  Especially when Jack and Landon talk to my belly.  They love telling "Baby Fred" (that's what they have named him) all about their days, what they ate and what they did.  I need to record these conversations because they are freaking adorable!  

I was low on iron so I have started taking an iron supplement and eating more iron rich foods (greens, spinach, beans etc) to help improve my levels.  My eyesight has improved with doing so.  My eyesight was getting pretty bad over the last month so I am glad my doctor caught that.  

I am continuing to eat a diet high in good fats and protein.  Lots of good research out there with having a diet high in healthy fats while pregnant and breastfeeding.  I am adding more avocado, coconut MCT oil, and Omegas to my meals and snacks throughout the day.  I definitely feel better when I do, especially when I am staying hydrated, I notice less swelling in my labia and legs.  I mentally feel better too! That's a bonus as a mom of 2 (soon to be 3!).  

Eating a diet high in healthy fats is also great for women of all ages because they help regulate our womanly hormones.  How wonderful is that!!  We could all use a little help with our hormones, am I right?!  hehe

Anyways, I'll be making a post on that soon!

Have a fabulous week!  If you want to chat about anything, remember, I do virtual consults now :)

Amanda 

5 Important Pieces of Information About Diastasis Recti (Abdominal Separation)

Abdominal separation (Diastasis Recti) of your mid line of six-pack muscles is all the chat right now in social media.  So...I want to give you the low down on what the hype is all about.

When I first started my training with pelvic floor physical therapy, I was under the impression that a 2 finger split was considered normal.  With time, more research and growing knowledge about this topic, we now know that not to be true.  

After you read this I hope you feel more comfortable about this topic.  

5 Important Pieces of Information About Diastasis Recti (Abdominal Separation)

Fact 1 :I feel like a see 3 new sponsored posts daily on this topic.  An abdominal separation can happen to the linea alba, the connective tissue within your mid line, due to the laxity that happens from growing uterus and baby.  Try not to stress out about an abdominal separation.  It is very common among pregnant and postpartum women and very possible to heal a diastasis recti (men can have Diastasis Recti too).  A study by Diane Lee, found 100% of women have abdominal separation at 35 weeks gestation (pregnancy).  Your body is smart one and knows what it is doing.  Your belly stretches to accommodate your growing uterus and baby. The study found that by 6 months postpartum, diastasis had decreased to 35-39%.  So it is important to check in with belly every now and then to see if yours has gotten stronger.  

Fact 2: Posture and alignment are important with strengthening the gap.  Pay attention to how you are standing, lifting and carrying baby. Make sure your shoulders and ribs are stacked over pelvis to keep your torso in good alignment, which decreases pressure in your abdomen (less pressure pushing on linea alba-midline of abdomen).  Try to be mindful of how you are lifting/ carrying baby, especially when in the car seat or baby wearing. This is also a great place to start seeing a pelvic floor physical therapist so they can help you with your alignment with activities and assist you on your road to recovery.

Fact 3: Another way you can decrease the pressure in your belly is by breathing out (exhaling) when you are lifting baby.  This is great to remember when lifting baby into car, crib, picking toys up from the ground, lifting holiday decorations etc.  

Fact 4: There is NOT one exercise that will heal your abdominal separation.  There is also NOT one exercise that will ruin your abdomen.  There may be exercises that you need to avoid while you are working on strengthening your separation, but you can get back to those exercises when your body is ready.  For instance, if you are seeing a pelvic floor physical therapist, they may ask you to avoid certain core strengthening exercises, like a plank, but that doesn’t mean you will have to avoid them forever.

Fact 5:  The internet gets us caught up in the separation of our abdomen.  Is it 2 fingers wide, 3 fingers wide or more.  I tend to not get caught up on the separation split width and try to not get my patients too excited on this either.  I am more interested in the tension created between the 6 pack muscles that run from the breast bone to the pubic bone. I want my patients to improve in their “bridge” between their mid line, meaning more “taut” with activities of lifting, carrying, exercise etc.  When your tension improves, you are getting stronger!   

Pregnancy Journal: 26 Weeks

#26weekspregnant 

#26weekspregnant 

#26weeks, feeling great and baby boy is the size of a head of lettuce!  Received my Bao Bai Maternity Belly Sport Band in the mail this week and I am in LOVE!  I am now doing my morning walks with the band and NOT my V2 because the band relieves enough pressure in my belly to decrease swelling in my labia.  Love that!  I still wear my V2 and compression hose during the day to help with blood flow, but when working out and walking, I just wear the belly sport band and feel good.

Ask for alternatives!  

Ask for alternatives!  

Well, this week I had my Glucose Test.  Did you know you have a choice on how you want to intake your sugar (50-100 grams depending on your doctor) for the Glucose Test?  You don't have to drink the orange, Glucola drink.  You have choices and there are alternatives for your body (and growing baby).  Which I think is awesome!  I try not to ingest too much sugar in my daily food intake (less than 40 grams daily), so to have options where I don't have to drink a sugary drink (because I avoid sugary drinks anyways) for the test, completely rocked my world.  If I am going to splurge on sugar, I would rather do it as a meal or dessert, than a drink full of ingredients I don't want in my body.  So...I called my doctor's office and asked if it was alright to take an alternative approach.  They said yes and gave me their acceptable substitute for the Glucola drink.  It consisted of unsweetened Cherrios, regular milk, orange juice, white toast and a little sugar.  Much better tasting than the "orange drink" and I didn't feel awful after eating it (like I have in my past pregnancies).  So...ladies...be an advocate for yourself and ask your doctor/ midwife what your options for the test are.  I think you'll be happy you did.  

Pregnancy Journal: 25 Weeks

Rocking my sweet compression hose (and V2)

Rocking my sweet compression hose (and V2)

Finding myself full with eating small meals these days. I am working on eating meals higher in healthier fats with this pregnancy and I am feeling better when I do!  A few of my favorites are adding avocados and good oils to meals.  

Over this last week, I have been having more low back spasms after being on my feet for prolonged periods of time.  I continue to walk my dog in the mornings (my reflection time) and have a little round ligament pain occasionally, mostly on hills.  I work on core hugging during the hills to lessen the pain.  I am hoping to try a core belly support here soon to help ease the pain as well.  Baby boy is the size of a cauliflower this week and kicking like crazy!  Jackson, my oldest, has been calling this baby "Fred" for the last couple of months.  So much, that I am having a difficult time coming up with a name for this child, because now we all are referring to my bump as "Baby Fred".  Any name I say, Jackson will reply with, "Fred is a fine name for a baby".  He is too cute!

Continuing to get in some core, arms and legs workouts, along with some prenatal yoga (very relaxing...pretty sure I fell asleep in class), after my morning walks and between patients, biz and mom life.  Life is crazy, busy right now, and I love it! 

 

Peeing My Pants Postpartum

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Growing a child is pretty wonderful.  Have you ever noticed how much excitement is brought to the room by a growing belly, the "pregnancy glow" or the changes in life that are about to happen as this new little human enters your world?  So much advice is given to you about what to name your child, how to raise it, what to feed it etc but what about the real information we need to hear as moms?  

I mean, I love my mother, all my aunts and female cousins in my family, but none of them, not even my sweet soft-spoken grandma, told me there would come a day when I would pee my pants (during pregnancy AND after baby) when laughing during a night out with friends, or while jumping on a trampoline OR when I sneeze during allergy season.  

Some would say, but Amanda, you are a pelvic floor physical therapist, you should have known this day would come.  Yes, I may have the background knowledge on this topic, but a little insight from friends and family BEFORE delivery would have been nice.  Maybe at Baby Showers, women should be given a handout of all the things that really happen to your body after baby arrives.  I do think, as women, we need to stick together and warn each other of the possibilities of peeing your pants after having baby and how soon this can start.  In reality, if you are leaking at 6 weeks postpartum, there is a high percentage you will STILL BE LEAKING at 12 weeks postpartum and EVEN 5 years postpartum.  So, if you happen to chat with a friend/ family member around 6 weeks postpartum or beyond- speak up!  Don't be afraid to say, "hey, you should probably speak with a pelvic floor physical therapist".  

I certainly don't hold back anymore.  My goal is to educate women on the changes that may happen to them and let them know they are COMMON but NOT NORMAL parts of motherhood. 

So, this week, I encourage you to speak to someone you know, (don't be the weird, creepy person in the grocery store telling women about incontinence---leave that to me hehe) about pelvic health.  You can help improve their health by planting a little seed of knowledge.  

Have a safe and wonderful week!

Amanda