pelvic organ prolapse

How To Perform A Kegel Correctly: Day 1 of Challenge: The Hammock

Hey girl!!

Props to you for joining in the challenge of learning how to use your pelvic floor muscles correctly.

This is a 4-5 day challenge and I will be sharing a little information with you from day to day on the pelvic floor muscles.

The first time you may have heard of the pelvic floor muscles, could have been when you were pregnant or after you gave birth, due to someone telling you to do Kegels.  Am I right?  

If you’ve never heard of pelvic floor muscles or “Kegel” exercises, than today is your lucky day! Go buy a lotto ticket (I kid, I kid)!

The Kegel exercise gained it’s popularity first in the 1950s for it’s way of contracting or tightening the muscles in the pelvic floor.

The pelvic floor is a group of muscles inside the pelvis that act like a “hammock” in supporting the bladder, uterus and bowel.  This muscle group helps stabilize your pelvis so you can walk, run, exercise, sit, stand, kneel, or reach for a glass out of the cabinet.  When you contract or shorten these muscles (like stopping the flow of urine), they close your three openings (if you are female) and keep urine or feces from coming out. And then when you relax the muscles, they should return to resting state.

Girl, did you know how you sit and stand can affect your pelvic floor muscles? For instance, sitting with legs crossed or with poor posture can cause clinching in your pelvic floor. Prolonged standing can also cause tension if doing it in poor standing mechanics as well.

Oh! And these muscles are the first ones in your body to tense up when you have anxiety or see something negative on the news, hear something negative etc...Talk about a “headache in your pelvis”. The pelvic floor is also affected by hydration, or lack of. If you are drinking more caffeine or soda and minimal water, you may feel spasms in the pelvic floor or lower abdominal cramping.

Alright…the next blog will be on Day 2 of How To Correct Your Kegel.

If you have any questions or concerns, please reach out!

xoxo-Amanda

Looking up at the pelvic floor (picture above).  Looking down into the pelvis (picture below)

Looking up at the pelvic floor (picture above).

Looking down into the pelvis (picture below)

Pelvic-Floor-3.jpg

Should We See A Pelvic Floor Physical Therapist Postpartum?

Image from Google Images 

Image from Google Images 

Just a little food for thought.  Delivering a baby, vaginally or cesarean, is a difficult job for our body.  I hate to say it, but birth is traumatic to our tissues.  The muscles are stretched during childbirth, some are torn or even cut through, in order to do what is best to get baby out safely.  As a pelvic floor physical therapist, I have often wondered, why are these women missing out on opportunities to improve the function of their pelvic floor and abdominal muscles after delivering a child?  In all other areas of muscle injury (strain) or rupture/ tearing, patients are usually advised to seek the help of a physical therapist for regaining muscle control, range of motion, strength, flexibility, stability and overall function.  For instance, someone might have a whiplash injury (similar to a childbirth with minimal or no tearing), they would see a physical therapist to stretch tight muscles and strengthen weak muscles.  If someone tore their Rotator Cuff, they may have surgery to fix the muscles (similar to repairing pelvic floor muscles or abdominal muscles after delivering a baby(ies)), then they would seek the help of a physical therapist to stretch the tight muscles, regain coordination of the muscles, teach the brain how to connect with the muscles again, and go through a program of improving range of motion and strength/ endurance of the muscles.  

I think we are missing this with our new moms.  Think about it.  Women are pregnant for approximately 9 months (posture changes, back muscles tighten, abdominal muscles weaken etc) and then they go thru delivery (with tearing or not) and their body's are expected to bounce right back while taking care of a rapidly growing new born.

What I see with my patients are poor postural stances of weakened and stretched abdominal muscles, tight and short low back muscles, sometimes tucked bums or ribs thrusts with carrying and lifting baby/ children/ car seat etc.  I think it would benefit so many new moms to be referred to a pelvic floor physical therapist postpartum.  Every new mom could come in for a screen to see if they are having any issues and if there are any things a new mom should be working on in the first couple of months.  I personally think, it would be beneficial to see a pelvic floor physical therapist for a screen PRIOR to getting back into an exercise program.  A pelvic floor physical therapist can evaluate women for diastasis recti, pelvic pain, pelvic organ prolapse, urinary incontinence and proper postural and body mechanics.  Hopefully with seeing  pelvic floor physical therapist, this would prevent more pelvic floor risks and issues in the future. 

So...see a pelvic floor physical therapist today, even for a screen, to see if you would benefit from starting a pelvic floor home exercise program.  Why not support your tissues for a stronger future?  

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