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By: Rhea Tomlinson (BMR-PT, BA)
Certified in Pelvic Health Level 3, Acupuncture & Dry Needling
RYT 200 hour
If you are pregnant or postpartum and you want to learn more about Pelvic Floor Physiotherapy, this blog is for you! Zen Physiotherapist Rhea Tomlinson is trained in Pelvic Health and discusses the importance of Pelvic Floor maintenance throughout your perinatal journey and here is why!
We hear about how it is “normal” to start peeing your pants or dribbling when you are pregnant or postpartum. How painful sex once you have given birth and been cleared to return is commonplace. I am here to tell you that these issues are common but NOT normal! They are often preventable with pelvic floor treatments during your perinatal journey!
I highly recommend coming in for your first Pelvic Floor assessment early on in your pregnancy, around the beginning of your second trimester. This gives you time to work on any interventions we might recommend. It is good to come in even if you feel there are no current issues going on. For example, you may have tight or weak muscles that we need to address through various exercises and techniques. Our goal with preventative maintenance is always to get you on a home program with very few follow up/hands on treatments required. Connection to the pelvic floor and your breath is a crucial part of our early visits and will help to facilitate labour and delivery.
We will also discuss physical activity through your perinatal journey and what is safe for you to do in each trimester, including the fourth trimester (0-3 months postpartum). General wellness will be a huge focus of our sessions. Complementary breathing techniques and meditations will likely be recommended. If you are open to having a perinatal health care team, referrals can be made to other wonderful practitioners to enhance your journey.
At our postpartum follow up, around 6 weeks postpartum, we will re-assess the pelvic floor. Whether you underwent a caesarian or a vaginal delivery, there may be changes in this area to be addressed and treated.
Diastasis Recti is the separation of your abdominals that occurs during expansion of the belly through pregnancy and can be assessed and treated. A thorough full body examination is also important in our postpartum follow ups to address any areas of tension from pregnancy, labour/delivery and feeding or caring for your little one. Core and general strengthening exercises will be recommended to suit your goals and needs.
What can I expect at my Pelvic Floor Physiotherapy appointments?
Initial assessments will include a thorough history of your pelvic floor issue and other past and present injuries and illnesses. In addition, you may be asked sensitive questions about your bowel or bladder function, sexual history, pregnancy, labour and delivery.
On assessment, your physiotherapist will do both an external full body screen and an internal pelvic floor examination. The internal examination will be performed either vaginally or rectally to access the pelvic floor musculature. Your physiotherapist will provide you with a sheet to drape yourself and will most likely have you lying on your back with your knees bent up, feet flat on the bed. Your physio will wear latex-free gloves and use a water-based lubricant for the internal examination. Each technique will be thoroughly explained, and your consent will be obtained prior to performing each intervention.
You will receive treatment at your initial assessment. This may include external joint mobilization to the spine, hips or pelvis. Myofasical release techniques may be performed where needed externally to hip and lumbar spine musculature, or internally to the pelvic floor muscles. Home exercises and education will be provided to reinforce any of the techniques we performed. Patient education is key to the success of pelvic floor physiotherapy and will be a focal point or your visits.
**It is very important to note that each technique will be discussed with you and you have the right to refuse or stop treatment at any time. If you are not comfortable with something, let your therapist know immediately. Assessment and treatment should not be painful, and if it is, we can stop that portion immediately. Remember, there are many ways to assess and treat any injury and we want to choose the best ways for you!
Perinatal Pelvic Floor appointments can be pivotal in preventing complications related to labour and delivery as well as various issues down the line as we age. It is our hope that one day every pregnant woman is referred to a Pelvic Floor physiotherapist to support them on their journey.
Please contact Rhea Tomlinson (rhea@zenphysiotherapy.com), or Zen Physiotherapy directly if you would like to discuss how we can help you further!