So you’ve had the baby, the stitches have healed, you’ve done a few pelvic floor exercises and you’ve attempted ‘relations’ with daddy. All seems good so far … then one day you get onto a trampoline with your tot or perhaps even attempt jump jacks at the local circuit class and suddenly it hits you. Things just aren’t the same anymore!
If you don’t know what I’m referring to then you’ve either had a C-section or you’re one of the lucky ones. Exceptionally fast or very slow pushing phases of labour, high reactivity to hormones during pregnancy, big or multiple babies, age at which first baby was delivered vaginally, intervention such as ventouse or forceps and occasionally even a baby coming out at an awkward angle can all damage you up there. And I say up there because that’s the point, it’s just so hard to know what’s going on up there because we can’t see it and until you try to do something energetic you might think all is well!
So is there anyway of screening pelvic floor health to know if you’re safe to start energetic exercise again? The simple answer is no, it’s all very individual and unless you have an ultra-scound scan it can be difficult to get any conclusive, measurable evidence. But all is not lost. There are some good places to start!
How is it all supposed to work?
Think of your trunk or your core like a box of Pringles. The sides of the box are, for the sake of simplicity, your deep abdominal muscles and lower back muscles. The top is your diaphragm and the bottom, is your pelvic floor. If you were to stamp on the packet (not that you would do this) and the bottom was not completely secure, it would pop off, expelling crushed Pringles all over the floor and making a nasty mess.
The same is true of your pelvic floor. Think of it like a hammock, or a trampoline, it has more give than a Pringle pot’s bottom to allow for some pressure build up but still needs to be able to clamp shut and secure the pressure within. If there’s a little bit of damage, an over stretch or similar then when put under extreme or continuous pressure, like a set of ten jump jacks, it might not hold up to the intensity.
How do I know if mine is damaged?
Again, you don’t know until you try. When it comes to high impact exercise we need to consider how your fast twitch pelvic floor muscles are working. Here are a few key pointers:
- Do you leak a little when you sneeze?
- Do you leak a little when you sneeze in a squatting position?
- Can you bounce on a trampoline with confidence?
- Can you do a squat jump, jump jack or series of jump jacks without leaking?
Pelvic Organ Prolapse
Now I’m all for exercise. It makes you feel great, helps manage weight and fat stores, can be sociable etc etc but too much high impact exercise when your pelvic floor isn’t competent could lead to further, avoidable problems, such as pelvic organ prolapse. I should also mention at this point that it’s absolutely nothing to be ashamed of, I spoke with a top level physiotherapist/Pilates expert who experience a vaginal prolapse following the birth of her second child due to running too soon. It doesn’t mean you’re unfit, it just means you’ve been injured. You wouldn’t try running with a torn hamstring.
What to do now?
In my next post I’ll be going into more detail on specific exercises you can do to build strength and competence in your core and pelvic floor. But in the mean time, get familiar with what’s ‘up there’. Do do your pelvic floor exercises and whenever you’re exercising remember to engage your core, from your floor. So literally pull up from your tail and your tummy to make sure everything is tucked in! Remember to do slow wave like exercises first, followed by the quick squeeze all the way up and all the way back down AND do exercise to fatigue. A quick squeeze isn’t going to cut the mustard if you’re injured.