I recently completed a course ‘Safe return to Exercise’ with Jen Dugard to update my knowledge on women’s health, especially post-natal women. I was actually shocked to find out that when a new mum has her 6-week post-natal check-up, often her pelvic floor muscles are not examined and that her abdominal muscles are not checked for ‘separation’. Many new mums are told at this check-up that they are okay to return to ‘what they were doing before’, however how can that be when their body has undergone massive change growing a baby for the last 9 months? I believe that it’s going to take at least 9 months for it to recover internally!
If a post-natal woman starts to train ‘too hard, too fast, too soon’ she can really do some permanent damage to her pelvic floor muscles and increase abdominal separation. Pretty scary stuff when it could have been avoided if she booked into a Women’s Health Physiotherapist straight after her 6-week post-natal check up! When visiting a ‘Women’s health physiotherapist’, the consultation normally involves the use of a ‘real time ultrasound’ machine and an internal examination.
How empowering would it be for new mums to know what tailored rehabilitation work they need to do to recover, to potentially stop pelvic floor dysfunction, pelvic floor prolapses or abdominal separation later?
So, now let’s talk about the role of Pilates. Qualified Pilates teachers will teach you how to strengthen your ‘deep core’ before the more superficial layers and only prescribe suitable exercises to help with your healing. This will start with re-training your pelvic floor and transverse abdominus muscles. As powerful as Pilates is though, we can only do an examination of a client from the outside and not the inside, so this is where we need to partner up with the expertise of a Women’s health Physiotherapist.
Tips on how to activate just your pelvic floor muscles (and for men too!):
Some interesting but shocking statistics:
So I’m not sure whether this is being communicated to new mum’s but certainly I will be recommending all of my female clients to a Women’s Health Physiotherapist from now on whether they are 6 weeks post-natal or 60 years post-natal, to go and have a check-up with a Women’s health physiotherapist and maybe they can get back to running, jumping and skipping without leakage and without doing further harm to their pelvic floor and abdominal muscles. It’s never too late!
From Jen Dugard: “In regards to the Chronic Disease Management program through the GP – you can request that referral to a WHP (Women’s Health Physiotherapist) of your choice (i.e. in a private practice) and the key criteria is that you have been experiencing symptoms for at least 3-6 months. In most cases post-natal incontinence should be sufficient for the GP (if they’re reasonable) to allocate at least a few visits (out of 5 total to any practitioner in a calendar year) .”
For the latest pregnancy guidelines, see the 2019 Canadian guideline for physical activity throughout pregnancy