When a woman first comes to see me, we talk through her medical questionnaire to find out a little about where she is at right now. Questions like: What kind of pregnancy did you experience? What was your birth like? Did you deliver vaginally or via c-section? Were you pushing for a long time? Was it an emergency or planned c-section? are really important to get to know what her body has been through and how to best work with her, moving forward.
For many women, being pregnant and giving birth is the bit they learn the most about. Most women keep themselves safe during pregnancy because they want to keep their baby safe. Most women don’t push their training too hard. They slow down when they feel they need to. They read books and search the internet, seek advice and ask questions.
But often once their baby is born, much of the research stops. They may have been told somewhere about their pelvic floor and maybe they do their exercises – or what they think the right exercises are (more on that later). They feel okay. They feel kinda back to normal. So they figure it’s okay to go back to what they were doing before they fell pregnant in a bid to re-discover their pre-baby body.***
But the truth is they may not actually be okay. I am going to talk specifically about pelvic floor.
Your pelvic floor is an internal muscle. As a personal trainer I can’t feel it. I can’t see it. I’m not qualified to do so. And I can’t tell you if it is working or not. No PT or pilates instructor, or yoga teacher, or ANY Fitness Professional can tell you that you are properly and effectively activating your pelvic floor – and that’s before we get into strength and endurance.
Did you know that 50% of women, when taught from a brochure or verbal instruction, do not do a ‘correct’ pelvic floor activation?
If a correct activation is a lift, then an incorrect one is a bearing down. And for some women this is exactly what they do. They mix up the movement pattern and push out through their pelvic floor. Imagine doing this 20, 30, 50 times a day. Not good. It has the potential to make a weak pelvic floor even weaker.
So when a woman comes to me, I recommend she sees a Women’s Health Physiotherapist for a proper examination. I let her know that I need to work with the physio to ensure she is properly looked after; that I need an eye on the inside so that I know the exercises I am giving her are not doing further damage, inside or out.
And if that doesn’t work, I let her know that symptoms may not show up now and I’d rather she wasn’t suffering incontinence in her mid 50’s or struggling when her insides become her outsides. Not the most subtle approach, but sometimes you just have to tell it like it is.
I have worked with many women who ‘thought’ they were okay; who having not gone to see a women’s physio might have pushed through into harder, more strenuous exercise without properly re-building from the inside out. Not because they were careless, but just because they didn’t know. You don’t know, what you don’t know and given pelvic floor weakness isn’t generally indicated by pain, and can often be non-symptomatic, then why would they think otherwise? Education is key.
I had a quick chat with one of the women that trains us at Body Beyond Baby and she offered to share her post baby story with you:
“I’d always been confident that I had a strong pelvic floor and before I fell pregnant with my first child, a women’s physiotherapist, who I’d seen for an unrelated pelvic issue, happily confirmed my assumption.
I started training with Jen when I was pregnant with my second child. I’d gained a huge amount of weight so after my daughter was born, I couldn’t wait to get back into running and strength training and rediscover my old body. Even though I’d had two vaginal deliveries, both labours had been relatively short and my pelvic floor had been stronger than average before I started having kids, so I was confident that all was well ‘down there’. I continued to brush off Jen’s encouragement to see a women’s physio until her encouragement became less gentle and more pointed.
I was shocked and dismayed to discover that things downstairs were no longer so great. I was activating my pelvic floor properly but strength-wise, it was just ‘ok’. My fascia were stretched, I had movement in the front and back wall of my uterus and I was at risk of bladder prolapse.
I felt frustrated having to return to walking, dropping the weights and so on but two years later I’m so pleased I did. Working slowly from the inside out has made me stronger than I was before. There’s still some minor movement through the front wall of my uterus but my pelvic floor is now a 5/5 and more than strong enough to counteract any risk from the stretched fascia. I’m running and back in the gym again and completely confident that my insides are going to stay where they belong!”
Emma Anderson, mum of two
I’ve worked with thousands of women over the years and not one of them has seen a physio, come back and said, “I wish I didn’t go.” If my words have peaked your interest even just a little then do yourself a favour, no matter how ‘old’ your baby is, go and get a check up and put your mind at rest.
***You will never, ever, have your pre-baby body again but what you do have is the potential for an even better and more awesome POST-baby body. And that’s cool! My post-baby body is so much more awesome and I give it so much more respect than I did before children. And if you commit to learning exactly what is going on, form the inside out, you have even more potential and are even less likely to be slowed down by injury or weakness down the track.