Have you heard of the boat theory?
Try to imagine that your pelvic floor is the water level, while your pelvic organs (your uterus, bladder and bowel) are the boat sitting on top of the water. Again, imagine the boat is attached by ropes (your supportive ligaments) to the jetty.
If after pregnancy and the birth of your baby, your pelvic floor muscles are stretched, so the water level is lower and the ropes are under tension. Imagine if the water level stayed low for years. If your pelvic floor muscles do not strengthen again, supportive ligaments overstretch, it increases the risk of you developing a prolapse. This can occur soon after the birth, or in the years to come.
If your pelvic floor muscles are strengthened after the birth, there will be less risk of ongoing tension on the ligaments supporting your pelvic organs, and therefore less risk of developing a prolapse in the future.
What would happen if you added jumping or running activities to a pelvic floor that is stretched? This would most likely further weaken your pelvic floor muscles, place further tension on the supporting ligaments and increase the likelihood of pelvic organ prolapse.
(Reference: Continence Foundation of Australia–The Pregnancy Centre 2017.)
It is therefore highly recommended that you arrange a 6 week postnatal check-up with a pelvic floor physiotherapist for an assessment and pelvic floor strengthening program. It is also important that your physiotherapist guides you on the correct technique as bearing down instead of lifting during pelvic floor contraction can precipitate a prolapse. Further, weakness of the core muscles with abdominal muscle separation (recti diastasis) can affect recovery of the pelvic floor as the core and pelvic floor are linked trough fascial layers. Arranging a Women’s Health assessment and commencing guided rehabilitation can facilitate a timeous recovery and return to sport postnatally.
WORDS: Sharmine Dewhurst – Women’s Health Physiotherapist – Beaches Physio