A host of new technologies, products, and physical therapies are aiming to support the pelvic floor and its issues pre- and post-partum.
Beyond Kegels: The Pelvic Floor Is Finally Getting the Attention It Deserves
It has happened during a Pony Sweat dance aerobics routine and when I’ve had to deadlift my toddler. Sometimes, it happens simply upon standing after many hours of being hunched over my computer. The “it” of which I speak is leakage.
There is a list of things that women are often told will never be the same after becoming a parent or giving birth: breasts (my own deflated and decided to go their separate ways), sleep (I want more), focus (I struggle with it), sex (I struggle with it), and, of course, the vagina. My own pelvic woes started before my baby’s arrival—evolving from third trimester throbbing (during long walks or attempting the Herculean feat that was stairs) to the painful postpartum wreckage following a prolonged vaginal delivery to, now, a few years later, occasional leakage and a frequent need to urinate. They are issues that all go back to the pelvic floor, an area that, while frequently mentioned in OB GYN offices, magazines, and by my Pilates instructor, is also just as frequently misunderstood.
The pelvic floor is a group of muscles that connects to an internal web of fascia. “This dynamic system is essential for organ position as it suspends the urethra, bladder, vagina, and rectum, while also providing stability for postural control, preventing leaking of urine, gas or stool, and playing a very important role in sexual function,” explains Michele McGurk, a pelvic floor physical therapist at Danu Physical Therapy in Brooklyn. Carey Macaleer, founder of A-Line Pilates, thinks of it like a hammock holding and supporting your organs and muscles and, when you’re pregnant, the baby too. The pelvic floor can feel the impact of pregnancy often beginning in the second trimester, explains McGurk. The pelvic girdle becomes lax as ligaments relax, creating an imbalance that leads to increased tone of the pelvic floor muscles. “This muscle overactivity, when evaluated, presents as muscle tightness, and a tight pelvic floor is a weak pelvic floor,” says McGurk. “As a baby gets bigger, the added weight and pressure on the pelvic contents causes pelvic congestion which further increases muscle tone and weakness.” During vaginal delivery, the pelvic floor needs to be able to lengthen to avoid injury.
Pilates’ focus on breath, precision, and activating the abdominals and pelvic floor make it an invaluable tool for strengthening the area both pre- and post-partum. “If we keep the hammock strong by knowing how to activate the muscles and work them, then it will take pressure off the lower back and also help with the pushing needed during a vaginal birth,” explains Macaleer. “With a strong pelvic floor post-Caesarean, you will be able to activate it in order to start moving around again and give you core support while the outer abs are healing.” Macaleer tells all her clients to practice their Kegel-esque lifts both in and out of the studio. For anyone who is pregnant, McGurk often recommends a combination of yoga and stretching (like squats and hip openers) and to see a pelvic floor therapist around 34 weeks. A licensed PT with a doctorate degree and additional specialized training in pelvic pain, a pelvic floor therapist can assess the tone and strength of your muscles and show you how to prep for delivery with self-perineal massage.
This story originally appeared on: Vogue - Author:Fiorella Valdesolo
