PT & Rehab: Physical Therapy and Pregnancy

“IGNORE IT. YOU’RE PREGNANT”

Often during pregnancy, women experience discomfort, pain, and even urinary incontinence. Frequently, physicians who treat them— whether general practitioners or obstetricians—give similar advice: “It’s because you’re pregnant. It will go away after you give birth.” But that’s not what research shows, states Valerie Bobb, PT, DPT, ATC, director of the women’s health program at the Baylor Institute for Rehabilitation in Dallas, Texas. “Research has shown that for 80% of women, if pain or urinary incontinence hasn’t resolved itself 3 months postpartum, it’s not going to,” she says. A study published in BJOG: An International Journal of Obstetrics and Gynecology found, for example, that among women who reported having urinary incontinence at 3 months, 76.4% reported having it at 12 years. Common post-pregnancy conditions that can be related to problems with the pelvic floor can last beyond the first six months or strike later in some women include: • Urinary Difficulties Women with urinary incontinence leak urine when they sneeze, cough, or run. Some women feel a frequent or sudden, compelling urge to pee, even when their bladder isn’t full. Others are unable to start the flow of urine at will or empty their bladder completely when urinating. • Anal Incontinence Many postpartum women have trouble controlling gas or bowel movements. • Perineal Pain This is common in postpartum women, especially those who tore during childbirth or are recovering from an episiotomy. (The perineum is the area of skin between the vagina and the anus.) A tight pelvic floor causes some new moms to experience persistent perineal pain, even after their wound heals. • Pelvic Pain Some women have pain during sex for many months or even years after childbirth. And some have chronic pain, itching, or burning in their vulva – the tissue surrounding the opening of the vagina. This can make it hard to tolerate wearing tight clothing and even underwear. Others have pain during bowel movements. These symptoms are often caused by tight pelvic floor muscles, which can lead to inflamed tissue and nerve endings.

• Pelvic organ prolapse When pregnancy and childbirth weaken the pelvic floor muscles, one or more of the organs they support – the uterus, bladder, and bowel – can slip out of place. Rehabilitating these muscles can help prevent or improve this condition. Do Kegels help? “It depends on what’s causing your symptoms. Kegels are exercises you can do to support your pelvic floor muscles. Your doctor may have recommended doing Kegels and may help some women, particularly those with weak pelvic floor muscles. But many women are not taught to do Kegels correctly. And if your problem is caused by chronic tightness in the pelvic floor muscles, practicing contracting but not releasing them can actually make the muscles tighter and the symptoms worse” explains Madhu Rishi PT, DPT. “Instead, these muscles need to be retrained so you can tighten and then relax them when you need to.” At Physical Therapy & Rehab Specialists are here to help you throughout your pregnancy and after. You can live a normal life free from pelvic floor dysfunction.

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