Physiotherapy following childbirth is designed to assist with recovery of the pelvic floor and core, along with the rest of the body and health in general. The initial 3 months following childbirth is referred to as the ‘4th trimester’, and during this time it is essential to allow the body to recover from pregnancy and childbirth.
During pregnancy posture must change to accommodate for the beautiful wee baby growing inside. The ribs widen as the heart increases by 50% of its normal size and the ligaments soften to allow the body to stretch. The muscle activity around the pelvis changes as the pelvic position changes. This is a normal process and a clever way the body adapts to have a child. The pelvic floor is a group of muscles that sit like a trampoline in the base of the pelvis. With the increased weight of the baby resting on the pelvic floor it also undergoes some stretch throughout pregnancy.
Changes to the pelvic floor during birth.
During a vaginal delivery, or attempted vaginal delivery, the muscles and nerves stretch significantly to allow the passage of the baby from the inside to the outside. The pelvic floor is designed to stretch to 250% of its resting length, much more stretch than any other muscle of the body. However, depending on the circumstances of the delivery, that stretch to the tissues may be temporary but sometimes if there is a greater degree of stretch, a longer duration of stretch or the need to use instruments such as forceps, the tissues may be injured and not be able to return to their predelivery state. Due to the constantly changing circumstances of each mother’s labour and delivery it is possible to injure other structures around the pelvis during vaginal deliveries such as the pelvic bones, the tailbone, the nerves and the tissues that hold the pelvic organs inside the body.
For those who have a caesarean section delivery the pelvic floor has undergone the stress of the pregnancy. There may have been stress to the vaginal and pelvic floor tissues and muscles if a vaginal delivery was initially attempted, and then in order to access the baby for delivery the abdominal wall tissues and muscles are injured as they are cut to access the baby therefore also need time to heal and recover. We know the scar takes at least 3 months to heal to a reasonable strength when it can then start tolerating more stress and loading.
Due to these significant effects on the structures around the pelvic floor and pelvis it is very important to allow time for these injured tissues to recover follow childbirth, and to rehabilitate them in a safe manner. Pelvic health physios can help to guide women in this recovery, as well as check if there has been injury to the pelvic floor muscles or other structures during childbirth. Allowing the appropriate time to recover and rehabilitate from the normal adaptions from pregnancy, childbirth and the potential injuries that may have occurred is beneficial to optimize recovery and to address any symptoms or difficulties women may be having in the 4th trimester, but also to reduce the risk of pelvic health problems later in life. Pelvic floor physical therapy has been proven to reduce the risk of pelvic organ prolapse, urinary, bowel, and sexual dysfunction and pelvic pain.
When to begin Pelvic Health Physiotherapy;
It is highly recommended to start pelvic floor physiotherapy around 6 weeks following delivery. This is to screen for any potential injuries, and to help to guide recovery including exercise and return to sports and fitness whether your goal is circus performing, running 5km or 50km. Having said that, it is never too late to see a pelvic floor physio. Many pelvic health symptoms that occur after having children and are often thought to be a ‘normal’ consequence are in fact common but not normal. They are a sign of pelvic floor dysfunction and often respond very well to pelvic health physiotherapy. A good example of this is leaking when you cough, sneeze or jump on a trampoline- this is common but not normal!
Postpartum physio can also help with:
Difficulty peeing or emptying the bladder, leakage of urine, and bladder urgency or frequency
Constipation, difficulty with bowel movements, and leakage of bowels
Painful sex, diminished or absent orgasm
Separation of the abdominal muscles
Restoring core function and strength of the abdominals and pelvic floor
Pelvic floor and pelvic girdle, low back, and hip pain
Caesarean section and episiotomy scar tissue and pain
Pelvic organ prolapse prevention and/or treatment
Eliminate pain from trauma to the pelvic floor and muscles
Reduce pain from nerve damage in the pelvic and pelvic floor
Postnatal physiotherapy helps with this and really should be a standard part of our healthcare as it is in France! As a profession we are excited that the upcoming ACC Maternal Birth Injury coverage will improve access for many new mothers to undergo postnatal rehabilitation- more on that in our next post.
Our Pelvic Health Physiotherapy team at Active Health are here to help you recover and live your best life! Call us at 03-383-6290 to see one of our team.
Now that winter is behind us, I am sure everyone is more eager to get out and enjoy the sunshine. Have you been thinking about getting back to some of your favorite hiking tracks or maybe set yourself some new running goals for spring. Well, there are some things you should consider before jumping up and getting into things.
Getting prepared!
If you have been more sedentary over winter or your schedule hasn’t allowed, you to be as active it is important to have a think about anything that may restrict you getting back out there.
There may be some underlying niggles that you haven’t thought of for a while. Prior to getting started think about your history of injuries and addressing ongoing problems before they impact on your function or get worse.
It is important to get a second opinion if you feel like you aren’t improving or need some advice. Working with one of our physios or podiatrists to assess any ongoing aches and pain, looking at your form and function or giving you some stretches/exercise to target those weaknesses.
Think about any specific braces or supports that you may need or feel more confident with. This may include ankle or knee supports.
If you have an old pair of sneakers, think about getting them updated and also making sure they are appropriate for the terrain. (Hiking – sturdy boots with good ankle support, thicker tread. Long distance running – cushioned footwear with good arch support).
If you are having ongoing foot/ankle/leg pain it would be worth getting a podiatry opinion and possible orthotic fitting.
New Zealand Hiking
Pace yourself!
It is important to ease back into things – depending on what you’ve been up to over winter you may need to start with lighter activity and progressively build your strength and endurance.
Start with smaller goals to then build up from. If you need to lower your pace then gradually progress things like your speed, intervals, distance, terrain.
Make sure to give yourself rest periods in between activity. It is important that your body recover from intense exercise.
Plan ahead!
Before you get going you should give yourself the best opportunity to succeed. This means not only preparing your gear but also your body. Thinking about fueling your body with nutritious food and hydration that will help you get through those longer journeys. Make sure you are well rested and giving enough time between when you were last active. You may want to include an active warm up/stretching before hand to get your muscles engaging. Check out and plan your route too, click here to find some good walking tracks to suit your level of fitness and experience.
Bring a pack!
There may be some things that you bring with you on longer hikes or runs. This important to keep you fuelled through this activity like more water or food. In case of an injury occurring while you are out it is important you have some way of contacting someone for help. You should also think about having some basic first aid supplies and possibly pain relief depending on the length of your hike/run.
Have fun hitting the hiking and running trails this spring.
.This is the first in a series of posts about Active Health’s Pelvic Health Physiotherapy program designed to improve awareness and understanding of pelvic health physiotherapy.
So what exactly is Pelvic Health Physiotherapy?
Pelvic Health Physiotherapy is physiotherapy designed to ease symptoms related to various pelvic health issues for both women and men. It is a specialized type of physiotherapy delivered by physios with extra training in pelvic health, in addition to their physiotherapy qualifications.
Pelvic health issues in physiotherapy generally fall into 2 categories: those associated with pregnancy and the postnatal period, and those associated with other pelvic health symptoms, such as concerns with the bladder, bowel, prolapse, pain or sexual activity, or related to surgery and/or cancer in the pelvic area. Of course there often is an overlap between these 2 categories!
Pelvic Health Physiotherapy; pre natal & post natal
Pelvic Health Physiotherapy during pregnancy and following childbirth is designed to both support the body as it changes during pregnancy, and to assist with recovery. Through exercise, muscular support during all of the trimesters can be optimized, women learn how to connect with their pelvic floor to aid with labor and delivery, and the pelvic floor and core can be rehabilitated after delivery.
Pelvic Health Physiotherapy also address various musculoskeletal or pelvic floor concerns that may occur before or after the baby is born. These can include pelvic/hip/back pain, bladder or bowel issues, difficulty moving and walking to name a few. It is highly recommended to have a pelvic floor check around 6 weeks following delivery to screen for any potential injuries, and to help to guide exercise and return to sports and fitness. More on this to come in a future post….
What else we can offer;
There is a large body of evidence to support the use of physiotherapy for conditions such as pelvic floor dysfunction, pelvic pain, bladder or bowel dysfunction, pelvic organ prolapse and sexual dysfunction. These methods may include hands on techniques, exercises for strengthening or release, education for bladder, bowel habits and lifestyle factors, release of scar tissue and connective tissue, functional dry needling and more. In addition, some pelvic health physios are trained to fit pessaries. These are medical devices designed to support the pelvic organs in conditions such as prolapse and some forms of bladder leakage. pelvic health physiotherapy near me
Pelvic Health Physiotherapy may also ease symptoms and help the management of pelvic pain. Conditions such as endometriosis, painful bladder syndrome (interstitial cystitis), vulvodynia and chronic pelvic pain. Due to a body of research demonstrating pelvic floor muscle involvement in these conditions, many health professionals are therefore including pelvic floor physiotherapy as a vital part of their patient’s medical care. All of our pelvic health physiotherapists have both musculoskeletal training and pelvic floor training, which is essential when treating the complexities of pelvic pain. See more about this page women’s pelvic health physio.
For a more detailed list of conditions that can be helped with Pelvic Health Physiotherapy click here
If you suffer from any of these pelvic health symptoms, or would like help and guidance during pregnancy or postnatally please contact us to see one of our Pelvic Health team in Christchurch and Rangiora.
“Tennis elbow” is the term used to describe pain located on the outside of the elbow joint. The pain originates from an irritation of the tendon attachment of the wrist and finger muscles.
Who gets a tennis elbow?
Anyone can get a tennis elbow! However, most commonly, they occur in 30-50 year old’s or those with jobs that involve repetitive movements of the wrist or elbow.
How do I know if I’ve got a tennis elbow?
Aside from checking in with your local physios at Active Health, you could try the following to see if a tennis elbow may be contributing to your elbow pain;
Position an object weighing 1-5kg in front of you at roughly waist level (ie; frying pan of food, house brick, dumbbell)
With your arm fully out straight in front of you, and your palm facing the ground, try to pick the object up and lift it to shoulder height
If this elicits your familiar elbow pain, you may have a tennis elbow!
What do I do if I’ve got a tennis elbow??
Don’t panic! In 90% of cases, the symptomatic tennis elbow can be settled with NON–operative treatment. This means you shouldn’t need surgery!
Tendons need to be loaded to adapt and get better, otherwise they may remain in their painful state. Some exercises are often a good way to achieve this! Catch up with one of our physios to make sure you are given an appropriate exercise plan that is individualized to you and what your elbow needs to get better.
Trial some self-management of the pain with any selection of the following;
Modifying activities that hurt your elbow to prevent aggravation the pain
Trial some basic pain relief as per packet instructions
Wear a brace or sleeve if you have one
Extra for Experts:
Unfortunately, this won’t be a problem that will disappear overnight. However, with an accurate diagnosis and appropriate intervention, there should be improvements to observe in your day-to-day function.
The sooner you can “nip it in the bud”, the better! From what we know of tendon aggravations like tennis elbow, it is much easier to reverse the pain if it has only been present for a short period of time. This means the Kiwi “she’ll be right!” will not do in this case. Get onto it early!!
If you have any questions, or you are concerned about your current elbow or arm pain and want to get it sorted, get in touch with us here at Active Health and we will sort you out.
After the last few years of dodging covid, these winters cold and flus have hit us all hard. There are so many bugs going around now and really taking their toll on our physical wellbeing. It is important for us to take time out to rest and recover well from any illness. A concern for many people is when is a good time to get back into physical activity or exercise after being unwell.
Whether you have had covid, or a winter cold or flu, you may be experiencing any of the following:
Muscle or body aches
Fatigue
Sore throat
Runny nose
Cough.
Most people will recover from these illnesses within a few days to less than two weeks. A cold or flu infection is usually located in the respiratory tract, impacting the lungs. This can make breathing hard, especially for those with pre-existing conditions like asthma. Exercising while unwell can also put you at risk of inflammation of the heart wall, this can be dangerous. It is important to rest and do no physical activity while you are recovering, as this will stress your immune system.
Once you no longer have symptoms and are feeling better, it is important to ease back into physical activity and exercise. This will reduce the likely hood of having prolonged symptoms.
Check in with your symptoms;
A good way to check in on whether you are ready to return to exercise is to check in with your symptoms:
If your symptoms are above the neck, sore throat, or runny nose, you are okay to begin gentle exercise provided your heart rate is normal and you feel okay.
If your symptoms are below the neck, like sore joints, fever, or aching muscles. You should rest until these symptoms are gone.
When you do begin exercising again, ease back into it. Be mindful of your breathing and heartrate when you’re starting out. If you are feeling okay, be smart, listen to your body and you will be back to normal in no time. It is also important to make sure you are getting enough sleep, eating plenty of nutritious food and allow for adequate rest between exercise sessions too.
If you need a hand getting started, chat to one of our personal trainers.
If you are experiencing any serious or prolonged symptoms, check in with your GP or Health hotline 0800 611 116.
More people than ever run today, whether training for leisure or competition. It is well known that running has many benefits both for your mind and body. This includes improved cardiovascular health and making you happier. Running is great for loosing or maintaining weight, strengthening your knees, making your mind sharper, adding years to your life. It is also known that running can reduce the risk of various diseases such as heart disease, type 2 diabetes, stroke, and some cancers; pelvic floor physiotherapy. After having a baby there are a few things to consider with regards to your pelvic floor.
Your pelvic floor post child birth.
It is understandable that after having a baby many women want to run as soon as possible. Its important for some woman to help them recover physically and mentally. It’s also easy, cheap and quick to do right from your back door. HOWEVER what many women are not aware of are the potential risk factors for pelvic floor dysfunction if a mother does not rehabilitate adequately before she returns to high impact exercise. It’s a topic that is still underestimated and misunderstood in today’s health and fitness world. This article will review the implications that pregnancy and childbirth have on the pelvic floor. It will also offer some guidelines to consider when planning a return to running after you have had a baby; pelvic floor pain after running.
Pelvic health refers to the function and wellbeing of all of the structures and tissues in the pelvic area. This includes the organs and the pelvic floor muscles. Pelvic health following childbirth is significantly affected, as demonstrated by the following statistics.
Between 15-30% of first-time mums will experience urinary incontinence (leakage of bladder). A startling 1 in 5 first time mums will complain of fecal incontinence (leakage of bowels) at 1 year following childbirth. At 3-6 months after delivery up to 56% of new mothers demonstrate Grade 2 pelvic organ prolapse. This means that one or more of the bladder, bowel or uterus have fallen downwards into the vagina, at least to the vaginal opening; Pelvic floor running.
Vaginal vs Caesarean births
Physical changes that occur during pregnancy and delivery in the pelvic area are a large cause of the above conditions. Research tells us that vaginal deliveries widen and stretch the opening in the pelvic floor for baby to pass through. Recovery time for this is understood to be between 4-6 months.
During a caesarean section, the thick supporting tissue in the abdomen (belly) takes 6-7 months to regain 73-93% of its strength. Knowing that the healing process following pregnancy and delivery is extensive. It lasts longer than the common perception of 6 weeks. It is important for women to understand and protect their pelvic health. This includes reducing the risk of leakage and prolapse. By allowing adequate time for pelvic health recovery, prior to loading and stressing the pelvic floor with high impact activities like running. This will improve mothers ability to return to running. It will also limit the chance of experiencing these common but not normal symptoms both short and long term.
Recommendations for post partum help;
Taking these factors into account, evidence-based guidelines from the UK (March 2019) recommend that women wait until at least 12 weeks after delivery prior to planning a return to running. At this stage pelvic health, strength, and impact loading should be checked for each woman to see if she is indeed ready to return to running yet.
The guidelines recommend that all women, regardless of how they deliver, seek out a pelvic health assessment with a pelvic health physio. The physio will check strength, function and co-ordination of the abdominal and pelvic floor muscles. They will also consider other factors that play an important role in healing and recovery after childbirth and may influence readiness for return to running. These may include sleep, nutrition, breastfeeding, weight and a condition that may develop in the period following childbirth called Relative Energy Deficiency in Sport (formerly known as the Female Athlete Triad).
When to see a pelvic health physio;
The importance of seeing a pelvic health physio is further highlighted if any of the following signs and symptoms are experienced prior to, or after attempting, return to running:*
Heaviness/dragging in the pelvic and/or vaginal area (can be associated with prolapse)
Leaking urine or inability to control bowel movements
Pendular abdomen or noticeable gap along the midline of your abdominal wall (this may indicate Diastasis Rectus Abdominis)
Pelvic or lower back pain
*these symptoms are an indication for any woman to seek pelvic health physiotherapy, not just those that have recently had a baby
Any of these signs or symptoms of pelvic floor dysfunction need to be further tested and treated prior to continuing and progressing training. This is to ensure the pelvic floor and abdominal wall can cope with the loads and impact from running.
There is strong evidence in the literature supporting individualized pelvic floor rehabilitation. For management of pelvic health conditions such as urinary incontinence, pelvic organ prolapse, sexual dysfunction and the prevention of prolapse. Physiotherapy management at this stage will address problems found with the pelvic floor. They will also develop a strengthening and low impact exercise program to prepare your body to start back running.
If you have any questions related to your own situation please don’t hesitate to contact our Pelvic Health Physiotherapy team in Christchurch or Rangiora at 03-383-6290.
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