The Pelvic Floor Postpartum: Reintegrating the Power Center Post-Birth

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By: Allison Oswald, DPT, WCS, CPT

The pelvic floor is the foundation of our bodies, both physically and energetically.  Pregnancy and delivery greatly impact this area, and that impact is unique to each individual. However regardless of personal symptoms or delivery experience, a reconnection to the pelvic floor postpartum is crucial to regaining balance, optimizing function and creating stability both physically and emotionally.  It is obvious that rehabilitation in any other area of the body would entail understanding how the muscles work, what a contraction and stretch should feel like, and how to integrate it’s proper recruitment in functional movement.  So why should the pelvic floor be any different?  And beyond that, our pelvic floor is also our pleasure center, which allows us to experience pleasure locally and globally.   And for all these reasons, it is key to establish a quality connection with the pelvic floor as part of the healing process during the 4th trimester shift.
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Understanding where the pelvic floor is and how it functions is step one. Simply defined, it is a group of muscles that span from the pubic bone to the tail-bone, as well as between the two sits bones.  Together these muscles form a diamond shape that are responsible for supporting the organs above them, closing off or opening the urethra, vagina and rectum, as well being a part of the sexual experience.  These muscles move up and down with the breath like a trampoline would, moving down/lengthening with an inhale and up/shortening with an exhale.  After pregnancy and birth, the coordination of the pelvic floor with breath is often disrupted, therefore re-establishing this rhythm is how to begin finding balance again.
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To find this rhythm, alignment of the ribcage over the pelvis will optimize the ability to find connection.  From here, one can practice breathing and begin to feel the pelvic floor move with the breath.  And finally, the recruitment of the pelvic floor muscles with function can be established.  Below are my 3 essential exercises for my postpartum clients to reintegrate their pelvic floor and be on the road to connecting with their pelvic power once again.  
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Alignment with Breath:  Sitting on an exercise ball, spread your buttocks to connect the pelvic floor with the surface of the ball.  Rock your pelvis forwards and backwards a few times to feel the range of motion available to you.  Now stop in the center, all the while keeping your upper body still, don’t feel the need to squeeze your shoulder blades.  Now you have found your most ideal alignment of your ribcage over your pelvis.  Breathe in through your nose feeling your ribcage expand all around, trying not to breathe into your shoulders.  Exhale through your mouth and feel the ribcage come back together softly.  Continue this breathing and begin to experience the movement in the pelvic floor with the breath.  As you inhale, it lengthens and gets closer to the surface of the ball.  As you exhale it draws up slightly.  Do this for 3-5 minutes daily.
Pelvic Floor and Deep Abdominal Contraction:  Get on your hands and knees with your wrists under your shoulders and knees under hips.  Ensure you have a slight arch in your low back, as you did in exercise #1.  Now maintain the shape of your spine as you breathe in (feeling your ribs expand and pelvic floor lengthen), then exhale drawing your pelvic floor up and in (actively contracting).  On the exhale you should also see a gentle drawing in of your belly. Do 2 sets of 10.
Pelvic Floor and Function:  As a new mom, a lot of squatting is involved with childcare.  Therefore I always have my moms practice squatting and utilizing their breath.  Stand with your feet hip distance apart.  On an inhale, squat down with your hips going back like you’re sitting in a chair (this is when the pelvic floor is lengthening).  On an exhale through your mouth, engage your pelvic floor and abdominal wall (as in exercise #2) and come back up.  (Tip: Always exhale through your mouth when lifting something heavy, coming up from the floor, or any other exertion, as this will set up and activate your core system to work) Do 2 sets of 10.
Be patient with yourself and remember quality of movement over quality.  And even though many women have postpartum pelvic floor symptoms (ie. leaking, pain, pressure), do not accept them as normal.  Seek help and know that healing is possible. You are in charge of your body and overall know what is best.

Allison Oswald (DPT, WCS, CPT) discovered a passion for working with women throughout their journey to and post motherhood. Since 2011, she has operated her own private clinic, Plumb Line Studios in Santa Monica, CA. From her studio, she works with women on an individual basis and sets them up on the proper treatment plan which also utilizes other aspects of her clinic, such as, pre and postnatal Pilates, lymphatic massage, a retail shop of the best products for mothers and shares a referral guide which includes other practitioners in California. Allison lives in Santa Monica, CA with her husband and two sons.www.allisonoswald.com

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