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How to Rehab Your Pelvic Floor with Physical Therapy Exercises

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After having a baby your pelvic floor muscles have been stretched and damaged. For many of us we need to repair our pelvic floor with physical therapy exercises. Kegels are great, but you need to go beyond that to strengthen your pelvic floor and your core postpartum. These exercises will help repair your body after childbirth.

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physical therapy exercises to rehab your pelvic floor

How can physical therapy exercises repair your pelvic floor?

During pregnancy you have a huge weight and a lot of pressure on your pelvic floor constantly. During birth, those muscles are stretched and damaged.

Your pelvic floor muscles support your bladder, bowel, and uterus. Your pelvic floor muscles control your bladder and your bowel. They are also help in sexual function. (Source: Continence.org)

Knowing the right exercises and having a solid exercise routine in place that focuses on pelvic floor repair using physical therapy exercises is of the utmost importance to repairing your pelvic floor.

The most common damage that can remain postpartum is to your core and pelvoc floor. Both are best handled by addressing the problem with physical therapy exercises.

Often pelvic floor disfunction and a weak core are related. So you also might want to look into a phenomenal program created by a Doctor of Physical Therapy and mom of 4 that helps you repair your abs at home with a gentle 12 week program as well!

Symptoms associated with a weak pelvic floor:

It’s no wonder that postpartum our pelvic floor muscles are stretched and often damaged. When your pelvic floor muscles are weak, you often suffer from incontinence.

You know, the dreaded mom sneeze postpartum. Many of us give up on running because the bouncing motion will make you pee. Sometimes the muscles are so weak that even squatting can trigger an embarrassing leakage.

Incontinence is the most common symptom women suffer from postpartum when they have a weak pelvic floor. But according to Better Health other symptoms include:

  • failing to reach the toilet in time
  • uncontrollably breaking wind from either the anus or vagina when bending over or lifting
  • reduced sensation in the vagina
  • tampons that dislodge or fall out
  • a distinct bulge at the vaginal opening
  • a sensation of heaviness in the vagina.

Personally, I even couldn’t wear a tampon without pain for an entire year postpartum. Until I found a physical therapist to guide me in exercises to repair my pelvic floor and finally feel normal again.

RELATED: How to make Padsicles to ease pain and speed postpartum recovery

the milky mama's postpartum plan

My Pelvic Floor Rehab Experience

My first pregnancy didn’t go as planned at all. (You can check out that birth story here.) Everyone is always saying to write up a birth plan and make copies for everyone who will be present at the birth so they know your wishes.

I found that to be a huge disappointment because nothing happened the way I wanted it to. (The second time around my plan was to have no plan. Not in an irresponsible way, but to be prepared to go with the flow. To have ideas of my desires but really play it by ear. That worked out perfectly. So don’t be afraid to have a less than concrete birth plan.)

I ended up going post date and having to be induced. After 14 hours I settled on getting an epidural. (None of this being my desired plan.) When you have an epidural you can’t feel anything going on down there and some people have trouble pushing at all, while others push far too hard and tear badly. I was the latter.

Postpartum I had a lot of pain for over a year.

  • My scars hurt.
  • My pelvic floor was beyond weak.
  • I suffered from incontinence.
  • Wearing tampons hurt.
  • Sex hurt.
  • I had an awful lot of pressure down there.
  • Running was out of the question without stopping to pee every quarter mile or wearing a giant pad.
  • I believe I had a mild uterine prolapse as well.

I felt weak and broken in that area. It was disheartening to say the least.

After peeing myself for the last time I knew something had to change. There had to be some way to fix this problem. What was I missing?

Then I found pelvic floor physical therapy exercises for women to repair your pelvic floor postpartum. A physical therapist guided me in gentle exercises that I then did at home religiously every single night.

I don’t give anything half of my effort. It’s all or nothing and I was committed to repairing these problems that made me feel so sad and embarrassed postpartum.

I am a personal fitness trainer, I can strength train you into shape. But repairing something as deep and small as the pelvic floor was nothing I had any idea how to do yet at 23. I knew about Kegels for pelvic floor strengthening. But you need more than kegels to repair your pelvic floor muscles.

While Kegels are an important factor to strengthening and pelvic floor control, you also need to continue strengthening the muscles that surround and support the pelvic floor to fully repair.

Following a guided exercise routine to strengthen my core was life changing.

How I wish I’d found out about pelvic floor and core physical therapy exercises for women sooner. After suffering from all those symptoms for over a year postpartum, within a month they were almost all gone. Strengthening my pelvic floor muscles was my key to finally healing postpartum.

It is so important to first focus on repairing your pelvic floor and strengthening your core before you progress to more vigorous exercise. I still focus on keeping my pelvic floor strong because like any muscles:

if you don’t use it, you lose it.

How to Do Kegels.

Kegels are a magical little exercise that you can do anywhere anytime. It is the term for contracting your pelvic floor muscles. Noone but you even knows that you are doing them.

First, identify the muscles you are using. The easiest way to locate your pelvic floor muscles is to go pee. Then stop the stream half way through. The muscles that you contracted to perform that odd sounding task are your pelvic floor muscles.

After birth your pelvic floor muscles may be so weak that you can barely contract them.

Doing Kegel exercises may seem that you are doing nothing at all. But continue doing them twice a day if you can. After a week or two you will begin to feel that you can now contract your pelvic floor muscles more.

Tricks to make Kegels easier:

  • It is easiest to begin practicing Kegels lying down. Then you can progress to doing kegels in a standing position. Once you master Kegels while standing you can try different positions as well.
  • I was taught to visualize your pelvic floor muscles as a basket holding your uterus and wrapping up into your abdominals. (Visualizing helps a lot when you can’t see and can barely feel the muscle contracting at first.)
  • It is also helpful to use your hand as a visual and physical guide for what your pelvic floor muscles are doing.

I’ve learned 3 ways to use your hand as a guide that are very helpful while doing Kegels.

  1. You can open your hand wide while your pelvic floor muscles are relaxed and squeeze into a fist as you contract your pelvic floor muscles. Then release your clenched fist as you release your Kegel.
  2. You can stretch your arm down straight with palm pointed downward and hand held in front of your pelvic floor. As you perform a kegel reverse your flat hand to a palm upward position and raise it slightly as you tighten the muscle. Visualize that you are lifting the muscle with your hand as you contract the pelvic floor muscles. (This is very helpful for The Elevator Kegel Exercise below.)
  3. The third tip works best for when doing kegel exercises laying down. Place your thumbs and index fingers together forming a triangle. Now place this triangle over your uterus. Having your hands placed here is very helpful to keeping your focus on those hidden muscles you are targeting.

Each day perform Kegels in the morning and the evening if you can manage to. Squeeze your pelvic floor mucles for 2 seconds and release for 1 second. Repeat 10 times.

The next Kegel exercise is called The Elevator. Lightly contract your pelvic floor muscles, then tighten them further, then tighten them as much as you can and hold briefly before releasing.

Repeat these 2 Kegel exercises 3 times each.

Do Your Kegels and the Following Exercises Daily… Then Come to Me

Utilizing these exercises to repair your pelvic floor can make a huge difference! Be sure to incorporate kegels and the following exercises daily prior to beginning more vigorous exercise.

I know I know, you’re eager to get that pre-baby body back. To finally feel strong again. To feel energized and proud, happy with where you are in motherhood. But strengthen your floor and core first, then move on! When you are ready for a more vigorous exercise try out the Milky Mama’s Postpartum Plan. It will walk you step by step through diet, nutrition, and workouts for a month to help you lose the baby weight while breastfeeding and increasing your milk supply and also help you regain strength you lost during pregnancy.

Pelvic Floor Exercises for Women

1. The Clam

the clam pelvic floor exercise to rehabilitate

Lay on your side supporting your head on your hand. Bend your knees and stack them in front of you. Keep your heels together, stacked, and in line with your body. Lift your upper knee as high as you can slowly and lower it back to the starting position. Repeat 20 times on each side.

2. Leg Raise

laying leg raise to strengthen pelvic floor muscles postpartum

Remain in the same position laying on your side on the ground but now straighten your legs. Allow your upper foot to go limp and lift your straight leg from the heel up to a 45 degree angle. Slowly lower back to starting position. Repeat 20 times on each side.

3. Bridge

glute and hanstring bridge exercise to strengthen pelvic floor postpartum

Lay on your back with your feet flat against the floor. Lay your hands flat along your sides on the ground. Raise your hips as high as you can and lower them slowly back down to the floor. Repeat this physical therapy exercise 20 times.

**As your pelvic floor and surrounding muscles become stronger you can also perform a kegel when you raise your hips.**

4. Inner Thigh Press

inner thigh press with a ball while sitting in a chair by the pool

Sit on the very edge of a chair with good posture. Tighten your core and place a small ball between your knees. Squeeze your knees together as hard as you can for 2 seconds before releasing. Repeat this exercise 20 times.

5. Outer Thigh Press

outer thigh press with resistance band to strengthen your pelvic floor

Tie a resistance band into a loop. Sit in good posture on the edge of a chair. Insert your feet into the resistance band and place it right above your knees. Tighten your core, keep your feet shoulder width apart on the floor, and open your knees about a foot apart. Slowly close your knees. Repeat this exercise 20 times.

pelvic floor exercise routine to rehabilitate pelvic floor muscles postpartum

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  1. How soon after a C-Section can I start these pelvic floor exercises? I am two weeks out and it feels safe to do them. However I’ve seen 6 weeks as the recommended wait time before starting exercise. I wonder if these are low impact enough to start sooner than 6 weeks?

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