Women lead busy lives caring for their children, working, being a good wife, helping friends or family, and trying to maintain good health for themselves. Oftentimes, their health may be the last on their list of priorities, for a number of reasons. An obvious reason is time restraints, but another might be because certain health issues are referenced as “normal” after having kids. Their moms, friends, and sisters might say that they experience the same things, and the concern or nuisance of the issue becomes ignored. However, some health issues should never be ignored:
1. Urinary Leakage
2. Pelvic Pain
3. Diastasis Recti
Urinary leakage is any involuntary loss of urine, no matter the amount, or reason. Many women, after having kids, experience this with laughing, sneezing, jumping, or working out. This is largely due to the fact that the pelvic floor musculature is weakened through the increase in weight it supports during pregnancy.
The pelvic floor muscles are a complex group of 12 muscles that span the bottom of the pelvis, similar to the bottom of a bowl. Strengthening the pelvic floor muscles can help to eliminate leakage issues as one of the functions of these muscles is to maintain control of the bladder by squeezing against the urethra so that urine does not escape. Kegels, or pelvic floor muscle contractions, can help to strengthen these muscles, but there is much more to improving leakage than just doing Kegels. There can be changes in behavior, such as not going to the bathroom “just in case,” and limiting bladder irritating foods and beverages. Urine leakage might be common after having kids, but having this issue interfere with playing with your kids, working out, and enjoying a laugh in public without fear of leaking is not necessary!
On average, it takes 6-8 years before a woman finds help with urinary leakage, pelvic pain, and/or diastasis recti.
Pelvic pain includes pain in the abdomen, vaginal region, reproductive organs, or even pain with intercourse. There are a number of reasons why a female might experience pelvic pain, and each woman’s story (and treatment) can be quite different. Oftentimes, it can be frustrating trying to find a medical reason for their pain, and the search may be given up on, rather than continuing to use time and energy to find a solution.
After pregnancy, the pelvic floor is weakened and can present with dysfunction, just as any muscle might after a “traumatic experience.” These muscles might be tender, tight, or even have difficulty contracting and relaxing as muscles should. Pain with intercourse, speculum exam, or insertion of a tampon can occur with this muscle dysfunction.
There are many changes that occur throughout the muscles and joints during pregnancy, including shifting of organs. The sliding and gliding that should occur among abdominal and pelvic organs may be limited due to being “squished” during pregnancy. This lack of normal movement among the organs can cause pain in the abdomen and may be a limiting factor in being able to perform various activities around the home, or even simple movements like bending over.
Experiencing pelvic pain can be difficult and frustrating, but even more difficult to talk about with others, including a healthcare provider. This can be overlooked among the varying health concerns discussed at an appointment. Pelvic pain is not considered acceptable or normal, as there can be effects on quality of life, the level of intimacy in marriage, and ability to perform various movements or tasks.
Diastasis recti is the separation of the “6 pack” ab muscles. These muscles run vertically. With the growth of the belly during pregnancy, these muscles become thin, stretched and can begin to pull away from the center of the abdomen where they are attached. This not only can create a bulge when doing crunches or lifting something heavy, but can create instability throughout the spine and body. This instability creates other dysfunctions at other body parts, such as the shoulder, hip, back, knee, etc. Although returning to the pre-baby body state can be difficult, it is vital to identify and treat diastasis recti, no matter the time since childbirth.
Seek Help from Women’s Health Specialists
On average, it takes 6-8 years before a woman finds help with these three issues, even though a variety of medical and behavioral solutions are available. A women’s health physical therapist can address these issues well. Treatment can include a variety of options: behavior changes, pelvic floor exam, strengthening exercises, manual techniques, etc. Research supports physical therapy for these issues.
Women have the ability to change the world. It is not okay that women silently struggle with these issues. Seek out help now!
—Pauline Hannan, PT, DPT (Women’s Health Specialist)