We take a closer look at a section of Dianne Edmond’s ‘Early Postnatal Programming’ online education for Fitness Professionals.
After more than 25 years working in women’s health as a physiotherapist, I still see postnatal women who have a pelvic floor hold of only three or four seconds in the early postnatal months. After three reps, their pelvic floor can become fatigued and, when observing the perineum area, little or no movement is seen, or tension starts to show in the adductors as they work to feel more in their pelvic floor.
Sometimes this will result because they haven’t learned about their pelvic floor muscles or trained them during their pregnancy, or they were unsure they were doing the exercises correctly, so they didn’t do them. Other times, it is a result of the birth process affecting their pelvic floor function.
A pelvic floor at this level of recovery would not be expected to have the amount of strength and control needed to apply force against the intra-abdominal pressure generated upon it from strong leg loading or core training exercises.
Initially, core control and loading for postnatal women needs to be at a level that allows the recovering pelvic floor to match the force generated. Allowing the pelvic floor to rebuild strength and endurance over the postnatal months and gradually building up the loading for core training helps to protect the pelvic floor as it recovers.
For example, a client may initially start with the clam as an exercise in side-lying, which places minimal strain on a weakened pelvic floor. As the client’s pelvic floor and core control improves from a three- to four-second hold upwards, leg loading can increase to abduction and single-leg cycling actions, with co-ordination of their breathing pattern to ensure there is no breath hold.
Often, it is challenging to teach clients lower-level training exercises initially as they prefer to feel more with stronger loading. When clients gain awareness of the level that their pelvic floor recovery is at following the effects of pregnancy and birth, they are more receptive to working at the level of core training that matches their level of pelvic floor muscle fitness and recovery. This helps to reduce their risk of developing pelvic floor problems such as urinary incontinence and pelvic organ prolapse.
This course teaches you how to progressively build load for postnatal core training as you consider the recovery of pelvic floor together with the changes that have occurred during pregnancy to the abdominal wall. Find out more here.
Dianne Edmonds is a physiotherapist with more than 25 years of experience with pregnancy, postnatal and pelvic floor education, treatment and fitness programmes. Dianne was the lead physiotherapist and project officer for the Pelvic Floor First project campaign, run by the Continence Foundation of Australia, and is a Pelvic Floor First ambassador. Dianne is the director and founder of The Pregnancy Centre and completed her Elite Personal Training course in 2013.