The MamasteFit Podcast Episode 99 – Strengthen Your Pelvic Floor in Pregnancy and Postpartum

[00:00:00] Gina: Welcome to the MamasteFit Podcast. In this episode, we are going to be breaking down all things pelvic floor, both for pregnancy, what it’s doing during labor, and then going into the postpartum. We’re going to discuss what the best exercises are. Should you be doing all the Kegels? And how can you recover your pelvic floor in the postpartum?

[00:01:08] Gina: So I had no idea that I had a pelvic floor until I was pregnant with my first baby. And so I am a college educated woman, and I just didn’t understand that there was this sling of muscles at the bottom of my pelvis that performed all of these different functions for me. And so what is the pelvic floor?

[00:01:25] Gina: The pelvic floor is a sling of musculature that sits at the bottom of your pelvis, and this is a part of your core canister, or your deep core system. And so your deep core system is involved with managing pressure within your abdominal cavity, which plays a big role in stabilizing your spine.

[00:01:40] Gina: The pelvic floor has five main functions. The first is providing that stability as a part of the deep core system. It’s going to help to support your pelvic organs. And so as women, we have three pelvic organs. We have a bladder, a uterus and a rectum, and the pelvic floor helps to support that. It’s going to have a sump pump function, so it’s going to help with lymphatic drainage through the pelvis. It’s going to help with sphincter control, so allowing poo and pee to leave, and also keeping it in. And then it plays a sexual function where it aids us in childbirth, it helps with orgasm. And it’s also going to play a big role during labor. And so again, the pelvic floor has five functions. It’s going to stabilize, it helps to support your pelvic organs, it has sump pump with lymphatic drainage, it’s going to help with sphincter control, and then it has a sexual function which plays a big role during childbirth.

[00:02:28] Gina: We also have different layers to our pelvic floor which helps to provide different levels of function as well. We have a very deep layer that helps with a lot of that support and sphincter control. We have a middle layer that also helps with sphincter control, and then we have a more superficial layer, which is gonna be more of the outer portion of the pelvic floor and perineal area.

[00:02:46] Gina: The pelvic floor definitely is a big highlight during pregnancy when it comes to birth preparation, so some of the most common exercises that you may hear is going to be to do a Kegel. And so what is a Kegel, and is this the best birth prep exercise that you can be doing for your pelvic floor?

[00:03:02] Gina: And so a Kegel is a pelvic floor contraction where you tighten the pelvic floor and draw it up and in. And then depending on who is coaching you, you may do short bursts of Kegels where you’re tightening, tightening, tightening, maybe you do long holds, but it’s important to note that a Kegel is only one portion of your pelvic floor’s range of motion. We need our pelvic floor to shorten and tighten, known as a contraction, which is going to be what that Kegel is, but we also need the pelvic floor to lengthen and to stretch. And so if I think about my bicep, I want my bicep to shorten to bring my hand towards my shoulder, which would be similar to that Kegel, but I also want my arm to be able to straighten and lengthen to stretch that bicep and then come back. And so I want my arm to be able to move through that full range of motion. If I only focused on these short little bursts and squeezes of my bicep, I would have a really hard time the moment I had to lengthen my arm, and so it would decrease the overall function of my bicep. And so when it comes to Kegels, if we are doing these types of pelvic floor activations, we don’t want just the shortening, we also want to be able to find length to the pelvic floor.

[00:04:11] Gina: And so there’s a few misconceptions when it comes to the pelvic floor with birth preparation. One is that the pelvic floor is going to push your baby out, so we need a strong pelvic floor to support pushing. The pelvic floor does not push your baby out of your body. It is on the bottom, and this is what your baby has to pass through. Your uterus is what is pushing your baby out, and so the pelvic floor really just needs the ability to release and to let go.

[00:04:34] Gina: The second misconception with the pelvic floor is that we need a strong pelvic four to support us in the postpartum, which is true. We do want our pelvic floor to be strong. But tight does not equal strong, and so having a very tight pelvic floor does not equal strength. Similar to if I had a very tight bicep that was always kind of stuck in this closed position, it would not be very strong or functional if I could not straighten my arm to be able to grab things and pull them to my shoulder.

[00:05:02] Gina: So Kegels are not necessarily the best pelvic floor exercise that you can be doing, and they’re certainly not the best birth preparation exercise that we should be doing. We can use that pelvic floor activation and contraction, however, to help support the overall range of motion of our pelvic floor, but we don’t want to just focus on the tightening. Overall, most of us tend to have a very tight pelvic floor as opposed to a very loose pelvic floor, and so additionally doing a lot of Kegels can sometimes cause more issues for you rather than help.

[00:05:32] Gina: Another aspect when it comes to the pelvic floor, both during pregnancy and the postpartum, is understanding that the pelvic floor attaches to the pelvis, and so different types of hip positions is going to change the tension within our pelvic floor. For a lot of us, we tend to favor a more externally rotated position during pregnancy, in addition to more extended spine positions, so more arch in our back and toes pointed out. This is going to change the tension within the pelvic floor, and so the front half of the pelvic floor tends to get a little bit more lengthened and stretched, while the back half tends to get a little bit tighter.

[00:06:05] Gina: And so this could impact things that are happening in the back half of your pelvic floor. So it can cause things like tailbone pain, SI joint pain, or even constipation. But in addition to just this tightening in the back half of the pelvic floor, we also tend to have a little bit of like a torque within our pelvis as well, because we tend to put more weight into our right leg. The organs on the right side are a little bit denser, and so we like to stabilize on that side of our body. The diaphragm on that side of our body is also bigger. And so when we put more weight into our right leg, that pelvic half is going to shift backwards as the left half shifts more forward, and this is going to cause that left back half of our pelvic floor to be even tighter.

[00:06:46] Gina: And so thinking about this common tension within the pelvic floor where the back half, particularly towards that left back half, tends to be a little bit tighter for a lot of us- both during pregnancy and the postpartum- it’s really going to shift the types of exercises that we should be doing to help prepare our pelvic floor for birth, to help it recover after birth, and also to help support us to have a comfortable journey the entire time. Because it’s not just about labor. We also spend 9 to 10 months being pregnant, and then however many years being postpartum, and we want our pelvic floor to be functioning well.

[00:07:17] Gina: And so because a lot of us tend to have a little bit more tension to the back half of our pelvic floor, finding more internally rotated and rounded back positions, so more of a posterior pelvic tilt, can be really helpful to stretching the back half of our pelvic floor. And so we can look first at finding more of those rounded positions where we find more internal hip rotation with back expansion breathing exercises. So we breathe into the backside of our body and then pull belly to spine. This is going to help to kind of stretch the lat musculature, the back half of our body and the back half of that pelvic floor by just breathing into that space.

[00:07:51] Gina: The next thing that we can do is we can find more hip shifted exercises where we shift our weight into the left leg. So we’re bringing that pelvic half backwards as we rotate belly towards the left thigh to stretch that posterior portion of the left side of our pelvic floor. And so with a hip shift, what we’re really looking for is the leg is more internally rotated, so we’re thinking weight in the big toe, knee kind of rotates in, and belly rotates more towards that thigh to bring us into that closed hip position, and into that hip shift. Within our prenatal fitness programs and our postpartum fitness programs we incorporate hip shifts almost every day within the programming because they’re so beneficial to keeping us comfortable throughout our pregnancy, to releasing tension within our pelvic floor, creating space within our pelvis, and then also just improving our overall pelvic floor function. Because again, tight does not equal strong, and so if we have tight portions of our pelvic floor, it could impact its overall function. And if you’re having a hard time visualizing what a hip shift is, head to the notes below, and we’ll link a few videos that we’re demonstrating different types of hip shifts because different variations of it may feel better for you than for others.

[00:08:59] Gina: And so with the hip shift, you can do it side lying, you can do it all fours, you can do it standing, and each of them is going to have a different level of activity throughout our body, which can change how deep you feel that you can get into these different positions. For some of you, you may find a side lying position feels the best because you can really just focus on the pelvic floor. For others of us, you may find that you need more activity throughout your body, you need more activation within the pelvic floor to feel it really stretch, and so you may find the more standing and upright positions to feel better for you. But if I could only pick one exercise to do to prepare for birth I would pick some sort of hip shifted exercise because of how beneficial it is to releasing this common area of tension within the pelvic floor.

[00:09:38] Gina: So when it comes to the pelvic floor during pregnancy and as a part of birth preparation we don’t necessarily want to focus on Kegels, which is just the tightening and tightening and tightening of the pelvic floor. Rather we want to focus on improving the overall range of motion of the pelvic floor, because tight does not equal strong, and your pelvic floor does not push your baby out, we just need it to release and let go. For a lot of us we tend to have uneven tension throughout the pelvic floor where we tend to have a little more tension and tightness in the back half of the pelvic floor, in addition a little bit, a little bit more to that left half. And so we want to find different movements that are going to stretch the tight areas of the pelvic floor, not just continuing to stretch the front half of the pelvic floor.

[00:10:19] Gina: So common birth prep exercises that you may see for the pelvic floor could include doing lots of Kegels, those deep squat positions, butterfly pose, where everything is very wide knee, but we would recommend kind of doing the opposite. So don’t do the Kegels, incorporate that full range of motion within the pelvic floor, both the lengthening and the shortening. In addition to, I would focus more on internally rotated positions with more of a rounded back position, because this is going to target more of the back half of the pelvic floor, where a lot of us tend to have more tension. And then we can incorporate those hip shifts to focus more on one side of that pelvic floor where a lot of us tend to hold even more tension.

[00:10:55] Gina: We incorporate all of these exercises into the MamasteFit Birth prep Circuit, where there’s six exercises to help support your baby’s position and to release common areas of tension so that you can release your pelvic floor and improve your pelvic mobility to support birth.

[00:11:07] Gina: Now, when it comes to labor, your pelvic floor plays a big role in supporting your baby’s head position. And so, if we have uneven pelvic floor tension, it could cause your baby to tilt their head to the side or be asynclitic. You may hear it as like, “kind of funky in there,” or, “cattywampus.” So, their head is either tilting to the side or maybe even like, tucking or extending a little bit, and this can make it a little bit harder for a baby to navigate through your pelvis. And so that’s why it’s really important during pregnancy to focus on releasing that uneven tension within the pelvic floor.

[00:11:39] Gina: And so there’s a lot of exercises that we can do towards the end of pregnancy to help support evening the tension within the pelvic floor to support baby’s head positioning. And you can work with a pelvic floor physical therapist, even during pregnancy, to help kind of address some of these movement patterns and different postural tendencies that you may be having that could be contributing towards this uneven tension. So for me, during my third trimester, towards the end of the pregnancy, I was working with our pelvic floor physical therapists here in the gym, and they did some internal work to help kind of release some areas of tension for me. They went over some different movements that I can do to help kind of even the tension throughout my pelvic floor as well, which I think really contributed towards a faster labor for me.

[00:12:18] Gina: During labor, we can also do different movements to help kind of release that tension within the pelvic floor as well. For me personally, I found doing lots of hip shifted exercises to feel really good as I was laboring. It also helped me to kind of release tension in the back half of my pelvic floor as I was moving through a contraction. And so that could be something that you also incorporate as a laboring position for you.

[00:12:39] Gina: You can also do different vocalizations to help relax the pelvic floor during labor. Because again, we really just wanted to kind of move out of the way to allow baby to pass through. And so like deep low noises, or like mooing, or like oooing type noises can help to relax the pelvic floor. And so during each of my contractions I would kind of be shifting into each hip as I was kind of vocalizing through them to really help relax the pelvic floor. Trying to release the jaw and the face can be really beneficial either with like face massage or just kind of like shaking your jaw or keeping the jaw open can be a great way to relax the pelvic floor. You may find like jiggling type motions or like counter pressure to be really helpful to release tension within the glutes and the pelvic floor.

[00:13:20] Gina: For me, in the early part of labor, I found like firm pressure to feel really good with counter pressure. And then as labor progressed and I got closer to pushing, I found jiggling to be really helpful to relax the pelvic floor. Because again, we want to be as relaxed as possible during our contractions to help baby pass through more easily.

[00:13:38] Gina: You may also find that laboring on the toilet is really helpful for you to release tension within your pelvic floor because that’s where we intuitively tend to release, just from like years of conditioning to relax on the pelvic floor, and so you may find that the toilet is like another really great place that you can labor.

[00:13:53] Gina: So the things that I would do during labor to help my pelvic floor relax to support my labor process is to, one, choose laboring positions that I feel are helping me to relax within my pelvic floor. For me personally, I found hip shifts to be really helpful. So I would stand just kind of like shift into each hip kind of rotating my belly towards each thigh. I found vocalizing to be super helpful especially with like deep, low noises because it tends to kind of vibrate through the body and relax tension within the pelvic floor. Focus on keeping the jaw open and relaxed can be really helpful. Keeping the face relaxed can be super helpful. You may find that different types of counter pressure techniques or jiggling techniques help you to relax the pelvic floor. And then of course you can labor on the toilet as well.

[00:14:36] Gina: And now after birth, as we navigate into the postpartum, you may be wondering, “Well, what can I do to help my pelvic floor heal?” especially because there’s a lot that probably just happened to the pelvic floor. Whether you had a vaginal birth or Cesarean birth, there’s a lot that happened during pregnancy for your pelvic floor, and then also however your birth went, happened to the pelvic floor.

[00:14:57] Gina: And so when we’re healing from birth, the initial healing timeline for birth is about four to six weeks, but then the healing from pregnancy is about nine months to a year. And so we need to kind of reframe our healing timeline to not just be birth, we also have to recover from pregnancy.

[00:15:14] Gina: And so during pregnancy, the pelvic floor takes on additional load. Whether you gained any weight or not, your pelvic floor is working a little bit harder during pregnancy because your uterus is significantly larger, you have more blood volume, you have more fluid, and so you just weigh a little bit more during pregnancy, and so your pelvic floor is going to be working a little bit over time. In addition, a lot of our postural tendencies tend to be a little bit more exaggerated during pregnancy. So there’s probably different pressure distribution onto the pelvic floor, different types of tension within the pelvic floor because of those postural habits from pregnancy. And so we have to kind of recover from all of that, in addition to the trauma of labor as well.

[00:15:53] Gina: And so with the pelvic floor, you may be feeling some heaviness, some discomfort, you’re also bleeding. If you’ve had any sort of vaginal tears or perineal tears, you’re recovering from that. If you had a Cesarean, you’re recovering from a Cesarean incision. And so there’s a lot that’s kind of happening within that first time frame.

[00:16:11] Gina: The first thing that we can do to help approach recovering within the pelvic floor is just allowing it to recover initially during the inflammation phase. And so this is where, like, using ice packs for the first 24 to 48 hours can be really helpful just for, like, comfort, but we don’t want to use ice kind of beyond that because it could inhibit the healing timeline, because we do want some of that swelling to help us during this inflammation phase. You may find that gentle compression feels really good at this phase as well. So LoveSteady has these bloomers that are really like, but there’s so many different brands out there that offer just gentle compression, which can help aid and healing as well. When we’re wearing any sort of, like, garments to support the pelvic floor, to support the belly, we’re never trying to shrink the waist, we’re never trying to suck everything back in. It should be gentle compression to where you can still exhale and inhale fully without feeling like you’re straining or like you’re restricted with your breathing at all. There shouldn’t be any increased pressure downward onto the pelvic floor when you’re breathing. And so we’re looking for something that provides a lot of that support. I prefer garments that have perineal support as well, but if you can only find like a belly band, that would be fine too, but we just don’t want it to be so tight that it pushes down onto the pelvic floor.

[00:17:24] Gina: If you had any perineal tears or you had a C section incision that you’re healing from, taking care of the stitches can be really beneficial at this point, and then also try to keep them clean. And so for perineal tears, using a peri bottle and perineal spray can be really beneficial, and for C section incisions, changing the bandages can also be really helpful.

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[00:18:29] Gina: Now in the early postpartum, any sort of increased pressure like coughing, sneezing, laughing may make it feel like your pelvic floor is going to fall out of your body, and this is where external splinting can be super helpful. So anytime you have to sneeze or cough or blow your nose, you can just take your hand and place it against your perineum to give some external pressure, known as splinting, and that can be really beneficial for your comfort. If you had a C section, you can also place your hand against your incision. to help kind of counter increased pressure and it’s still, it might still be a little bit painful, but it should be way less painful than when you had nothing.

[00:19:03] Gina: Now you may be wondering what exercises can I do to help support my pelvic floor healing and when can I start doing them? You can start doing pelvic floor specific exercises very early in the postpartum phase, but don’t feel the pressure to do them if you just aren’t ready for them either.

[00:19:18] Gina: And so the best exercise that we can do for our deep core, which includes our pelvic floor, is diaphragmatic breathing, where we are just breathing down into the abdominal cavity and then exhaling to gently contract in. So when I inhale, my ribcage expands out to the side and my back pushes out. And this is going to bring length to kind of the back side of our body, the back half of the pelvic floor. And then I’m going to exhale and lift up and the front half of the pelvic floor pull belly to spine. And so we have this gentle expansion with our inhales and gentle exhalation to lift and contract upwards with our exhales. And so this kind of breathing pattern can help you start to reconnect and to move the pelvic floor in a really gentle way and to integrate it with the overall system.

[00:20:00] Gina: So we never really want to focus on muscles in isolation. It can be helpful to do some isolated movements to like remember where that muscle is, but overall, all of our muscles work in coordination with each other. And the issues that we may be experiencing postpartum such as leaking, prolapse, like, discomfort, may not be associated with just the pelvic floor not working well, it may be more that the pelvic floor is not working well with the entire system. And so when we breathe, we’re integrating the entire deep core system to work together as we expand and contract. So you can start diaphragmatic breathing fairly early postpartum, you can be in your bed in a supine position, you can be side lying, you can progress towards more upright positions. And in our early postpartum recovery course, which is a free course, we do break down different breathing drills that you can do, and then different gentle mobility exercises that you can do as well.

[00:20:51] Gina: Something else that may contribute towards discomfort in the postpartum, especially within the pelvic floor, is going to be pelvic floor tension. So remembering that our pelvic floor just went through a lot during pregnancy, it just went through a lot during birth, it is common for it to kind of clench in an effort to stabilize and to heal.

[00:21:08] Gina: And so sometimes the heaviness that we feel is not a pelvic organ trying to fall out, but rather the pelvic floor is just really tight. And you may notice it more if you’re on your feet a little bit more, if you’re carrying your baby a lot. So those can all be things that can contribute towards more of that heaviness feeling and it’s typically tension.

[00:21:25] Gina: And so doing some mobility exercises to kind of release these areas of tension, thinking about our posture when we’re standing up and moving around can also be really helpful, and then doing some of that breathing can be super beneficial. So for me, anytime I was starting to feel more tension within my pelvic floor, I would, one, focus on resting a little bit more. I would put on some sort of support garments that aided with some gentle compression, and then I would focus on more of those back expansion, hip shifted exercises, kind of release tension in the back half of my body.

[00:21:53] Gina: After you’ve been working on the deep breathing, you’ve been working on some gentle mobility, around like 10 to 14 days postpartum, if you feel up to it, you can start doing some short walks in addition to some gentle core exercises. But again, all of this is like very general guidance. Each of our births are going to be different, and so when we want to start approaching movement, regardless of how gentle it is, may differ for each of us. But in general, usually around like the two week mark is when most folks feel ready to begin to walk and incorporate a little bit more movement into their postpartum routine. And we can also start to integrate more core specific exercises.

[00:22:28] Gina: So again, the core is not just your six pack abs, it’s not just your pelvic floor, it’s an overall system, and we want to coordinate the system while we breathe and then begin to move our arms and legs. Our core is where we anchor all of our movement for as I reach to grab something, as I step, and so we want to focus first on that deep core system. And so maintaining my torso position as my arm extends, as my leg extends. And so we can do some very, very supported core exercises, which again, we include within the early postpartum recovery course, and that we include as the warmup for our postpartum return to fitness programs.

[00:23:03] Gina: And now a key thing when it comes to pelvic floor function in the postpartum, especially as we recover, is one, reconnecting with it, learning how it moves again with this whole system with our breath, and then progressing that as we navigate the postpartum. And so something that can be really helpful to supporting your pelvic floor as you return to fitness- so this is after like four to six weeks postpartum or beyond, so you’re starting structured exercise, your bleeding has stopped- we want to think about how we are exhaling and inhaling with our movement.

[00:23:35] Gina: Commonly when we move with gravity is when we want to be inhaling. And so when I’m in the eccentric portion of a movement, so we’ll use a squat, for example, when I get ready to lower in a squat, I can either inhale as I lower, or I can inhale at the top, kind of maintain that pressure, and then lower. And then I’m going to exhale to stand up.

[00:23:55] Gina: Now, with the exhalation, I can either exhale, then stand up, or I can exhale as I stand up. Commonly, I find in the early postpartum time frame, within like the first few months, it’s helpful to exhale and then initiate the movement to kind of prep the system to know what to do. And then over time, this becomes more simultaneous.

[00:24:14] Gina: And so when you get ready to like do an exercise, so let’s say I’m getting ready to press a weight overhead, I’m going to exhale to lift up in my pelvic floor, pull belly to spine, and then I’m going to press the weight overhead. This is going to help to activate the deep core system a little bit more to help strengthen it, so that we can progress movement onto it. We can increase the load, we can add more demand.

[00:24:35] Gina: So in our postpartum fitness programs, we now incorporate on demand videos where I’m walking you through each workout and I’m telling you and cueing you how to breathe with every repetition because we found that it’s so beneficial for folks to have more of a walkthrough with their workouts as they navigate workouts in the postpartum phase.

[00:24:52] Gina: Now some common issues that folks may experience in the postpartum when it comes to the pelvic floor could be things like pelvic organ prolapse, where a pelvic organ is pushing into the vaginal wall and kind of coming into that space. This is usually something that involves… that creates a lot of fear for folks when they find out that they have it.

[00:25:10] Gina: It’s important to note that our bodies are just different after we give birth. Our skin is a little bit looser, like, things are just going to be different after we give birth. But it does not mean that there is less function, or that we are dysfunctional by any means. The majority of us will have some sort of pelvic organ prolapse after birth because things are just happening to the pelvic floor, they just sit a little bit lower, especially as we are healing. And it can be normal to have some sort of prolapse. I personally have a grade 2 cysticeal, which means that my bladder pushes into the vaginal wall. Which when I first heard that I had some sort of prolapse when I was like 8 months postpartum, I was mortified. I had no idea what that meant. I was really scared. I thought that it meant like things were over. However, I realized that I didn’t have any symptoms from it and it didn’t impact my life in any way. I was able to run and jump and do all the things. And so I began to learn that having prolapse did not mean dysfunction, it just meant that my body was different.

[00:26:04] Gina: So again, similar to like how we have looser skin after we give birth, it doesn’t mean that we are less functional. You can have some grade of pelvic organ prolapse and not have it impede function at all. Our bodies are just different.

[00:26:17] Gina: Now, if you do have symptoms with the prolapse, or you feel heaviness, you feel like something’s falling out, it’s really uncomfortable to run or to jump, this is where working with a pelvic floor physical therapist can be super beneficial. In addition to, there are other support options available to you, such as like internal pessaries, which is kind of like a sports bra for your pelvic floor and that can be really helpful. Wearing like external support devices can be really helpful, such as like these different like support shorts or underwear. And so there’s different things and tools available to help you be asymptomatic with any sort of pelvic organ prolapse. But I would definitely start with pelvic floor physical therapy if you are noticing that you’re having symptoms.

[00:26:56] Gina: If you are working with a pt and all they’re having you do is Kegels and glute bridges and clamshells and nothing else off the table, we need to find a new PT. If you are struggling to find a PT, I would look for one that has a PRI certification, so Postural Restoration Institute, I find that that approach is really beneficial for recovering in the postpartum, or you can work with our PTs virtually or in person. And so we have two pelvic floor PTs out of our gym that do pelvic floor PT consults online in addition to working with clients in person at our gym. And I’ll link them down below, but it’s Hayley Kava. You can find them @HayleyKavaPT on Instagram, and that’s their website as well.

[00:27:34] Gina: Other things that you may be experiencing postpartum would be things like leaking. So you are jumping or running or laughing and you leak a little bit. And this is sometimes known as like a badge of motherhood, like, “I leak because of you.” However, peeing yourself is not a mandatory part of motherhood, and it definitely does not need to be a part of motherhood, and it’s associated with some sort of dysfunction within the pelvic floor. One of the common things that you may be told, or you may hear to do to help fix if you’re leaking is to do more Kegels. Because obviously, the pee is leaking because it’s too loose. And that is not accurate. If we recall from the beginning, tight does not equal strong. So having a tighter pelvic floor does not equal a stronger pelvic floor. The pelvic floor is kind of like a trampoline, it needs to lengthen and then recoil to contract, lengthen and recoil to contract. And so when it lengthens, it’s going to increase the distance that the pelvic floor moves, which can then increase the power of the pelvic floor can generate. So if I was jumping, for example, and I jumped with my legs straight and try to jump up as high as I could, I would not probably jump very high. I can’t jump very high in general, but if I had no bend in my knees or my ankles, and I just jumped straight up, I would not jump super high. Compared to, if I bent in my knees and my hips and my ankles and then try to jump I could jump much higher, and that’s because I moved more distance and so I can generate more power. And this is the same for our pelvic floor. Our pelvic floor needs to move a distance so that I could generate power to contract to keep our pee and all the other things inside.

[00:29:04] Gina: And so if you have a very tight pelvic floor, it’s like trying to jump with your legs straight. It can’t kind of expand and lengthen so that it can then recoil and generate power. And that could actually be why you are leaking, because your pelvic floor is too tight. So doing more Kegels can actually make it worse for you.

[00:29:21] Gina: In addition to your pelvic floor’s tension within it, we need to remember that sometimes we have uneven tension within the pelvic floor. And so there may be an uneven distribution of pressure onto the pelvic floor based on our posture and our positioning. And so being able to improve the mobility of the pelvis, to improve the mobility of the pelvic floor to adjust our spinal position can sometimes help to decrease leaking as well. So if you are kind of stuck in this more extended position where you’re arching in your back and you’re jumping or running, you’re putting more pressure to the front half of the pelvic floor just based on that posture. And so if we can bring the rib cage down while we jump or we run, it usually can decrease pressure to the front half of the pelvic floor and decrease symptoms such as leaking.

[00:30:03] Gina: And again, this is where working with a pelvic floor physical therapist can be super beneficial because they can kind of take a look at what your positioning is, how you’re breathing, the tension within your pelvic floor, to help kind of correct any issues that you may be having.

[00:30:16] Gina: Because you do not need to be in pain, you do not need to pee yourself, you do not need to do anything in the postpartum that is associated with dysfunction as some sort of badge of motherhood. There is help for you out there. You can join our fitness program so that you have a step by step rehab guide so that you can feel strong as you navigate motherhood. We can decrease symptoms. We can improve our quality of life, because we do not need to suffer at any point throughout pregnancy and in the postpartum.

[00:30:43] Gina: So the pelvic floor plays a big role during pregnancy, during birth, and then after birth, as we recover in the postpartum. And it’s kind of like a buzzword when it comes to this phase of life. You need to understand that the pelvic floor is a sling of musculature at the bottom of our core canister. So it’s one piece of this overall system. And so we had a whole episode where we talked about the core, about like two or three weeks ago, so check that out. If you wanna learn more about what the deep core is, what the next layer of core is. But the pelvic floor is a system, it is a part of a bigger system, and so it does not operate in isolation. So doing movements that only focus on just the pelvic floor is not gonna help it work better altogether. And if we’re experiencing symptoms or dysfunction, it is not usually because the pelvic floor sucks, it’s rather it’s not working well with this overall system, or another piece of the system is working a little bit too hard, or your pelvic floor is working too hard.

[00:31:34] Gina: The pelvic floor has five main functions. It helps to stabilize as a part of that deep core system, it helps to support our pelvic organs, it has a sump pump function so it helps with lymphatic drainage, it’s going to help with sphincter control, and then it has a sexual function which is a big role during childbirth.

[00:31:50] Gina: During pregnancy, we want to focus on learning how to release tension within our pelvic floor so it can open and release when labor does come. A lot of us tend to carry uneven tension throughout the pelvic floor- so more towards the back side of the body, a little bit more towards the left side- and so being able to stretch and release in the back of the pelvic floor is going to be really beneficial. In addition, we can focus on learning how to lengthen and stretch the pelvic floor with our breath and then exhale to contract to lift it up and in. So it’s not just Kegels, we want the full range of motion.

[00:32:21] Gina: When it comes to birth, we want the pelvic floor to have that even tension as well because it could impact our baby’s head positioning. If there’s uneven tension within the pelvic floor, it can cause baby’s head to tilt to the side, making it harder for them to navigate through the pelvis. And so things that we can do during labor to help release tension within the pelvic floor is we can do different hip shift exercises or just different movements that help you relax the pelvic floor. We can focus on vocalization, so deep low noises to relax the pelvic floor. We can focus on releasing tension within the jaw and the face. You can also add in some counter pressure or jiggling techniques to help release tension within the pelvic floor, and then laboring on the toilet is another really great place to be.

[00:32:59] Gina: When it comes to the postpartum, the first core exercise that we can do to strengthen and release tension within the pelvic floor is going to be just diaphragmatic breathing, so learning how to gently move that pelvic floor again. We can use supportive garments like bloomers or compression garments to help kind of support that pelvic floor, and then you can use external support with your hand or soft object if you do have a sudden increase in pressure, such as you’re laughing or you’re sneezing, to help find some comfort for the pelvic floor.

[00:33:24] Gina: The common things of dysfunction in the postpartum could include pelvic organ prolapse, maybe we’re leaking, or we have pelvic pain. It’s important to note that none of these things are things that you need to be suffering from in the postpartum. They are not a badge of motherhood. We can absolutely find relief if we have a symptomatic prolapse, or if we’re leaking ourselves, or we are in pain. And you can usually seek out a pelvic floor physical therapist. I highly recommend working with a pelvic floor PT that has a PRI certification, so they’ve been trained with the Postural Restoration Institute. I find that that approach seems to work really well for our clients here in the gym, and you can also work with our PTs, both virtually and in person, at HayleyKavaPT.com, or you can find her @HayleyKavaPT, and I’ll link them down in the notes below.

[00:34:07] Gina: The pelvic floor plays a big role throughout the entire perinatal timeframe, and it is definitely a buzzword for all of us. You may not have known that you had a pelvic floor, but it does exist, and it is an important part of our entire experience, but it’s only one part. It is a part of the overall system, and we’re here to support you as you navigate this journey with our prenatal fitness programs, with our postpartum fitness programs, and all of the offerings kind of in between.

[00:34:30] Gina: If you want more support throughout your pregnancy with pelvic floor exercises, how to integrate the pelvic floor with the rest of your core, with the rest of your body, birth preparation exercises to release tension within that pelvic floor, to figure out what a hip shift is, join our prenatal fitness programs. We offer our prenatal fitness programs both in the app, so the TeamBuildr app is a list of exercises with demo videos and has full length workout videos that you can follow with at the same time, that will be our on demand program. In the postpartum we have a similar setup where we’re going to be going over hip shifts, different pelvic floor strengthening exercises, how to integrate it with the overall system. We have our app based program. Our app based program has both self paced workouts and full length workout videos with every part of the workout for the first six weeks. We also have a mini program, which is going to be that program split up into three workouts each, and then we just have just the videos if you only want the videos as well, depending on your workout preference. But we found that the videos are really important for folks as they navigate the postpartum fitness, and again, I walk you through every rep. I tell you when to breathe, I tell you how to exhale, I help you with your form in all the movements, because it’s really important how we support and how we navigate the postpartum to support our lifelong health.

[00:35:39] Gina: So if you want to check out any of our online offerings, you can use code STORY10 to get 10 percent off anything that we offer, and you can check them all out on our website at mamastefit.com.

[00:35:48] Gina: This podcast is sponsored by Needed, a perinatal nutrition company that specializes in optimizing nourishment for the perinatal timeframe. You can check them out at thisisneeded.com and use code MAMASTEPOD to get 20 percent off your first order.