Prenatal PT Appointment: shifting from strengthening the pelvic floor to relaxing it
Proactive Pelvic floor health and preparing for childbirth.
A few weeks ago I made a prenatal appointment with my women's health physical therapist. I first met with Cristin Zaimes, PT DPT, owner of Oceanside Physical Therapy after the delivery of my son Jack in 2012. I had returned to running three weeks postpartum, but was experiencing a "falling out" sensation and was leaking during every run. I was worried I had developed a some sort of uterine prolapse. Thankfully that was not the case, and thanks to a regular routine of strengthening exercises I was back to running and no leaking a few months later.
For the last two years, pelvic floor, hip and glute strengthening exercises have been central to my cross training regime. I knew going into this (my third) pregnancy that, although I was much stronger than I was during previous pregnancies, I wanted to run conservatively and probably not as late into my pregnancy as I had with Jack.
So at 35 weeks (four weeks ago) I paid a proactive visit to Cristin to check-in and see what her thoughts were about where I was at in terms of pelvic floor, hip and glute strength. I was also looking for her opinion on whether or not it was prudent to keep running or if I should stop altogether for the remaining weeks of pregnancy.
I'm so glad I met with her because up until 35 weeks I had been incorporating the pelvic floor strengthening exercises of the Hab-It DVD into my weekly cross training regimen. The exercises on this DVD are focused on tightening the pelvic floor through various abdominal, back, glute, adductor and yes, kegel exercises.
What Cristin informed me of was that in the remaining weeks of pregnancy I should be more focused on learning to "relax" the pelvic floor and should back off or put the strengthening exercises on hold until after labor and delivery.
[Tweet "As you approach labor/delivery learning to relax #pelvicfloor becomes more important than strengthening it."]
She gave me several simple seated exercises that mostly involved deep breathing and focused relaxation of the pelvic floor, exercises similar to the ones I recall from my hypnobirthing classes we took years ago prior to the birth of our daughter (who is now five). The shift from strengthening to relaxing seems a natural progression to prepare for childbirth, but it's one I hadn't thought of. I was so focused on the postpartum return and being more prepared than I have been in the past that I'd forgotten that learning to relax the pelvic floor is just as important.
As for her opinion on continuing to run: if it feels fine there's no problem. But if it's uncomfortable, don't push it. At 35 weeks running had become increasingly uncomfortable so I decided to call it quits after a beautiful (and not too uncomfortable) run along the beach at 35 weeks. I also drew the conclusion on my own that if I'm starting to focus on relaxing the pelvic floor (in preparation for labor and delivery...the baby has to come out somehow...better if there's less resistance) I probably don't want to be pounding the pavement just for the sake of a short run.
My focus as of late has been on preparing for childbirth mentally and physically. I'm glad that I made a proactive appointment with my physical therapist and I'll be seeing her again postpartum before I return to any running.
[Tweet "A trip to a women's health PT can make a world of difference if you experience leaking during your runs #pelvicfloor #womenshealth"]
Have you ever had an appointment with a PT who specializes in women's health? If you've experienced leakage during running, I'd highly recommend you see someone. Physical therapy can make a big difference.
--Sarah
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