You’ve probably heard people talking about your pelvic floor and if you’ve had a baby you might find that it doesn’t work as well as it used to! Do you have back or pelvic pain? Have you found that you go to the toilet more than you used to? Do you worry about your next coughing fit? Do you dread a playdate at the trampoline park? Did kegel exercises actually make your continence worse? If this sounds familiar don’t suffer in silence – help is available. Jaime Sawiuk, sports physiotherapist and Mummy MOT practitioner, answers some frequent questions about pelvic floors.
What is a Mummy MOT?
It is a specialist postnatal assessment following both vaginal and caesarean delivery. It will assess your posture, breathing, pelvic floor muscles, scars and stomach muscles. Each assessment is tailored to your individual needs based on a screening questionnaire. A bespoke exercise programme based on your pelvic floor assessment will be given on the day, with a report that you can keep or give to health care providers. In addition, you will be signposted to links on nutrition, “mum tum” advice and all exercises provided can be viewed online.
What will happen at my appointment?
At your appointment, you will be made to feel at ease,. (Remember it’s just a mum assessing another mum. ) It begins with a detailed discussion of any ante or postnatal problems you may have. Followed by your full body MOT. An internal pelvic floor examination will be offered to see if it’s doing what you think it is. This is a very gentle examination and you are in control at all times. It checks strength, what happens when you cough and areas of tightness. All women’s health physiotherapists learn on each other so we’ve all been there!
My pelvic floor feels ok, should I still have a Mummy MOT?
It is recommended that all women have their pelvic floors assessed. Even if you feel okay the muscles may not be, or your awareness of them may not be as good as you think. Depending on delivery muscles may be weakened, stretched or even tightened. Even if you can’t feel it now it may present in later menopausal years.
Research has shown that nearly 40% of women are pushing down or doing an ineffective contraction instead of squeezing and drawing up forwards.
I’ve got back pain and I’m struggling to take my baby out in the sling. Could a Mummy MOT help?
If you’ve had back, hip or pelvic pain that it could be a tight or weak pelvic floor. On internal assessment, half of women have weakness in either their tummy muscles or pelvic floor following birth. This can create a weak core and translates to pain, bladder or bowel weakness. A Mummy MOT will pick up on any weaknesses and together we can work to correct them.
I’ve been doing Kegels like the midwife advised but it has increased my frequency to the loo and laughing can cause me to leak. Any Advice?
It’s not always about the squeeze! If you have bladder weakness, doing Kegels can actually make some women worse!
If you have an overactive pelvic floor (works too hard and is tight) then doing kegels can wind it up even more. It becomes so tight that it can increase your sense of urgency and you can still lose control on a cough, sneeze or during exercise. A tight pelvic floor cannot move up and down properly and therefore cannot effectively support your bladder. However, the “ KNACK” is a great technique for some, draw in your pelvic floor from your back passage to your front passage before coughing or laughing.
I’ve got a ‘tummy gap’. What can I do to bring it back together?
There are many factors but It can be related to your breathing and pelvic floor function. If you are a shallow breather then your diaphragm does not descend fully on the in-breath. In turn, your pelvic floor does not lengthen to its full potential. This can cause both weakness and tightness which can then prevent the gap closing. This will be picked up in a Mummy MOT and any advice will be written down and practiced so even the most sleep-deprived mum won’t forget and have something to work on. It sounds strange but deep breathing is a good place to start.
I gave birth over 18 months ago. Is it too late to have an assessment?
It’s never too late for an assessment or treatment! Most women wait an average of 7 years before seeking help! Don’t let pelvic floor problems dictate your life.
Jaime first became interested in women’s health 7 years ago following work on the delivery wards and MSK clinic. Her interest grew significantly following the birth of her son 3 years ago. Although she was physically fit she suffered with pelvic girdle pain from 8 weeks in pregnancy. Following a difficult birth and recovery, she was treated by a women’s health physio and wanted to learn more about what happened to her and why. She is now a qualified Mummy MOT practitioner and wants women to know that help is out there.
Jaime works in Leeds and Harrogate at Physio Action based in David Lloyds. To book an appointment call 0113 2687578 or visit the website.