By Sheree DiBiase of Lake City Physical Therapy
All women, but especially postpartum moms, need to be able to understand how their pelvic floor and abdominal muscles work throughout the day. The ability to contract and relax the pelvic floor muscles are very important to the health of their bladder, bowel, and sexual organs. The ability to engage the over-elongated abdominal muscles are just as valuable after having a baby.
Understanding how to do that correctly for a postpartum mom can be a real challenge because of all the changes that physically occur and the resulting hormones on board, especially when breastfeeding.
Because these sets of muscles are an integral part of the overall “core” trunk muscles, all of the core muscles need to be trained separately to ensure proper function and then together to facilitate high-level activities, such as lifting and carrying baby, car seats, diaper bags, home chores, and community activities.
Knowing what the “core” muscles are is important. You can imagine your “core” like a can of soda or like a closed bag of chips. There are 4 muscle groups in the core. The diaphragm makes up the superior part of the container. The pelvic floor muscles make up the inferior part. The abdominal muscles make up the anterior portion and the back extensor multifidi make up the rear component. The balance between these muscles is what we need during normal daily activities.
The core muscles are definitely challenged during pregnancy, labor, delivery, and postpartum. So much change has happened that the body hasn’t had a chance to reset and adapt.
This is why it is very important to have a postpartum musculoskeletal physical examination by a trained Women’s Pelvic Health Physical Therapist at 2-6 weeks postpartum to make sure proper reintegration is occurring. Remember, muscles atrophy with trauma, and long-term change during pregnancy can cause impairments that need to be addressed sooner than later.
The use of trans-abdominal real time ultrasound to be able to “see” the pelvic floor muscles and the abdominal muscles contract and relax correctly is extremely valuable.
Generally, the techniques used to evaluate the pelvic floor muscles are physically and psychologically invasive for a postpartum mom, who might have had tears and/or stitches, or a baby with a large head that tore or compromised the pelvic floor muscles. Mothers with forceps and vacuum delivery are at more risk for pelvic floor muscles tearing and damage, so this intervention is very beneficial and can be used early on to help moms feel better sooner.
The trans-abdominal real-time ultrasound is able to measure the quality and integrity of the pelvic floor and abdominal muscles after delivery and you can also view the core and lower extremity integration.
Evaluation of the pelvic floor and abdominal muscles functional strength is necessary so that you can teach and give feedback to a woman as she is contracting and relaxing these muscles. It is also a great way to document changes in pelvic floor muscle function and strength throughout her training interventions.
Trans-abdominal application of diagnostic ultrasound is a non-invasive imaging method for assessing and treating the pelvic floor and abdominal muscles. It is especially beneficial postpartum, but it can be used to evaluate anyone’s pelvic floor and abdominal strength, mobility, and function no matter how long ago you delivered. We can use this intervention with all of our athletes, as well.
Sheree DiBiase, PT, ICLM, is the owner of Lake City Physical Therapy, which utilizes transabdominal real time ultrasound to evaluate and treat patients. Check out Lake City Physical Therapy’s high-visibility ad under the Postpartum Care & Physical Therapy section of the Spokane Birth Resources Directory.