Category Archives: Pelvis

Kate’s Post #Baby-Bod Tummy is NORMAL!

Royal BabyBy Marianne Ryan PT, OCS
Clinical Director MRPT Physical Therapy

This article quotes several parts of an article by Ceridwen Morris and posted on Yahoo.com

What a picture of a fairytale story come true! We all rejoiced in the birth of the first prince of this century with pictures of “a beautiful, healthy baby, a doting, proud father, and a glowing, serene mother. But wait! Look closely. When Kate passes the swaddled heir to her charming William, she reveals a real-life new mom belly. Round as a six month pregnancy. Clear as day.”

What’s up with that?

“Can anyone tell me why Kate’s stomach still looks pregnant after the baby isn’t inside her anymore? I had no idea that happened … Is it fluid or something?”

“Women are often surprised to learn that looking very pregnant is not only normal for the first few hours or days after giving birth but for weeks or more. Women have 40-50% more blood volume during pregnancy; all that excess fluid doesn’t go down overnight.  Also, the uterus must shrink back down to a fraction of the size it was during pregnancy. But it can take about a month or so.”

shutterstock_55118254
What can Kate do to help her belly heal and flatten faster?

Studies have shown that compression helps to heal wounds faster, even post baby-bod bellies, but it has to be the correct amount of compression. To facilitate healing there should be enough elastic in the garment to compress the belly without pressing so hard that the garment takes over the work of the abdominal muscles.

Many of you may have seen articles written about celebrities who claim wearing very tight abdominal binders for a few months helped them to develop a flat tummy after childbirth. Nothing could be further from the truth!

As a physical therapist who specializes in treating postpartum women, I would like to give a warning that tight abdominal binders will not help to flatten your tummy; and using an abdominal binder actually weakens stomach muscles. Another problem with abdominal binders is that they create compressive downward forces which push internal organs down towards the worn out muscles at the bottom of the pelvis (pelvic floor muscles). This can lead to problems such as chronic urinary leakage and pelvic organ prolapse.

The answer to how to help heal and flatten your post baby-bod tummy is to wear a compressive garment that will help to encourage your abdominal and pelvic floor muscles to contract and to hold your organs “up and in”. So, you need to wear a garment that will offer compressive support at the bottom of your pelvis and your tummy. As I mentioned before, you need to use just the right amount of compression. “Shape wear” under garments, the ones we see advertised all over the internet, are too tight and can weaken the abdominal muscles. To date, I am not aware of a garment available on the market that I can recommend. So, for now, try using a sports top, like a yoga top, and underpants with enough elastic to give your pelvic floor support.

Should you have a baby over 40? Essentially Fit Radio Show

Essentially Fit RadioMarianne was recently interviewed by Wess Murray for his Essentially Fit radio show on the subject of “Should you have a baby over 40?”

During the 50 minute show they discussed a number of issues including:

 

  • Why you must take care of your joints during pregnancy.
  • Having a 2nd child later in life: what steps should you take?
  • Exercise after childbirth The pros and cons of having a baby after 40
  • How modern technology has made it possible to have children
  • How to have realistic expectations when losing weight after a baby

Click here to listen to the show

You can also download the show here from I Tunes

Prevent Pelvic Organ Prolapse (POP) with Better Birthing Techniques.

Pelvic_floor_side_view_larger_fontBy Marianne Ryan PT, OCS
Clinical Director MRPT Physical Therapy

A very common side effect of childbirth is Pelvic Organ Prolapse, POP, some studies show up to 25% of women will develop it at sometime in their life.

What is Pelvic Organ Prolapse?

POP occurs when organs such as the uterus or bowels slip down from their normal positions inside of the pelvis.

There are different degrees of how much the organs slip, in severe instances organs can protrude outside of the vagina, especially when performing activities that require abdominal bracing such as heavy lifting, sit-up exercises and even passing a bowel movement.
POP can lead to several complications such as incontinence, pelvic and back pain and sexual dysfunctions.

Prevent Pelvic Organ Prolapse With Better Birthing Techniques:

Did you know that certain childbirth techniques could reduce the risk of developing pelvic organ prolapse (POP)?
The more strain placed on the pelvic floor during childbirth, the more a woman is at risk of developing POP. Choosing better positions, breathing techniques, and timing can benefit both mom and baby.

To read more about this in an article I wrote for the Association for Pelvic Organ Prolapse, “Reduce the Risk of Developing Pelvic Organ Prolapse: Birth Techniques For Less Strain on Pelvic Floor Muscles”, click here.

Did You Know Physical Therapy Treatment Can Reverse or Reduce the Severity of POP?

In an earlier post I discussed a study that shows that  1/3 of the surgeries performed to reverse Pelvic Organ Prolapse fails within 7 years. That is a really bad statistic! click here
What most people do not realize is that physical therapy treatment has been proven to reverse or lower the severity of the amount of slippage, and therefore may be used in the treatment of incontinence, pelvic and back pain and sexual dysfunctions.

Painless Parenting the Radio Show

Move Forward Radio Marianne Ryan PT, OCS is interviewed by Move Forward Radio on the subject of Painless Parenting.

“Parenting provides challenges but it doesn’t have to be a pain. In this episode, Marianne Ryan PT, OCS discusses how to help parents avoid the minor aches and pains – and even significant injuries – that sometimes occur during pregnancy and after childbirth”.

Tell me what you think?

Click below to listen to the show:

Listen to Move Forward Radio’s segment about Painless Parenting or dowload the podcast on Itunes.

Common Pregnancy Pains. Did you know..?

shutterstock_82822033 Pregnant backMoms you are not alone!
Did you know “Fifty percent to 70% of pregnant women experience low back pain during pregnancy. In addition, 30% to 50% of pregnant women report low back pain severe enough to cause lost time from work. It’s more manageable, however, than most women (and their doctors) think”.

Did you know that physical therapy treatment is the best way to get rid of and to prevent back pain while pregnant?

Move Forward PT posted some great tips on how to avoid and treat pregnancy aches and pains:  Click Here

http://www.moveforwardpt.com/Resources/Detail.aspx?cid=8d523b23-9f02-4ac7-a107-c464ae6840b2

Wanna’ Get That Pre-Baby Body Back? Here are 5 Tips:

Woman Lifting DumbbellThis is a summary of a good article that I helped write for Move Forward PT. (see link below)

“While moderate weight gain is a common concern for women during and after pregnancy, there are many other factors to consider in the 4 to 6 weeks after childbirth. You may want to get back into pre-pregnancy shape immediately, but it is important to make a slow return to full activity.”

Here are some “tips on what you can do in the first 6 weeks after delivery to begin getting your body back into pre-pregnancy shape.”

  1. Get help with tasks. During the first 6 post-partum weeks DO NOT LIFT ANYTHING HEAVIER THEN YOUR BABY.
  2. Breathe. Your diaphragm works as a breathing muscle and is a major core muscle. Breathing exercises will help you to restore stability in your trunk and to regain tone in your core muscles, so you can achieve that flat tummy look.
  3. Focus on your core. After birth woman’s abdominal muscles are stretched out and can sometimes develop a separation, called diastasis recti.  During the first 6 weeks you can do some gentle Kegel and breathing exercises to get a jump start on your recovery. Avoid activities that put pressure on your abdomen such as getting out of bed by doing a sit up. A physical therapist can prescribe exercises to help “close the gap” between muscles.
  4. Strengthen abdominal and pelvic floor muscles.  Women can do gentle Kegel (pelvic floor) exercises immediately after childbirth, whether the birth was vaginal or by caesarian section. Strengthening the pelvic floor also can improve sexual satisfaction and help prevent incontinence.
  5. Every minute counts. Try to incorporate fitness into your everyday routines—such as taking a family walk around the neighborhood or doing your kegel and breathing exercises while you are nursing or feeding your baby. New moms should sleep whenever they have the opportunity.

Click here for the full article

http://www.moveforwardpt.com/Resources/Detail.aspx?cid=4064e184-e3bf-473e-a002-e814a8aa4050

One Third of Childbirth Repair Surgery Fails?….Why?

shutterstock_55118254By Marianne Ryan PT, OCS
Clinical Director MRPT Physical Therapy

Did you know that “a common surgery often performed to repair damage caused by childbirth fails one-third of patients within seven years, a new study shows”?

Yup, it is the surgery women have done to cure incontinence and other problems caused by pelvic organ prolapse (POP), which often occurs as a result of childbirth.

An article written by Liz Szabo, for USA Today, goes on to explain:

1. “In nearly one-third of cases, surgical repair failed or women saw symptoms return”

2. “About 225,000 women undergo some kind of pelvic organ prolapse surgery each year”

3. “Some surgeries can be prevented; pelvic physical therapy can cure many milder cases”

Szabo also mentioned “about one in four women suffer either prolapse or incontinence at some point, and studies show that 11% to 19% of women undergo surgery for it.”

Let me repeat: 25% of all women develop incontinence or pelvic organ prolapse. That is one out of four of your female friends!

Cheryl Iglesia of the Georgetown University School of Medicine was quoted in Szabo’s article as saying, vaginal deliveries increase the risk of developing pelvic organ prolapse (POP), and in the future doctors will need to perform C-sections rather then vaginal deliveries for women at high risk for prolapse.

Yikes! Iglesia’s answer to the problem is more surgery and more C-sections?

What about more physical therapy?

The article does mention that studies show that “pelvic physical therapy, which includes Kegel exercises that strengthen pelvic floor muscles, can reverse many mild cases of prolapse”, but there is no mention on how pelvic physical therapy can prevent POP. There are also studies that show pelvic physical therapy can reduce the level of prolapse, for example reduce a grade 3 to a grade 2, etc.

If pelvic physical therapy can reverse pelvic organ prolapse, why aren’t women knocking down my door to get physical therapy treatment? 

Why? Because I don’t think we take postpartum recovery seriously in our country. Women traditionally receive excellent prenatal and obstetric care during delivery, but postpartum care is lacking. 6 Weeks after delivery, women are usually given a pat on the back and told “good job done” and that they can resume sexual activity. What about postpartum rehabilitation? In our country women are left to fend on their own after delivery.

In other countries, such as France, they take postnatal care seriously. Did you know all French women receive free physical therapy after they give birth. I have been told by some of my patients that postpartum physical therapy is “mandatory” in France and they go for about 20 visits focusing on rehabilitating the pelvic floor and abdominal muscles after every baby they deliver. 
In a light hearted article written by Claire Lundberg, “The French Government Wants to Tone My Vagina”, for Slate Magazine, Lundberg discusses the positive experience she had with the French postpartum rehabilitation program called la rééducation périnéale and how she was glad “a medical professional was paying attention to what happened down there.”

What about more physical therapy after one of these surgeries?

Did you know that after having surgery for pelvic organ prolapse most women do not receive pelvic physical therapy?

I recently asked a urogynocologist, who refers patients to my practice, why she did not refer her patients to physical therapy after preforming these types of surgeries. The answer was that she did not think it was necessary, and was not convinced that physical therapy would help the patient recover. 
It is common practice to go for physical therapy treatment after surgery on other body parts, like the shoulder or knee; why isn’t is considered part of the rehabilitation process with pelvic surgeries? 
If surgeons started sending their patients for physical therapy treatment after prolapse surgery; doesn’t it follow logic that it would help them reach better outcomes? Maybe physical therapy treatment could prevent surgical failures? 
(Just in case you didn’t know, you can go directly to a physical therapist without a doctor’s referral in most states.)

More surgery is not the answer. More physical therapy is the key to solving pelvic organ prolapse. 

References:

http://www.usatoday.com/story/news/nation/2013/05/22/common-pelvic-surgery/2325055/

http://www.slate.com/articles/life/family/2012/02/postnatal_care_in_france_vagina_exercises_and_video_games.html