The latest Sports Medicine Review mentions the importance of strengthening the muscles in the abdomen and lower back. For postpartum women, these exercises go hand in hand with rehabilitating the pelvic floor muscles.
The pelvic floor has two important roles in the female body. First, it helps support the organs located in the pelvis (bladder, uterus, rectum). Second, it contracts in response to stress such as sneezing or lifting a load; the musculature clamps the urethra, preventing the flow of urine.
Changes in posture
During pregnancy, women often experience changes in posture culminating in hyperlordosis.
This change in the curvature of the lower back changes the orientation of the bladder and urethra such that the pelvic muscles are no longer able to clamp down effectively. As a result, pregnant women may present early signs of stress incontinence.
Changes to the abdominal muscles
Changes in posture are often accompanied by changes to the core muscles. The expansion of the abdomen significantly lengthens the rectus abdominis muscle, sometimes even causing it to tear down the middle, a condition known as diastasis. The tearing of the rectus abdominis weakens the abdominal wall and exacerbates hyperlordosis, along with all of its related consequences.
Changes to the pelvic muscles
Changes to the pelvic muscles are due mainly to childbirth. As the baby passes through the birth canal, the muscles are stretched to their maximum. This stretching is sometimes accompanied by trauma (e.g. episiotomy, deep superficial tear). This weakens the muscles and hinders their ability to support and clamp. The following symptoms may occur: pelvic pain and/or heaviness, pelvic organ prolapse, urinary or bowel incontinence, decreased ability to “hold it”, a sense of urgency (pressing urge to urinate and continuous flow of urine), painful bowel movements, and pain during sexual intercourse.
Getting back to normal
Given all of these changes, it may be necessary to follow certain rules in order to optimize recovery.