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Archive for October, 2012

Post Partum Body and Exercise

Posted on: October 16th, 2012 by Laurie Plouffe No Comments

Whether you had a vaginal or a caesarean delivery, your abdominal and pelvic floor muscles have been stretched and possibly damaged.  It is important to get these muscles working properly again.  Many women are concerned about losing weight gained during pregnancy and flattening their stomachs, but it is important to get into a safe exercise routine as some types of exercise can cause back pain, create difficulty controlling urine or stool or cause dropping of the uterus, bladder or rectum.

What are safe exercises to perform post partum?

1. Pelvic Floor Muscle Strengthening (Kegels)

Breathe in and as you breathe out, imagine closing the openings in your pelvic floor, then lifting the pelvic floor up towards the center of your body.  Relax the pelvic floor muscles and imagine your sitz bones (the 2 bony prominences that you feel in your bum when sitting) spreading apart to help with relaxation of the muscles.

You may begin this exercise right away post partum, but only perform this exercise if you can do so without pain.  If you have pain, listen to your body as your body is healing and wait to do the exercise until you can perform it without pain.

Begin with 10 reps, 3 times/day.  Once that is easy, begin increasing the hold time of each rep. Goal is 10 sec. hold.

2. Deep Abdominal Muscle (Transversus Abdominus) Strengthening

Lay on your back with your knees bent and feet flat on the ground. Place your hands gently over your lower abdomen.  Breathe in  and as you breathe out, slowly and gently pull your abdomen away from your hands, towards your spine.  You should feel a light tension under your hands if you are recruiting the correct muscle.  If you feel a bulge outwards into your hands, you are working the wrong muscle, so relax and begin again.  Once you have the correct muscle working, hold the tension in the muscle and continue breathing for 2 more breaths in and out.

You may begin this exercise right away post partum, but only perform this exercise if you can do so without pain.  If you have pain, listen to your body as your body is healing and wait to do the exercise until you can perform it without pain.

Begin with 10 reps, 2 times/day.  Once this is easy, increase the hold time of each rep.

3. Walking

For cardiovascular exercise, walking is a good choice for the first eight weeks after delivery.  Make sure you have good posture while walking.   Pointing your chest forward will help you maintain good posture.

See a physical therapist if you are unsure about performing the exercises correctly.

What exercises should be avoided post partum?

Any version of sit-ups, crunches or pelvic tilts.  It is important to train your deep abdominal muscles and pelvic floor muscles post-partum to regain your core stability.  Sit-ups, crunches and pelvic tilts work the outer layer abdominal muscles and these muscles are not responsible for your core stability.  Also, if you have a separation down the middle of your outer layer abdominal muscle (called diastasis recti), exercising the outer layer muscle can worsen the separation.

When is it safe to increase my activity level?

Once you are 8 weeks post partum, you may begin gradually increasing your activity level and returning to other classes/activities if

  • you are pain free (including back, abdomen, pelvis and hips)
  • you are not experiencing leakage of urine or feces
  • you do not feel heaviness, pressure or bulging in your vagina or pelvis
  • you do not  have a bulge in the center of their abdomen while performing exercises or sitting up in bed.

If you are experiencing any of the above issues, see a pelvic health physical therapist prior to beginning an exercise routine.

How Physiotherapy Can Improve Your Pelvic Health

Posted on: October 16th, 2012 by Laurie Plouffe No Comments


Many women don’t understand that physiotherapy — or physical therapy — can benefit pelvic health. As many as 50 percent of women, between the ages of 50 and 79, will be diagnosed with a condition called Pelvic Organ Prolapse (POP). In some cases, symptoms of this condition are so mild they require little or no treatment. In other cases, women may eventually need surgical intervention to reverse their symptoms.

However, by paying attention to pelvic health, women may be able to avoid severe symptoms of POP. The sooner women begin to focus on pelvic health, the less likely they will be to experience any symptoms at all.

Pelvic Organ Prolapse

Pelvic Organ Prolapse (POP) occurs when weakened connective tissues begin to stretch or pull away from the pelvic bone structure. This allows pelvic organs to move toward the pelvic floor. The most common factors causing POP are pregnancy and childbirth. However, a prior pelvic injury, obesity, smoking and genetic predisposition can also contribute.

In mild cases, a woman is unaware she has POP, and it will be diagnosed by her doctor during her annual pelvic exam. These cases are usually monitored, and women can use physiotherapy to help rebuild pelvic muscle strength. In other cases, symptoms are more severe and the uterus or another organ may even prolapse into the vaginal canal.

Severe symptoms of POP usually require surgical intervention. Surgery always poses some level of risk, but transvaginal mesh implants — used to repair POP — have been linked to high numbers of serious health complications. Mesh erosion is one of the most serious, some women affected by this have filed vaginal mesh lawsuits. Physiotherapy can be used proactively to improve pelvic health and reduce the chances of developing more severe cases of POP.

Physiotherapy for Pelvic Health

  • Kegel Exercises. These are one of the most basic exercises women can do on their own to improve vaginal tone and pelvic floor strength. The sooner women begin doing them, the better. When done every day, studies have shown that women have less chance of developing severe symptoms of POP and/or urinary incontinence.
  • Electrical Stimulation. Doctors can use electrical stimulation to exercise severely weakened pelvic floor muscles. Once the muscles are strengthened, women can use Kegels, yoga, Pilates and other exercises that focus on maintaining core strength and pelvic muscle support.
  • Pelvic Physical Therapy. There are physical therapists who specialize in pelvic health. They can help women design a daily exercise routine to target their weak muscle groups, maintain pelvic health, and provide information and feedback regarding healthy postural techniques, which has also been linked to reducing symptoms of POP.
  • Pelvic Massage. Massage techniques that focus on connective tissue and myofascial tissue layers can help to realign organs and facilitate healing. Some of the most effective techniques include Shiatsu, Myofascial Release and Maya Massage.

Physiotherapy is so successful at restoring pelvic health that both the American Academy of Family Physicians and the American Congress of Obstetricians and Gynecologists recommend that non-invasive physical therapy should be prioritized when treating mild to moderate POP. This can often prevent women from experiencing the health complications associated with surgical treatments.

Elizabeth Carrollton writes about defective medical devices and dangerous drugs for

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