DOING MORE KEGELS EXERCISE - IS THAT BENEFICIAL OR NOT????

Maintaining the right balance between strength and flexibility is crucial. While strong pelvic floor muscles provide necessary support, excessive tension—also known as pelvic floor overactivity or hypertonicity—can create complications.

The Importance of Pelvic Floor Strength in Pregnancy . A well-conditioned pelvic floor contributes to:

1. Support for the Growing Baby

The uterus expands significantly during pregnancy, placing additional strain on the pelvic floor. Strong muscles help distribute this weight, reducing the risk of pelvic organ prolapse.

2. Bladder and Bowel Control

Hormonal changes and increased abdominal pressure can lead to urinary incontinence. A functional pelvic floor helps prevent leaks and maintain continence during pregnancy and postpartum.

3. Easier Recovery Postpartum

Pelvic floor training before and during pregnancy can enhance muscle tone and promote faster healing after childbirth, reducing issues like postpartum incontinence and pelvic organ descent.

4. Improved Posture and Core Stability

The pelvic floor works in synergy with the core muscles to stabilize the pelvis and spine, reducing pregnancy-related back and pelvic pain.

The Dangers of Pelvic Floor Overactivity

While strength is essential, excessive tightness or hypertonicity can be problematic. Signs of an overactive pelvic floor include:

1. Pelvic Pain and Discomfort

A constantly contracted pelvic floor can lead to chronic pain, pressure, or spasms in the pelvic region, making pregnancy more uncomfortable.

2. Difficult Labor and Delivery

A hypertonic pelvic floor may resist expansion, leading to prolonged labor, increased chances of tearing, or a higher likelihood of requiring medical interventions like forceps or C-sections.

3. Urinary and Bowel Dysfunction

Paradoxically, overactive muscles can contribute to incontinence, as tightness prevents the bladder and bowel from fully emptying, leading to urgency and frequency issues.

4. Pain During Intercourse (Dyspareunia)

Increased muscle tension can lead to painful intercourse postpartum, affecting both physical and emotional well-being.

The Importance of Pelvic Floor Assessment

A comprehensive pelvic floor assessment is essential for identifying imbalances, dysfunctions, and weaknesses. This assessment, conducted by a pelvic health physiotherapist, helps determine whether a woman’s pelvic floor requires strengthening, relaxation, or a combination of both.

1. Why Is Pelvic Floor Assessment Necessary?

• Identifies Weakness or Overactivity: Determines if the muscles are underactive (weak) or overactive (tight).

• Prevents Pregnancy-Related Issues: Helps mitigate risks like incontinence, prolapse, and pelvic pain before they worsen.

• Customizes Treatment Plans Ensures that exercises and interventions are tailored to the individual’s needs, preventing ineffective or counterproductive approaches.

• Prepares for Labor and Postpartum Recovery: Assesses readiness for vaginal delivery, potential need for perineal massage, and postpartum rehabilitation needs.

2. What Does a Pelvic Floor Assessment Involve?

• Medical History & Symptom Analysis: Evaluates previous pregnancies, existing pelvic issues, and symptoms like pain, leakage, or discomfort.

• External & Internal Examination: May involve manual palpation to assess muscle tone, coordination, and trigger points.

• Functional Testing: Checks how the pelvic floor engages with the core and responds to movement, breathing, and posture.

• Biofeedback & Ultrasound: In some cases, tools like biofeedback or real-time ultrasound help visualize pelvic floor activity.

3. Who Should Get a Pelvic Floor Assessment?

• Pregnant women experiencing leakage, pain, or pelvic pressure.

• Those with a history of difficult labor, perineal tears, or cesarean sections.

• Women planning for a smooth postpartum recovery.

• Anyone unsure whether they should be strengthening or relaxing their pelvic floor muscles.

The Role of Physiotherapy in Managing Pelvic Floor Health

Physiotherapy plays a critical role in maintaining pelvic floor health during pregnancy. A specialized pelvic health physiotherapist can assess and provide tailored interventions to ensure the right balance between strength and relaxation.

1. Assessment and Diagnosis

A physiotherapist can evaluate whether the pelvic floor muscles are weak, overactive, or imbalanced, allowing for a customized treatment plan.

2. Guided Pelvic Floor Training

Strengthening Techniques: Targeted exercises to build endurance and support pregnancy demands.

Relaxation Strategies: Techniques like biofeedback, stretching, and guided relaxation to reduce excessive muscle tension.

3. Manual Therapy and Release Techniques

For those with hypertonic pelvic floor muscles, physiotherapists use manual therapy, myofascial release, and breathing techniques to improve flexibility and reduce discomfort.

4. Education and Functional Movement Training

Physiotherapists educate pregnant women on proper posture, movement strategies, and lifestyle modifications to prevent strain and discomfort.

5. Postpartum Recovery Support

Physiotherapy aids in postpartum rehabilitation, ensuring the pelvic floor regains optimal function and preventing long-term complications like prolapse or incontinence.

How to Find the Right Balance

Maintaining a functional pelvic floor involves a combination of strengthening and relaxation techniques. Here’s how to achieve optimal muscle function:

1. Assess Your Pelvic Floor Needs

Every woman’s pelvic floor is different. Consulting a pelvic health physiotherapist can determine whether you need strengthening, relaxation, or both.

2. Incorporate Strength Training Mindfully

These help strengthen weak pelvic floor muscles. However, they should be done correctly—excessive or improper Kegels can worsen overactivity.

Functional Core Training: Strengthening the deep core muscles ensures the pelvic floor is not overcompensating for core weakness.

3. Prioritize Relaxation Techniques

Diaphragmatic Breathing: Helps release pelvic tension and optimize oxygen flow.

Perineal Massage: Prepares the pelvic floor for childbirth by improving elasticity.

Stretching & Yoga: Poses like deep squats and child’s pose encourage relaxation.

4. Practice Mindful Movement

Avoid holding tension in the pelvis throughout the day.

Perform pelvic tilts and mobility exercises to maintain flexibility

Maintain good posture to distribute pressure evenly across the pelvis.

Conclusion

The pelvic floor is a vital yet often overlooked component of pregnancy health. Striking the right balance between strength and relaxation is key to preventing complications and ensuring smoother childbirth and recovery. A pelvic floor assessment is an essential first step in understanding individual needs and ensuring the best outcomes for pregnancy and postpartum health.

Action Step: Consult a pelvic health physiotherapist to assess your pelvic floor function and implement a personalized approach for pregnancy wellness.