As a trainer who works with new and expecting mums, I get a lot of questions about Pelvic Floor and its function (or dysfunction!)...
"what is it?" "How do I activate it?" "I think something is going on down there, how do I know if it's normal?" "I wee went I cough, is that ok?" 

So to leave no stone unturned, I interviewed the amazing Women's Health Physiotherapist, Janette O'Toole from Better Health Physiotherapy on Pelvic Organ Prolapse, one type of Pelvic Floor Dysfunction which can occur. I hope this Q&A helps all you mummas out there who have questions but might be a little hesitant to ask. So here it goes...

​What are the most common types of pelvic floor dysfunction that you help women with at Better Health Physio?
I see women of all ages with a large array of pelvic floor issues. These include

• Leaking with coughing, sneezing or during exercise
• Rushing to toilet (urinary urgency) 
• Needing to go to toilet many times a day (frequency)
• Difficulty emptying the bowels or straining
• Poor wind control and/ or urgency with bowel movements
• Prolapse
• Reduced sensation during sexual intercourse
• Trapping of wind in the vagina
• Difficulty using tampons
• Pain with gynaecological procedures or sexual intercourse
• Hip and back pain
• Chronic pelvic pain- for example endometriosis
• Vaginal/ vulvar pain

 
What are the symptoms of Pelvic Organ Prolapse?
Women with pelvic organ prolapse usually describe a feeling of a ‘bulge’ or something sitting inside the vagina. They may also describe a feeling something has ‘dropped’ or an awareness of a lump inside the vagina.
It is not normally painful, just a feeling of discomfort or awareness of something not feeling quite right.
This may be a constant feeling or may come and go, particularly at the end of the day, when they are tired or if they have been on their feet all day.
Some women may also report some bladder symptoms (such as urgency, frequency or a change in urine flow) or bowel symptoms (such as difficulty emptying the bowel).
Some women will have no symptoms at all.
 
How is a Pelvic Organ Prolapse diagnosed?
A prolapse is diagnosed with a vaginal examination. 
A pelvic floor physio will usually use a single clean gloved finger and ask the person to cough or strain so that they can feel for any descent or laxity in the vaginal tissues. This can be done in lying and sometimes in standing (when the prolapse is usually more evident).
A gynaecologist will usually use a speculum to do this.
 
How can Women’s Health Physiotherapists like yourself help treat Pelvic Organ Prolapse?
An initial physiotherapy appointment is usually 1 hour and will include:

• A comprehensive assessment including questions on general health, bladder and bowel health as well as obstetric and gynaecology history.
• Screening for any risk factors for pelvic floor dysfunction
• Provide a vaginal examination to assess pelvic floor including prolapse
• Pelvic floor muscle exercises- specific guidance and progression
• Manage any avoidable factors such as constipation and straining
• Bladder, bowel advice to reduce symptoms
• Graduated exercise program to help the person achieve their fitness goals.

In your opinion, are there any exercises that a new mum with POP should avoid?
Regardless of if you have had a vaginal or caesarian delivery, ALL mums have some degree of pelvic floor (and abdominal) weakness. Therefore all exercises need to be introduced gradually.
Try to avoid:

• any exercise which causes symptoms as this is a sign of pelvic floor weakness. This includes symptoms of leakage, abdominal bulging or vaginal pressure.
• Sit ups, planking and heavy lifting as these all place increased load on the pelvic floor, therefore it is best to avoid these at first.
• Running should be avoided for at least 3 months. It is best to have a pelvic floor check at this time, prior to starting this.

With pelvic floor strengthening, these exercises can be safely and gradually introduced.

​Thanks Janette, you are a wealth of information!!
For more information about the services Janette provides and to book in with her, click here 

For additional Pelvic Floor resources and information, visit Pelvic Floor First here

Pelvic Girdle pain is literally a pain in the bum, not to mention the groin. If you've ever had it, you know exactly what we're talking about! It's really an umbrella term for pain that occurs within the joints of the pelvis. 

What does it feel like?
Symptoms and severity vary between women, however the most common ones are:
Pain deep down in the groin (on the bony part of your public bone)
Pain near the dimples of your lower back 
Pain that radiates from the lower back and into the bottom 
Pain when walking, stair climbing, rolling over in bed, getting out of the car, stepping to the side, vacuuming, putting on your underwear whilst standing, and any other movement when one side is favoured.

When does it happen?
Pelvic Girdle Pain can present at any time, however it is most commonly seen from about 14 weeks into your pregnancy. The pain often decreases after childbirth.

Why does it happen?
There's a clever hormone called Relaxin which helps prepare the body for birth by making the ligaments a little more stretchy. This hormone peaks at about 14 weeks gestation. Due to increased laxity in the ligaments in the pelvis, a little bit more shearing happens between the pelvic bones and spine which can create instability, inflammation and pain.

What can I do about it?
Pelvic Girdle Pain can be very debilitating and when it comes to treating it, it's not one size fits all.

• We recommend a trip to your Women's Health Physiotherapist so they can assess your condition. 
• ​Talking to your Women's Health Physiotherapist about wearing a Pelvic Belt to stabilise your pelvis or compression shorts
• Strengthening your glutes, core and pelvic floor
• Apply ice to the achy areas such as your pubic bone for 10 minutes, twice a day
• Minimise excessive walking and stair climbing
• Stand on two legs rather than one as much as you can. For example when you're getting dressed/putting undies on, sit on your bed so your pelvis is supported
• Wear supportive shoes and walk on even ground as much as you can 

Factors that may contribute towards Pelvic Girdle Pain Include:

• ​Increase of relaxin at 14 weeks gestation 
• High work load at work
• Weak pelvic floor and deep abdominal muscles
•  Previous trauma to pelvis 
• Previous lower back pain
• Hypermobile joints 

At Mummas On The Move we can liaise with your Physiotherapist and develop a personalised exercise plan to work around your Pelvic Girdle Pain. We know it's a pain (literally) and we are here to help!

Hey mummas!
Does anyone else have a sore neck? It may have started as a niggle here and there but now that your eight weeks deep into mum life, it's an overwhelming achey feeling that you can't shake. Well don't worry, I've got you. You see, most online exercise videos that are out there at the moment don't address the underlying problems that most mums tackle. Sure they might get you moving or help you shift some post baby weight, but what about actually addressing the physical aches and pains that you face on a day to day basis?
And that's where I step in! I've designed a series of videos called The Rehab Series on our Move Online Portal which break down how to overcome common physical issues that new mums experience. Over the next few weeks, these videos will be released on our Online Portal.
If you enjoyed this video and you want more, you can register for a one week free trial, just click the button below to create a free account and register for your free trial. We also have some awesome workouts specifically designed to strengthen and tone your body as a new and expecting mum.  

The only pain in the neck you'll have now is trying to source nappies and toilet paper during the current lockdown!

Looking forward to moving with you soon!

​Sarah