Pelvic Floor Muscle Retraining Can Reduce Urinary Incontinence in Late Pregnancy and Post Partum Women in the First 12 Months
Urinary incontinence (UI) is a common female pelvic health problem and physical therapy is the most commonly recommended first line therapy for it. About one third of women have UI. It is usually recommended for mixed UI (stress and urge) and less commonly for urge incontinence alone. Pelvic floor muscle (PFM) retraining is usually done over five to 12 sessions in order to adequately localize the correct muscles to train and reinforce therapy and adherence.
There are no adverse effects of doing PFM retraining. Overall, it is most beneficial when individually taught to the individual woman who is immediate post-natal but at high risk for incontinence (urinary or fecal), such as after instrument delivery, vaginal delivery after a large baby or a third degree perineal tear.
If women perform PFM training during pregnancy or just after birth, here are the findings:
- In women without UI who have never given birth yet, or those with only one birth, PFM reduces UI in late pregnancy (34 weeks or more pregnant) immediate post partum (up to 12 weeks), and even up to three to six months after birth.
- In women with UI at baseline, PFM retraining did lower UI in late pregnancy but did not show lasting effects into the post partum period.
So for all you soon-to-be new moms or those with only one child who do NOT have UI, start doing those Kegels about two months before the baby is due to help cut down on UI after birth.
Link to blog: http://femaleurologyaz.blogspot.com/2009/07/pelvic-floor-muscle-retraini...
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Pelvic floor muscle training is so much more effective if you can identify and isolate the correct muscle and then exercise by squeezing a resistance - which is what Arnold Kegel said was essential! See www.betterkegelexercises.com for more help
In addition to kegels, women should work the coordinating muscles to help strengthen the pelvic floor. Many of these are core exercises that you may be familiar with from pilates or yoga. I know it is hard to fit in exercise at all, let alone additional exercises -- but a good strengthening program can be done in ~15 minutes 3x per week. And the bonus is that the coordinating muscles include your abs -- which most of us want to be working on post-baby anyway! Also, women should make sure their posture is good. Proper posture can also help. See http://hab-it.com/blog/?p=48 from more info on this.
Tasha Mulligan MPT, ATC, CSCS
Creator of Hab It: Pelvic Floor DVD
www.hab-it.com