Common “Pinch Points” in Pelvic Health Recovery
A “pinch point” is an area on the road more prone to traffic jams and accidents. In physical health, I think about pinch points as areas where we have to be a little more diligent in order to stave off injuries and other problems. Here are a few that might come up in your postpartum recovery:
Returning to run– This may be your first high impact activity that you’ve done since pregnancy. The pelvic floor has to be able to accommodate the pressure that rapidly pushes down on it each time you hit the ground. This is a wonderful skill for your pelvic floor to work on but if it can’t quite handle the job, you may need to make some adjustments to your training.
Returning to any sport that requires speed– Being able to move quickly is a highly coordinated skill. Sometimes your pelvic floor has to relearn how to anticipate movement. The faster a movement is, the quicker the muscles have to activate. This type of anticipation has to happen automatically- meaning, we can’t simply do a Kegel and expect good results. If you have to move quickly for sport or for life (ie toddler is running away!) and suddenly you notice some pelvic floor symptoms, you might need to take your pelvic floor training to the next step of gradually building in speed work.
Intimacy– this can include penetrative sex, arousal, orgasm and more and is a complex topic where factors aren’t just physical of course. There is a dynamic interplay between hormonal, mental and emotional factors. If symptoms come up during intimacy, there are specific exercises that can help.
The return of your menstrual cycle– many women notice symptoms in certain phases of their cycles. There are hormonal shifts to take into consideration as well as movement and change occurring in the uterus as the lining thickens and then sheds. Also, some women complain of menstrual cups and tampons not feeling “right.” Sometimes they can be harder to position, don’t fit well or can fall out. This is of course something that wouldn’t be noticed until menstruation starts back up again. So, if that’s the case for you, know that there are ways to make things more comfortable throughout your cycle and to continue healing your pelvic floor.
Getting sick– coughing and sneezing creates quite a bit of pressure in the abdomen, which then pushes downward on the pelvic floor. Normally the pelvic floor can accommodate this but sometimes it simply can’t. This might be because the muscles aren’t strong enough or perhaps they’re strong enough for a while but eventually get fatigued and worn down (especially if it’s a doozy of a cold). First and foremost get well soon. Don’t be too discouraged, this is quite common and a good time to add back in some pelvic floor work.
Life Stressors (such as return to work, baby not sleeping well, lack of support at times, a health situation etc.)– These can be busy and emotionally challenging times. The pelvic floor muscles are “emotional muscles.” This means that they respond to how we feel and tend to hold tension when we feel tense. The combination of this and not having as much time to take care of yourself can be really challenging. If you can find a few minutes to prioritize “down training” work that calms the nervous system and releases muscle tension that will likely give you the most bang for your buck during this stage.
Constipation– Bearing down to push out a firm bowel movement puts a lot of pressure down onto the pelvic floor. For this reason, a bad bout of constipation can often irritate symptoms.
So, if you notice symptoms showing back up down the line, it doesn’t mean you’re back to square one, it means you’re dealing with a new challenge. These challenges put a heavier work load on your pelvic floor so your body just needs a little more time, learning, and strength to adapt. When you see a challenge coming, be ready to make some adjustments, revamp your PT exercises, or call a pelvic health PT. You’ll actually be much stronger when you get through a pinch point!
