Person exercising on mat with baby

Core and Floor: A Breath-Centric Approach for Childbirth Recovery

If the pelvic floor is working well, women can get back to an active, healthy lifestyle now and set themselves up for a better quality of life in their golden years.

Having a baby changes everything, including your body. It takes time to recover from childbirth, so you should allow yourself to gradually get back to exercising. We tend to focus on the extra weight we have put on, especially around our midsection, and are tempted to jump into doing isolated abdominal exercise, when instead we should focus on how to engage our pelvic floor muscles in our pursuit of overall core training. If the pelvic floor is working well and in coordination with breathing and functional tasks, women can get back to an active, healthy lifestyle sooner and set themselves up for a better quality of life in their golden years.

Pregnancy and delivery can cause a lot of trauma to the pelvic region, even if you had a C-section. It’s not unusual, for instance, for women to experience urinary incontinence. Other issues that affect women after having a baby may include leaking gas or stool, pelvic pain, pelvic organ prolapse (when organs descend downward), pain during sex, and rectus diastasis (abdominal muscle separation). The body is amazing, and some of these issues will resolve on their own, but in other cases the effects of childbirth may affect women decades down the road.

Incorporating pelvic floor muscle training into our daily routines can help to manage the stresses and pressures we encounter, to prevent and even resolve some of these problems. We want to make sure we recruit the muscles correctly, and a good way to do this is to think “core and floor.” This means activating the pelvic floor and recruiting the abdominals while working out and when doing challenging activities. I teach women to do this more naturally with “cannister” breathing. This brings in the diaphragm, pelvic floor and the rest of the core. I tell them as they breathe in, to allow the belly and ribs to expand, and then when exhaling, to focus on bringing the abdominals in toward the midline, like closing elevator doors, while also lifting the pelvic floor up and in. Think of the pelvic floor as the parts that hug a bike saddle. One could imagine contracting these muscles when trying to stop the flow of urine or hold back gas. It is very important to relax and release fully after each contraction, to best set up the body’s pressure management system and avoid fatiguing the muscles. And, once mastered, it can be done throughout the day, whether it’s pushing a stroller, lifting your kids, doing chores or working out.

This combination of breathing and muscle training can be challenging – it takes practice. Overlake offers pelvic floor wellness classes, and we have a great team of specially trained pelvic floor physical therapists who help women with these issues. Ideally, we should be strengthening the "core and floor" before or during pregnancy, but it’s not too late after baby arrives to train the muscles. After all, it is worth it to help avoid some of the issues that might happen in the future if the pelvic floor is neglected.

Watch Kathy on New Day Northwest talking about this very topic:

Kathy Golic, PT is a physical therapist at Overlake Medical Center & Clinics who specializes in pelvic floor issues. She is active in speaking publicly and leading classes on the topic of pelvic health.  

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