1) Peeing your pants with lifting, jumping, sneezing, etc is normal, especially after having a baby
This may be COMMON, but NOT NORMAL. This kind of leaking is called stress incontinence. The majority of people believe this happens due to a weak pelvic floor (cue the Kegal recommendations), while this may be true for some people, it is more often due to an overly tight pelvic floor or a mismanagement of core pressure. Your diaphragm, abdominals, back muscles, and pelvic floor all work closely together to regulate pressure (think breathing and bracing techniques) for these activities. If one part of this “core canister” isn’t functioning correctly, it can cause leaking. Also, if your pelvic floor muscles are too tight, they have no room to contract in order to brace and prepare for activities, causing incontinence. Seeing a physical therapist who is trained in pelvic health can help with pressure management techniques and determine if your leaking is due to a weak or over-active pelvic floor and prescribe exercises and provide manual therapies accordingly.
2) Diastasis Recti means your abs are torn and you can never do sit ups again
Diastasis Recti is a widening of the linea alba of your abdominal muscles. This happens in 100% of pregnancies to some degree and is completely normal. This is the body’s way of providing more space for baby to grow. Diastasis Recti is also seen in babies, people with increased adipose tissue around their mid-section, and men. Even in women who have never had children, the normal gap range is 0-35 mm. Doing sit ups isn’t necessarily going to make this widening worse. What’s more important is learning proper pressure management techniques which include breathing techniques, coordinating your deep core muscles and pelvic floor muscles (watching for coning/doming). Other important things to note are making sure you don’t have pain or leaking with exercises, determining how firm your linea alba is when you push down on it, watching your posture, and progressively loading your core. A pelvic floor therapist can help determine the degree and depth of your gap and help guide you in proper exercise progression.
3) Heavy lifting will cause pelvic organ prolapse (POP) or make it worse
There are degrees of prolapse ranging from Grade 1 when a person is bearing down you do not see tissue introitus to Grade 4 where tissue is visible beyond introitus without bearing down. Physical therapy can help with Grades 1 and 2 where surgery is usually required at Grade 4. If you are recently post-partum or breastfeeding, prolapse will seem more pronounced. It can take up to 6 months post breastfeeding for ligaments to return to their “normal” state. Prolapse can be managed and you can strengthen supporting musculature. With proper guidance by a physical therapist you can address lifting and breathing mechanics, toileting habits, muscle imbalances, and postural awareness. If activity increases prolapse symptoms you should avoid it or do less initially, but you can return to your desired activity level once you have mastered proper mechanics and developed adequate strength.
Comments