Pelvic floor rehabilitation and benefits for mothers after childbirth

This is an automatically translated article.

The article is written by MSc, Dr. Vu Duy Chinh, High-tech Unit for Treatment of Cerebral Palsy and Autism - Vinmec Times City International Hospital

Pelvic floor dysfunction in postpartum women is a very common problem. The reason is that when giving birth many times, the pelvic floor is stretched and prolapsed, causing a number of functional disorders such as: urinary incontinence, constipation, sexual dysfunction... Rehabilitation exercise Pelvic floor with Kegel exercises or exercise with machines will soon help improve the dysfunctions caused by pelvic floor prolapse, thereby improving the disease status and quality of life in women after childbirth.

1. Effect of exercise on pelvic floor rehabilitation

Childbirth is one of the main causes of weakening of the pelvic floor in women. On the way out through the vagina, the fetus can stretch and tear the supporting tissues and pelvic floor muscles. Multiple births is one of the causes of weak pelvic floor muscles, leading to functional disorders such as: urinary incontinence, urgency, urinary incontinence, constipation, fecal incontinence, and sexual dysfunction. Exercise and restore pelvic floor function with Kegel exercises or exercise with a machine will help prevent and effectively treat urinary incontinence, uncontrollable farting, fecal incontinence, urinary incontinence, and nocturia. , helps to control urination and defecation at will. Prevent prolapse of organs in the pelvic area including: prolapse of uterus, bladder, rectum. Improve the quality of sex life. Therefore, postpartum mothers with abnormal symptoms of the above functions need to go to medical facilities to be examined and evaluated by a doctor as soon as possible.

2. Pelvic floor muscle recovery exercises

2.1. Kegel exercises

Kegel exercises were introduced by gynecologist Arnold Kegel Henry in 1948. This is an exercise for the muscles of the perineum region - the area that protects the genitals. Kegel exercises help activate the perineal muscles and help the genital organs, anal sphincter to be firmer.
Scientific evidence shows that this method also helps the practitioner improve sexual desire, prolong sex time, increase arousal and promote benefits to sexual health in general.
This exercise is also especially effective for women after childbirth, especially mothers who choose to give birth naturally. Normally, it takes months or even years after giving birth for a woman's vagina to regain its firmness after one labor. However, this time will be shortened if you persist in practicing Kegel exercises. Kegel exercises also help postpartum women prevent uterine prolapse and urinary incontinence. Therefore, women from the moment of pregnancy and have just given birth, should start practicing this exercise right away.
First of all, the practitioner must identify the pelvic floor muscles that need to be exercised, know how to practice contractions and contractions when exercising according to the following instructions:
Step 1: Sit or lie down, relax the muscles in the thighs and buttocks and belly. Step 2: Contract the sphincter around the rectum as if trying to hold back a urine or a bowel movement, then relax these muscles, contract and relax again once or twice until the correct muscle is identified. . During the exercise, the patient tries not to contract the muscles of the buttocks, thighs, abs... Step 3: When urinating, try to hold the urine halfway for a short time and then continue urinating. After determining the pelvic floor muscles to work, start practicing Kegel exercises.
Exercise posture: Can be practiced in any of the following three positions:
Sitting: Sit with your back straight in a chair, knees slightly out, or sit cross-legged on the floor, or sit stretched Straight leg forward. Lie down: Lie on your back in an upright position or rest your head on a pillow, knees bent, feet apart. Standing: Stand clinging to a chair, knees slightly bent, shoulders wide, feet and toes slightly apart pointing outward.

Exercises:
Level 1: Hold your urine Contract your vaginal muscles and then relax like you are urinating and then hold it back. Repeat this movement many times for 10-20 minutes, practice at least twice a day for the best results.
While exercising, remember not to cause contractions of the abs, legs, back and buttocks (after exercise, if you feel fatigue in these muscles, it means that you have not exercised properly). You can put your hands on your stomach during the exercise. If you feel your stomach is a little heaving, it's not enough. When practicing, you must breathe evenly, slowly and deeply.
Level 2: Finger Kegels Wash your hands before your workout. Insert one of your fingers into the vagina and try to contract the vaginal muscles to squeeze your finger. You will feel your vagina shrink.
This exercise is advanced and slightly more difficult than the previous exercise. So don't be discouraged if you can't do it right away.
Level 3: Vaginal contractions, hold for 5 seconds. With this level, you take turns to follow the instructions as follows: Contract the vaginal muscles a little, count to 5. Contract a little more, count to 5. Contract as much as you can, count to 5. Relax vice versa, step by step, each step counts to 5. This exercise will take more time and requires more patience than the previous exercises, but the effect it brings is also much better.
Level 4: Repeat repeatedly: Once you have achieved the results of the above levels, try to practice at a more difficult level as follows: Contract the vaginal muscles for 3 seconds, relax. Repeat 10 times. Contract and release as quickly as possible. Repeat 25 times. Imagine you are trying to suck something into your vagina. Hold it for 3 seconds, release. Repeat 10 times. Imagine you are trying to push something out of your vagina, hold for 3 seconds, release. Repeat 10 times. You can do Kegel exercises anytime, anywhere, even while working, while cooking because no one will notice that you are practicing. Should practice right after pregnancy and right after giving birth, it has no side effects, no need to use drugs, can bring significant effects to your sex life. You should practice step by step, do well in lesson 1 before moving on to lesson 2...

2.2 Electromechanical fitness and biofeedback

In addition to practicing Kegel exercises as instructed above, mothers can go to specialized rehabilitation facilities for instructions and conduct pelvic floor muscle training with neuromuscular electrical stimulators with The electromechanical fitness program is scientifically designed and effective with the program on the machine. The patient will be able to exercise the pelvic floor muscles with the machine through the use of electrodes placed in the rectum, vagina or adhesive electrodes. Exercises with the machine will help the muscles to be properly trained to bring fast results.
The implementation of biofeedback exercises combined after the electromechanical exercise program further contributes to improving the treatment effectiveness, improving the good pelvic floor function for the patient.

2.3. Exercises for pelvic muscles

Kegel exercises are still said to be the best for the pelvic floor muscles. If you don't like doing kegel exercises, you can try these 5 moves to strengthen the pelvic floor muscles. Strong pelvic floor muscles will help prevent leakage of urine and stools (especially when sneezing and increasing emotions during sex).

2.3.1. Plank pose

Lie face down and then lift your body up to form a push-up position. Arms straight and shoulders straight with wrists. Neck, hips and legs should be in a straight line, avoiding the hips to sag below the floor. Tighten your abdominal muscles. Hold this pose for 30 seconds to a minute. Repeat 2-3 times.

2.3.2. Rotate hips figure 8

Lie on your back with feet hip-width apart and arms flat on the floor. Lift your hips off the floor, keeping your shoulders close to the ground to create a bridge pose. Then, use your hips to draw a figure 8 in the air. Lower yourself by lowering your spine to the floor. Repeat 2-3 times, 8 beats each time.

2.3.3. Leg lift

Lie on your back, legs straight together, hands clasped together hidden underneath your back. Lift your feet with your feet off the floor, pause. Then raise your legs up again until they form a right angle with your hips, hold for a few seconds and return to the starting position. Repeat 2-3 times, 10 reps each time.

2.3.4. "4-legged" movement

Support your hands so that your wrists are directly below your shoulders and kneel with your knees on the floor. Bring your right arm forward and your left leg straight behind you. Bring both arms and legs back to the starting position, then repeat with the left arm and right leg. Continue alternating arms and legs while keeping abs tight and trying not to move the torso. Do this 2 times, 10-12 reps on each side.

2.3.5. Squat

Stand with feet wider than hips. Bend your knees and squat down as if you were sitting in a chair until your thighs are parallel to the floor. Keep your abs tight and torso as straight as possible, knees not past toes. Stand up straight to return to starting position and repeat. Do 2-3 times, 12 reps each time.

3. Notes when performing Kegel exercises

You can do this exercise in any position (lying, sitting or standing). During exercise, the practitioner still breathes normally. Just pinch and pull up. Do not tighten the buttocks and let the thighs relax. Try to start this Kegel exercise regularly after giving birth. Success only comes to those who are persistent enough to practice every day. If you practice continuously and with the right technique, after only 3-4 weeks you will feel a great change in your body.
For examination and advice on effective treatment of pelvic floor dysfunction, please contact to make an appointment with Ms. Vu Duy Chinh, Rehabilitation Doctor, Regenerative Medicine Clinic, Vinmec Times City International General Hospital or contact the hotline system for detailed advice.

Please dial HOTLINE for more information or register for an appointment HERE. Download MyVinmec app to make appointments faster and to manage your bookings easily.