View Full Version : How long for pelvic floor muscles to improve?
I am 3 weeks postpartum and still have very weak pelvic floor muscles (I was not expecting it and had good pelvic floor prior). I can hardly feel them, have to rush to the toilet, feel uncomfortable walking and have had a couple of leaks. I had a rather quick vaginal delivery, only a couple of perennial stitches for 1st degree tear. I am trying hard to do regular exercises. From others experience, how long do you think it will be before I see some improvements?it's making me nervous :(
I'm four and a half weeks postpartum and my pelvic floor has been gradually recovering. It's almost normal now except when I cough or sneeze.
You say you've been trying to do the exercises, have you also been spending as much time as possible lying down? The physio at the hospital I had my baby in recommended an hour in the morning and an hour in the afternoon lying flat to take all pressure off the pelvic floor. The printed handout she gave new mums went further, recommending a 15 minute lie down in every hour. Raising the pelvis on a pillow can help relieve pressure, too. It's easier to do your pelvic floor exercises lying down at first, so it may help with that.
(Sorry if you've already know all this and I'm preaching to the choir!)
Did you give birth at a hospital? If so, is there a physio associated with the maternity department you could call?
Thanks for this! No, my hospital booklet does not mention anything about lying flat and it does make sense...I will start doing it today. They do have a physio I can contact, I just wanted to give myself a little bit more time to see if there were any minor improvements, hopefully the lying flat will help, I def haven't been doing much of that...I need to learn how to slow down!!
I've found that the easiest way to incorporate horizontal time into my day is to breastfeed while lying on my side. It takes DD about an hour to have her meal so I manage to kill two birds with one stone!
A tip I found useful when my pelvic floor was still very weak was to physically give it support when doing activities that could weaken it further. For instance, when I laughed, coughed or sneezed I would try to tighten my pelvic floor AND I'd put my hand on my crotch over the vulva and perineum area and pull upwards. When having a bowel movement I'd grab a wad of toilet paper, hold it on the perineum and press upward. The physio recommended not straining during bowel movements, too. Instead keep your spine straight while sitting on the toilet, lean forward, lift your heels with your toes on the ground and let your muscles do the work for you.
Good luck with your pelvic floor. I hope it strengthens up soon.
That's great advice form the previous posters.
When you say you can hardly feel your pelvic floor do you mean you cant feel if you are tightening them or not, or do you have a loss of sensation of the skin and the general area of the perineum?
If you cant feel if you are tightening your pelvic floor you can try putting two fingers inside to feel the tighthening. Another important thing is to ensure the contraction is actually lifting inwards and upwards and is not actually a pushing action that is opening the pelvic floor. Use a mirror to see if the perineum moves inwards when you do a pelvic floor muscle tightening. (A good place to look at is between the vagina and the anus or look for the anus puckering more and drawing inwards). Sorry if TMI/ too graphic. A lot of women actually push out when they think they are doing a pelvic floor contraction and so they are straining their pelvic floor muscles with every exercise session.
If you cant actually feel the skin being touched on the your perineum, or just inside the sphincters then you should get an assessment by your obstetrician to rule out that you dont have any nerve damage. I would think this is unlikely given that you had a quick vaginal birth without the need for instruments or a significant tear. It can happen from a very big baby, and if you were pushing for a long time (more than an hour is considered a risk) however.
It takes a good solid 6 weeks of regular pelvic floor exercises to notice a difference. And you need to do at least 50-80 contractions a day to change the strength of a muscle!!! Problem is that with a brand new baby not many women find the time to do the exercises or remember to do them. If you can set a timer somehow to remind you when to do some exercises then that can help. I find that doing the exercises after every time I go to the toilet is a good reminder. In the early days it is better to do the pelvic floor exercises lying down until you can feel a more stronger contraction of the muscles. Then you can do your exercises while still sitting on the loo, after you have emptied your bladder.
As a test at six weks, try to stop the flow of urine just once by squeezing your pelvic floor muscles when emptying your bladder on the toilet. Another test is to be able to jump up an down with a full bladder and not leak urine.
If you find that after another 3 weeks of concentrated pelvic floor exercises you dont find you are getting anywhere, I would go and see a Women's Health Physio. You should be entitled to go to the physio attached to the hospital if you gave birth in a public hospital. The only thing is that not all departments have physios who can do a full pelvic floor muscle assessment, as this is a specialised area. They should be able to refer you to a specialist physio that can help you though.
If you are breastfeeding, the vaginal walls will still be a little floppy until you stop breastfeeding unfortunately. But you should be able to hold on to get to the toilet in time.
Hope this helps.
Thanks HouseOfFun your reply is very helpful. I could actually feel my pelvic floor muscles tightening but now I'm starting to which is good. One question you may or may not be able to help with...is it normal for my pelvic floor muscles to feel like they've had a workout or too much exercise? I notice sometimes after I do them, what feels like irritation in the vagina area. I'm pretty sure I'm doing them right as I did them during pregnancy.
Oops I meant I couldn't feel my muscles tightening but now I can
Whenever my pelvic floor starts playing up.... I tell DH I need a few intense orgasms.. lol.
So that, in combination with my pelvic floor exercises... you should notice an improvement in a week.
It get's better daily.
I had very quick births too, and had the same issue.. but my last baby was 18months ago, and I have better bladder control than my DH these days.
Good to hear you are noticing some strength improvements avenew05. It is common to feel some ache after doing a lot of pelvic floor exercises (just as you would feel in other muscles from a heavy workout). Just make sure you are actually lifting and you aren't pushing outwards.
If the irritation feels more like it's in your urethra (bladder opening) then it might be from the muscles realigning your bladder in the correct position (lifted up). As long as you arent getting burning when you wee or white discharge like thrush then it should be fine.
Thanks so much for your help, I'm pretty confident I'm doing them right as I can feel the 'in and up' movement . I have made an appointment to see a physio at the hospital I delivered at just to make sure everything is correct and progressing...for piece of mind. As for the sensations I feel after doing exercises, I'll discuss that with them too, it's just getting annoying...the only way I can describe it is like irritation sort of around the urinary tracy area I think.
I meant 'tract'
Oh and the fact that after exercises its almost like its weaker...like I feel i might wet myself (but this doesn't happen). Will have it checked
This article has some info on how squatting can also help restore and maintain pelvic floor tone.
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