Written by Mathilde Gout, qualified physiotherapist and manual therapist - Updated on Jul 25, 2024
By Mathilde Gout – physiotherapist, D.U. perineology
Photo ©MelissaJean
You have just had a child, carried them, and felt them grow inside you.
Your body, this wonderful "machine" capable of creating and giving life, has worked hard these past months.
Today, it certainly needs rest, but you still have a little extra effort to make for it to regain its previous tone.
Yes, your body is now that of a mother and may be changed (those stretch marks that mark the traces of your former belly or breastfeeding, your pelvis, perhaps a little wider, struggling to fit into your old jeans...), but your posture and the capacity of your muscles must be recovered so that all the functions of your body are optimized.
WHAT IS REHABILITATION FOR?
Rehabilitation serves to restore the postural and tissue imbalances secondary to pregnancy and childbirth (whether vaginal or cesarean).
Indeed, the postural changes related to pregnancy will have several effects on your body and its functions: - a change in the distribution of pressure on the lumbar area (lower back), the pelvis, and the perineum, - a lack of stability and support in this same area.
The consequences can be back, pelvic, or hip pain, digestive disorders, urinary or anal incontinence, organ prolapse (or pelvic organ prolapse), etc.
Moreover, we can also improve the appearance of a cesarean scar or an episiotomy/tear and help if there is pain during sexual intercourse.
On paper, we distinguish between "perineal rehabilitation" and "abdominal rehabilitation," but in practice, this is absurd. Indeed, the entire abdominal cavity (which extends from the diaphragm to the perineum, including the lumbar region, ribs, and abdominals) is a highly coordinated unit that needs to relearn how to work in synergy.
Abdominal rehabilitation, contrary to what one might think, is not intended to make you (re)find your twenty-year-old six-pack abs. It mainly serves to ensure that your deep abdominal muscles protect your perineum during exertion and even simply when standing.
REHABILITATION: FOR WHOM?
For all women who have had a pregnancy!
Photo ©Pinterest
Even if you don't feel no symptoms, no discomfort, your body has undergone changes that require a little "reset." Sometimes, your gynecologist asks you during the postnatal exam to contract the perineum and assures you that "it's fine, everything is okay, you don't need rehabilitation." Unfortunately, the muscle strength is just one point among many others to consider and which will, inevitably, have been a little damaged.
REHABILITATION: WHEN?
Between 6 and 9 weeks after childbirth, but you can start it early if you have complications: poor healing, severe incontinence, perineal edema, pelvic congestion, etc.
Know that you can also undergo rehabilitation during your pregnancy, to treat any pain and prepare your pelvis and perineum for childbirth.
Photo ©MelissaJean
HOW DOES REHABILITATION WORK?
The technique will depend on your needs and expectations. There is no single method, especially if the one offered to you does not suit you. A good therapist should be able to offer you different tools and be capable of changing techniques if the proposed one is not sufficient. In all cases, a manual examination (a vaginal touch) is necessary.
An initial assessment will observe your posture, note the presence of tensions, evaluate the tone of your muscles, their voluntary and reflex control, assess the elasticity of a scar and whether it is still painful, and finally, check the mobility of your joints.
Then, manual techniques can be combined with exercises, and the use of devices, such as a vaginal probe, may be proposed if necessary.
« Self-rehabilitation » tools (connected probes, Geisha balls, etc.) can also be used but cannot replace rehabilitation done with a health professional. Indeed, every woman is different and will not need the same exercises. Hence the importance of the initial assessment!
REHABILITATION: BY WHOM?
A physiotherapist specialized in pelvic-perineology or a midwife.
NB: abdominal rehabilitation and scar tissue work can only be performed by physiotherapists and must be started at the beginning of rehabilitation.
It may also be helpful to surround yourself with a osteopath, a naturopath, a sophrologist, or any other professional who can bring you well-being during this period of major changes. It is well known that physical well-being primarily depends on mental well-being. So I invite you to consult in case of low spirits (even temporary), lack of confidence, a period of doubt, which are certainly normal for this period but that you are not obliged (and you should not!) to go through alone.
To find a physiotherapist specialized in pelvic-perineal rehabilitation near you, you can consult the following specialized directories:
- https://www.arrep.org/annuaire-des-adherents/adirectory/blog/10-membres-de-l-afrepp.html
- https://www.eirpp.com/annuaire/
- https://annuaire.degasquet.com
- https://www.lesclesdevenus.org/annuaire-pro/
#rééducation #post-partum #grossesse #enfant #bébé #kiné #allaitement
