Pelvic floor PT & exercise: a must-do for an optimal pregnancy!
Welcome to your Morning Pour! ☕️
I’m so excited to feature my friend on this month’s blog post, Dr. Jasreen Zambrano, pelvic floor physical therapist and founder of Cultivate Pelvic Health in the Bay Area. Dr. Zambrano earned her Doctorate in Physical Therapy from the University of the Pacific and has a passion for helping people feel more comfortable, confident, and connected to their bodies. She specializes in pelvic floor dysfunction, pelvic pain, bladder and bowel symptoms, and pregnancy and postpartum care, using a combination of hands-on treatment, movement, and education to support patients through every stage of life.
Pelvic floor PT is often thought of as something you seek out after pain or dysfunction develops, but Dr. Zambrano is here to explain why it can be an incredibly valuable part of preventative pregnancy care, fitness, and birth preparation.
In her post, she breaks down how pregnancy changes the way we move, breathe, and manage pressure, and how working with a pelvic floor PT can help you stay active, build strength, prepare for labor, and feel more confident throughout pregnancy and postpartum. Whether you’ve been exercising for years or are just getting started, there’s something here for you!
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In many countries around the world, pelvic floor health is considered an important part of pregnancy and postpartum care. However, in the States, our current practice typically reserves this care for when we are already experiencing pain or dysfunction. While pelvic floor PT can certainly help with pregnancy related low back, pelvic pain (such as the dreaded pubic bone pain), and other conditions such as urinary leakage, it can also be a great tool for preventative care, maintaining or increasing activity levels, and birth prep.
Typically, the recommendation for exercise in pregnancy is that you can maintain the current level of activity you are doing, with some consideration to modify activity in later stages. However, what this doesn’t account for is how we adapt as our body changes. Pregnancy changes your center of balance, and hormonal changes can contribute to increased laxity in your joints. Your growing baby and belly change the way you perform movements, your breathing and ability to manage pressure change, and an exercise that felt great before pregnancy can suddenly feel incredibly challenging. A pelvic floor physical therapist can help identify muscular imbalances and inefficient movement patterns, and potentially help prevent or manage pain by addressing these factors early on in pregnancy through strength training and activity modification.
Of course, it is never too late to become active if your OB or midwife agrees it is safe to do so, and women who have not been active during pregnancy can safely increase their exercise and activity levels with the help and guidance of a pelvic PT. By gradually increasing tolerance to load, identifying movement patterns that may be contributing to symptoms, and modifying exercise to fit what your body needs, a pelvic PT can help you feel stronger and more stable during pregnancy and support your transition into postpartum.
While I’ve listed so far the many whole-body benefits of pelvic floor PT, let’s focus a bit on the pelvic floor! The pelvic floor is a group of muscles at the base of our pelvis. They work to manage pressure in our body in response to things like lifting, jumping, or sneezing. It takes a lot more than Kegels to help the pelvic floor work efficiently to manage the increasing pressure of a growing baby inside our bodies. It is also just as important for the pelvic floor to be able to relax and lengthen, which contributes to our ability to empty our bowels and bladder, and allows the pelvic floor to accommodate baby during a vaginal delivery.
The most challenging activity we will endure during pregnancy, of course, will be labor and delivery. Strength training in various positions, such as kneeling, hands and knees, squatting, and lunging, can help build endurance and tolerance for holding these positions while laboring. Upright and mobile positions during labor can be beneficial for comfort and may help shorten the duration of labor, and some evidence suggests that they may also slightly reduce pushing time. In pelvic floor PT, we also prepare for birth by reviewing pushing and breathing mechanics, using perineal or pelvic floor massage to improve tolerance to stretch, and discussing positioning and comfort measures during labor.
Whether you have exercised your whole life or are just starting your fitness journey while pregnant, strength training with the guidance of a pelvic floor PT can help you prepare for the physical demands of pregnancy, birth, and postpartum. And whether you deliver vaginally or by Cesarean, learning how to adapt your body to the changing demands of pregnancy can help you feel stronger and more confident throughout the process. 💛
Dr. Jasreen Heer Zambrano, PT, DPT