Your Pelvic Floor Is Still There — Here’s How to Find It
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Down-there muscles ghosted you after childbirth? This DIY guide can help you reconnect so you can recover — and get back to training — more comfortably.
- Your pelvic floor stretches and swells significantly during childbirth, which can make the muscles seem MIA for weeks afterward.
- Pelvic health physical therapists recommend trying different visualizations and techniques to help feel your muscles again.
- The Nike (M)ove Like a Mother program in NTC has a Postpartum Recovery breathing series dedicated to your pelvic floor — feel free to start as soon as you’re home.
Read on to learn more...
*This content is designed to inform and inspire, but it is not meant to diagnose, treat or give specific medical advice. Always check with your health care provider about how to stay healthy and safe before, during and after pregnancy.
As relieved as you might feel to hold your baby in your arms instead of your uterus, those first weeks (OK, months) at home aren’t exactly breezy. Aside from all the new responsibilities and ~feelings~, your body is still changing all the time, and you might not feel quite like yourself. A biggie: Even if you want to get started with some pelvic floor recovery work (good for you!), you may be surprised to find that when you try to engage those muscles, you feel a whole lot of…nothing.
Don’t freak out. Your pelvic floor, the trampoline-like group of muscles between your tailbone and pubic bone, had to stretch like crazy to push that baby out. (If you had a C-section, the pelvic floor is probably still exhausted from supporting the extra weight of the baby and placenta.) And it’s very typical, even for people who religiously strengthened and stretched the PF during pregnancy, to feel a little weird down there or not be able to feel anything at all when they try to tap into the area postpartum, says Laurel Proulx, DPT, PhD, a pelvic health physical therapist in Colorado Springs and the founder of FEM Physical Therapy.
Helping the pelvic floor recover with some gentle retraining and stretching in the early weeks post-birth is a great way to prepare for exercise down the road: “You should feel stronger, more supported,” says Proulx. And it could help prevent those accidental pee leaks that can happen when you work out postpartum. But it’s pretty hard to start if you can’t find your pelvic floor at first.
“We don’t regain the exact feeling or coordination directly after an ankle sprain or an ACL injury, and the same goes for your pelvic floor muscles after delivery,” explains Proulx. Over time, you should naturally feel more control over your pelvic floor as the muscles heal, but it’s always smart to get evaluated by a pelvic health physical therapist as early as four to six weeks postpartum. In the meantime, try these methods to reconnect at home.
1. Sync your breath.
Find a quiet place to lie down and tune into your breath. On each inhale, try to allow your pelvic floor to relax and open as your belly expands. On each exhale, do a gentle Kegel-like contraction (squeeze your pee-and-poop muscles) with a quarter of your normal effort. (If you’ve never done Kegels before, do a fraction of the intensity you think you’re capable of.) Keep it low-key: “You’re not trying to strengthen your pelvic floor right now, just reconnect to it with your breath,” which helps you heal and restore the mind-body connection, says Proulx. Even if you feel nothing at all at first, just directing your breath into the pelvis for a couple of minutes each day can help over time (and taking a mindful moment never hurts).
2. Do towel “lifts.”
Imagining your pelvic floor physically moving can help reawaken the contraction-relaxation sensations you’re aiming to feel. Ann Nwabuebo, DPT, a pelvic health physical therapist in Philadelphia and the founder of Body Connect Physical Therapy, suggests rolling a hand towel into a hot dog shape, then sitting down on it lengthwise so it’s directly beneath your butt and vagina. (No need to be naked unless you want to be.) Then, use the muscles between your tailbone and pubic bone to gently squeeze and “lift” the towel up into your body. Hold for three seconds, then completely relax for three seconds. Perform 8 to 12 reps (up to three times a day if you have time). Again, you may not actually feel any movement, but picture it happening.
3. Get handsy.
Once your ob-gyn or midwife clears you for exercise, sex and maybe seeing a pelvic health PT — usually around six weeks postpartum, potentially four for the PT— you can use what experts call manual feedback to find your pelvic floor. While lying in bed or sitting on the toilet, try placing your finger or thumb slightly into your vagina, says Nwabuebo. Gently contract your pelvic floor and see if you can feel it gently squeeze your finger, almost as though it’s pulling it up into your body. (Don’t do this one for reps, Proulx says: It’s a helpful way to test for the connection, but depending on your individual situation, squeezing too much could worsen a pelvic floor issue.)
4. Keep the blood flowing.
As your pelvic floor recovers from delivery, reducing inflammation and swelling there can make it easier to connect with the muscles again, says Proulx. She suggests lying on your back with cushions or pillows beneath your hips once or twice a day for a few minutes (you can hang out as long as you feel comfortable, but stop if it doesn’t feel right). The position puts your hips above your heart, which should help fluid move out of and new blood move into the pelvic floor area more easily. You can also apply an ice pack to your perineum region, anywhere from your pubic bone to tailbone where you have pain or swelling, for 10 to 20 minutes at a time, once a day, although more often is fine if it feels great.
Still struggling to connect? Try to stay chill about it. Doing too much too soon could delay your progress or worsen any pelvic floor issues you may be having. “Your muscles just went through a large stretch, so be gentle with yourself and don’t try to overcompensate with increased effort,” such as all-out-intensity Kegel contractions, says Proulx. Just keep practicing the connection methods above, especially the breathing one. You can also check in with your ob-gyn or midwife with any concerns or, better yet, visit a pelvic health physical therapist for a muscle-function assessment.
It may take longer than you’d like, but with a little patience and support, you’ll start to feel like yourself again — down there and everywhere else.
Words: Ashley Abramson
Photography: Vivian Kim
Check out Nwabuebo’s towel trick from the expert herself to find your pelvic floor again. It’s there — we promise!
CHECK IT OUT
No need to figure out postpartum wellness on your own. Hop into the Nike (M)ove Like a Mother program in the Nike Training Club app for more guidance, a breathwork series that can support your recovery, and efficient workouts for when you’re cleared to exercise. Then learn even more about what’s happening down there with pelvic health therapist Ann Nwabuebo, DPT, on the Trained podcast.