Pelvic floor health and postpartum exercise - two absolute KEY things for your physical and mental wellbeing you should consider on your pregnancy journey and two things that can easily be ignored postpartum. That's why this week we are excited to talk to Rachel from Rachel Fitt Physiotherapy.
Rachel is a Melbourne based Pelvic Floor & Continence Physiotherapist and is passionate about empowering women throughout their lifespan, preventing women's health issues that hinder both physical and wellbeing goals.
Hi Rachel! I did a post the other day about my atrocious pelvic floor, so I'm very interested in hearing about your work and I think many other women will be too! Can you tell us a little bit more about what you do and the services you offer?
Hi Bron, thank you so much for having me. It is so great to hear that you are speaking & sharing about pelvic health on your socials – It is such a passion of mine to get women speaking more about pelvic floor.
I am a Pelvic Floor & Continence Physiotherapist. I work only with women and specialise in treating Pelvic Floor Dysfunction. I see women of all ages, my youngest patient at the moment is 16 & my oldest is 85! I am not your typical physiotherapist. The Pelvic Floor is all internal, literally making up the floor of your pelvis and surrounding the urethra, vagina & back passage. The most accurate assessment of the pelvic floor requires an internal vaginal examination, which you may or may not have known. The type of Physiotherapy I do requires extra training and a post-graduate degree – the study never stops!
I offer a range of services including; Pelvic Floor, Pregnancy Screening, Postpartum Screening, Pelvic Girdle Pain & occasionally general musculoskeletal appointments.
Rachel, Pelvic Floor & Continence Physiotherapist extraordinaire.
And what are the main things that women come to see you for?
The most common presentations I see are Stress Urinary Incontinence and Sexual Pain. Women presenting with these concerns are of all ages. For those that are not familiar, Stress Urinary Incontinence is bladder leakage occurring with activities such as a cough, sneeze, jump, run etc. Sexual Pain is discomfort/pain during or after intercourse.
In my clinic I also run a lot of screening appointments. I typically offer Pregnancy Screening’s at 12-24 weeks gestation and Postpartum Screening’s at 6-12 weeks post natal. These are purely preventative appointments where we screen bladder, bowel and sexual health as well as pelvic floor function.
The other common presentations I see are bladder urgency (rushing to the loo), constipation, pelvic organ prolapse and pelvic pain.
Our pelvic floor is mentioned often during pregnancy, and some of us exercise it better than others - can you give us any tips for how we can keep this baby strong pre and post baby?
Absolutely. Ensuring you train your pelvic floor has been shown to improve birth/delivery & minimise complications (YAY!!!). The only way to know for sure if you are using your pelvic floor correctly is to see a Pelvic Floor Physiotherapist & have an internal vaginal examination.
For those that do not have access to a Pelvic Floor Physiotherapist, do some research on your pelvic floor so that you have a good understanding of what the muscles are & where your pelvic floor is located. Secondly, like any muscle you want to be able to contract your pelvic floor but more importantly you need to be able to fully RELAX your pelvic floor muscles. Thinking about ‘squeezing your back passage’ has been shown to have the best pelvic floor activation amongst women who do not know how to contract the muscles.
Once you are confident with how to contract & relax your pelvic floor you can train your muscles just like any other muscle in the body. For example you could do; strength training, 3 sets x 8-10 reps of 3-10 second holds; you can train endurance where you contract and hold for 10-60 seconds; or co-ordination where you contract & relax your pelvic floor as fast as you can.
Here is a video I did on pelvic floor anatomy & function.
The old squeeze really tight, hold, relax and release… is that still the tried and true method for working the pelvic floor muscles?
Yes but also no – Haha! It really depends what we are trying to work on. Your Pelvic Floor Muscles are postural muscles, which mean they work without you thinking about them. It is usually only when you have concerns or are pregnant that all of a sudden we start thinking more about pelvic floor. Isolating your pelvic floor muscles and training them with exercises like I have mentioned above is great for awareness and re-training a muscle that has dysfunction. However, if you have a pelvic floor that is already strong and functioning well, we can train your pelvic floor more functionally and incorporate what we call ‘The Knack’. This is where you can contract your pelvic floor to brace prior to activities that increase abdominal pressure and push down on your pelvic organs & pelvic floor. For example if you cough, sneeze, lift, bend, sit to stand, squat, jump etc. You can contract your pelvic floor prior to the activity to provide support and relax following. This can be a great way to train the pelvic floor throughout the day and decrease your risk of bladder leakage and prolapse.
For those that have no pelvic floor dysfunction - I am a big believer in training the pelvic floor with general exercise. I think if your technique and form is good, then your pelvic floor & deep core muscles will be automatically working to help you stabilise.
OK, you’ve had your baby/babies and you’re a victim of “peezing”. Can you regain control of that area?
This is a hard one because I don’t want to give anyone false hope. ‘Peezing’ or leakage with sneezing is one of the most common symptoms postpartum. Stress Urinary Incontinence can be due to Pelvic Floor Dysfunction or Urethral Hypermobility; where the urethra moves downwards into the vagina with increased pressure from the abdomen. To be honest, Pelvic Floor Physiotherapy will cure 1 in 2 women, which is great! However, that also means 1 in 2 women won’t be cured. In saying this 80% of women will see significant improvement in their symptoms following Pelvic Floor re-training.
As a Pelvic Floor & Continence Physiotherapist it is so important to be honest with patients about chances of cure. I usually have this discussion in my first consult with patients so I have a clear understanding of their goals and they know what the likely outcomes will be.
If you suffer from ‘peezing’ make sure you ‘squeeze before you sneeze’ and this will hopefully decrease your leakage.
Ensuring you have a detailed assessment with a Pelvic Floor Physiotherapist will be vital in understanding the cause of your leakage and to determine a treatment plan. Don’t put it off – Pelvic Floor Dysfunction doesn’t get better on its own!
"Peezing" is something a lot of us live with... but we don't have to!
You’re based in Melbourne (sending lockdown love!) but you do offer some online resources for women. Can you tell us a bit more about your online offerings?
Good old Melbourne – definitely not the most liveable city at the moment!!! Thank you <3
Yes, I have just launched a 12-Week Postpartum Exercise E-Book for mum’s to complete following pregnancy & childbirth. I am so passionate about helping mum’s rehabilitate their pelvic floor, core, balance, stability, strength and fitness postpartum. I found it so challenging to find quality evidence based programs for my patients, so I decided to create my own!
You can get Rachel's fab guide here!
I also use my Instagram platform to post education information for women. If you would like to learn more head to my instagram @physioforwomen_
Are there any TMM products you would recommend to your customers?
Yes the Fanny Freezer!! Pads with a built in cooling strip – how great. To all the women who birth vaginally that sustain a tear or episiotomy during delivery, ICE will be your best friend. It is great to settle pain & inflammation in the first 72 hours postpartum.
What advice would you give to a first-time mum to be?
Invest time into your pelvic floor & postpartum recovery. I know you can be so time poor and tired when you have a newborn but your body will thank you later!!
Think of childbirth (whether it’s a vaginal or caesarean delivery) as a hamstring injury. You need rest, sleep, good nutrition and a rehab program to prevent further injury.
And how do people get in touch with you to learn more about Rachel Fitt Physiotherapy?
Thanks SO much for being part of Profesh Sesh Rachel, we just love what you do and how you help women tackle something that can be so uncomfortable - uncomfortable physically and uncomfortable to talk about. We are trying to help change that narrative so thanks so much for being a part of the change!
Thank you so much for this amazing opportunity to be featured on TMM <3
If you're interested in being interviewed for Profesh Sesh, sharing your knowledge and profiling your business please reach out to us at email@example.com. This is the mumma advice network in action!