Abdominial separation, diastasis recti, or rectus diastasis is common in pregnant and postpartum women. The separation is actually a thinning of the tissue between your six-pack muscles, your linea alba. This stretching and thinning is necessary for a growing baby bump and will either naturally heal, and thicken over time or may stay separated. The muscles may remain weaker due to the tissue thinning, but you can also strengthen and become functional while still having a separation. There are multiple ways you can assess and treat abdominal separation or prevent it from getting worse. I know you may be concerned about the appearance, but major improvements in function can be made over time and with the right intervention.
Pelvic Girdle Pain is the general term given for pain around the joints of your pelvis including your pubic bone or your sacroiliac joints in the back. This pain can be caused by many reasons and is often due to changes in posture or the way you walk due to pregnancy, as well as hormonal changes softening the supportive structures in your joints. There may be inflammation at the joints, a lack of muscle stability or a need for outside support like a compression belt or band to help calm down the inflammation.
There are many names for specific symptoms of pain around the vulva, vagina and pain or difficulty with intercourse or use of a tampon. There are many reasons for pelvic pain around the entrance of your vagina and it really necessitates an individual assessment from a Pelvic Health Physical Therapist to find your root cause. Changes in hormones can change lubrication and tissue quality, scar tissue can cause soreness and increased tissue stiffness, and experiencing personal, sexual or even medical trauma can cause your pelvic floor muscles to spasm in reaction to something trying to insert it. Other injuries like hip injuries, tailbone injuries or abdominal surgeries can also contribute to pain with intercourse or penetration.
When this type of cramping pain, nervy pain, or achey pain happens outside of your period week then we call it "noncyclical pelvic pain." Although this pain can be caused by other diagnoses like endometriosis, interstitial cystitis or even IBS, it often affects our abdominal and pelvic floor muscles by guarding up and tightening in a reaction to pain. Finding the root cause of your pain is important as well as treating your pelvic floor symptoms that may be happening as a downline affect of the root cause. Other causes of your pelvic pain may be scar tissue restrictions from abdominal or pelvic surgeries, limited mid-back mobility entrapping nerves going from your spine to your pelvis (think sciatica for your pelvis) or a number of other causes. With proper treatment and a plan of action many people can reduce their pain and get back to the things they enjoy.
Sensation of a support dysfunction can be a sign of pelvic organ prolapse or POP. POP is a descent of your uterus, bladder, or rectum pushing into the tissue of your vaginal canal. This is not a diagnosis that can be made from a quiz and instead needs a full evaluation by a urogynocologist or pelvic health physical therapist. POP may be caused by excessive pressure down during child birth or consecutive chronic bearing down due to chronic constipation or strategies with heavy lifting. Genetically, your tissue composition may also play a role in your chances of experiencing POP.
A pelvic organ prolapse may be a very scary or intimidating thing to hear. But remember this, the symptoms of your prolapse may not correlate with how far down your tissues are descending. Some people have severe symptoms with not such a severe diagnosed prolapse. Only an examination by a physician and pelvic health PT can diagnose and determine the factors contributing to the symptoms your are experiencing. But know there is so much that can be done to reduce your symptoms with proper training, manual therapy, strength and range of motion. There is help!
Stress Urinary Incontinence
SUI doesn't mean you leak more when you are stressed but you leak more when there is more downward stress on the bladder, or more pressure down on the bladder. This is very common and there are so many ways that you can improve and get back to the things you love doing without leaking. This is not just a part of having a baby or aging. With making changes in pelvic floor strength, range of motion or relaxation, coordination and reaction time the pelvic floor can better support the bladder and stop leakage - it's more than just Kegels! A full evaluation by a pelvic floor physical therapist is necessary to find the reason why you may be leaking and work on your specific root cause.
Urge Urinary Incontinence
The loss of urine after a strong urge is often present with having to go to the bathroom multiple times a day; more frequently than every 3 hours. Often this type of incontinence can be linked to overactive pelvic floor muscles, an overactive nervous system making the bladder spasm or a diagnosis affecting the bladder itself like interstitial cystitis. Finding the root cause of your incontinence is necessary for proper treatment since the overactive pelvic floor or nervous system are just symptoms of a more complex issue. Reach out to your physician and get into see a pelvic health PT. Another possibility is that your body has learned the behavior of going to the restroom frequently due to previous leakage experiences. Now, your body sends the signal to urinate sooner and faster than normal. The good news is there is so much that can be done to help your body relearn the proper timing and capabilities of your bladder.