Ask Kait: How Can I Make Postpartum Pelvic Floor Exercises More Enjoyable?

Anonymous asks:

Hey Kait—I’m postpartum and have to get my pelvic floor in shape! Any advice on “fun” tools or tips for kegel exercises? I know I have to do them but it’s always a chore, and thought this looked interesting but wanted your take on it.

Props to you for knowing the importance of and taking steps to support your pelvic health postpartum! While this conversation has long been steeped in the misogynistic obsession with being “tighter,” pelvic health is about so much more than that! Sitting at the center of your body, the pelvic floor supports the entire core and internal organs. Supporting these muscles is a powerful way to support your overall health, confidence, and wellbeing—I love that you’re prioritizing this for yourself! 

I reached out to my colleague, pelvic floor physical therapist and founder of Its Private Practice, Dr. Marqui Rennalls, PT, DPT, to get her advice on postpartum pelvic health as well as her take on this new-to-me product.

Postpartum advice is highly individual—but there are some universal concepts to keep in mind.

While postpartum advice really depends on the person’s birth experience and body, Dr. Rennalls says there are a few things everyone can try. 

First, take a look! Pregnancy and childbirth can cause a lot of physical changes to the birthing parent’s body, inside and out: “Don’t wait for your six week [OB-GYN appointment] or for the doctor to look before you do. It’s your body. Get a hand mirror and take a look for yourself.”

Here are some questions to ask yourself during your look:

– Did you have stitches? 

– Where were they and what does the scar look like?

– Is there a scar?  

– Does the tissue feel, look, and sense the same as surrounding tissue?

Dr. Rennalls also recommends trying a Kegel while having that look. “What’s moving, if anything at all? Movement is the outward signal that your Kegel has some power. No movement is your sign to look deeper and find a pelvic floor therapist.”

You don’t have to wait to start Kegels.

A common misconception is that you have to wait a certain period of time to start Kegels. Dr. Rennalls says that’s not the case. “You can start with Kegels as soon as day one. With or without a mirror or prescription you can Kegel as soon as you feel ready. Instead of waiting for your six week postpartum appointment, start ASAP.”

There are ways to make tending your pelvic health more fun

Of course knowing what you need to do and actually doing it—as our anonymous submitter mentioned—is different. It can be hard to remember and kind of boring! So how the heck can you make this process more fun? 

Here again, Dr. Rennalls offers some guidance to prevent feeling like it’s a chore. She suggests:

– Involving your partner if you have one.

– Work your exercises into your daily tasks. For example, one set of exercises during your morning drive or one set before a commercial ends. 

As a fan of Gretchen Rubin’s work on habits, I’d also invite you to get to know your Tendency—aka how you respond to expectations and put some associated accountability and structure in. Finally, given the ups and downs of postpartum life, I encourage you to celebrate each time you do your Kegels the same way you celebrate every new moment with your baby! Think lots of encouraging words, cuddles, excitement, and maybe a fun beverage or snack.

Using an exerciser can add fun and accountability.

Now that we’ve covered general postpartum pelvic health tips, what about that exerciser? 

Dr. Rennalls is a fan. “[The Perifit exerciser] looks pretty fun! I’ve seen other companies like Elvie create trainers similar. However, the first thing I noticed was the differentiation between superficial and deep muscles and that’s important.  My hope is that they have different games to target those separate sensors which would more accurately let us know where the contraction is coming from.”

If you decide to go with an exerciser, one of the main differences between Elvie and Perifit is the size and shape of the part that gets inserted into the vagina, with Elvie being smaller and lacking the beaded shape. Dr. Rennalls notes there may be differences in what feels comfortable to you. 

Pelvic health is about more than Kegels.

For many people (myself included!), there’s both tension and weakness in those muscles. That means, we need to relax them before we strengthen them in order to help the muscles get the maximum possible movement. 

Here again, Dr. Rennalls gives points to the Perifit, saying, “I also love the fact that it keeps track of your relaxation and your ability to do so. Kegels are important but so is relaxing and being able to reach a relaxed state.” That being said, this tool—or any one at that!—is not the best fit if you have a painful, spasmodic, or overly tight pelvic floor

There are really valid reasons to support your pelvic health—postpartum and otherwise! 

I always recommend working with a physical therapist who can provide fully customized feedback and support, even if it’s only for a single visit to get a sense of what’s going on. 

At the end of the day though, Dr. Rennalls reminds us of the most important thing to remember:

 “Above anything else, give yourself some grace.”

You’re doing great!

Kait xo

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