How to take care of your pelvic floor when doing sports, especially during pregnancy and postpartum

Nowadays, no one doubts that regular physical exercise is more than recommended. Increase our cardiovascular endurance, strengthen muscles and joints, control our weight, improve our mood… are some of the benefits that derive from this healthy habit. And these are the reasons why both in pregnancy and postpartum, you should also practice specific exercise on a regular basis.

However, not everything is good at all stages of our lives and not all people are the same, and this is the MOST important thing. We must know the state of our body, including that of the pelvic floor that is often forgotten, and know how to choose the right activities for each one. Some physical activities or poor execution of some exercises can put our pelvic floor at risk, that set of muscles and ligaments located in the lower part of the pelvis that is responsible, no more and no less, than for supporting the bladder, vagina and rectum, and that makes urinary continence possible, among many other functions. For this reason, at MAMIfit we always insist on how important it is to know how to work in order to take care of our pelvic floor while practicing physical exercise and, if possible, even more so, in the pre and postpartum periods.

In fact, some sports practices subject the perineum to a series of pressures that, maintained over time, or exerted in a punctual but very intense way, can translate into problems or dysfunctions in our pelvic floor. Physical exercise requires the activity of our perineum, but this does not mean that we are building it. In other words, when we do sports, and in fact when we make any effort, we are increasing the pressure exerted on the pelvic floor. And if our pelvic floor is not in good “condition” as it usually is in the postpartum period, we will surely be making it worse or at least not improving it, if we do not take into account a series of premises, which we will now clarify.

By this I don’t mean that you have to stop exercising to make sure that the pelvic floor is in perfect condition, not at all, this is not the solution! Since it is essential to lead a very active and healthy life, especially during pregnancy and after giving birth. The key is in:

1. Know how our pelvic floor is, before starting to practice physical exercise, with a previous check-up by a physiotherapist specializing in pelvic floor
2. Consult with a physical activity professional to find out which type of exercise is most appropriate in our case
3. Learn and execute those exercises correctly
4. Take into account the basic guidelines to take care of the pelvic floor while doing this activity, which is what I will detail below.

Basic guidelines to follow when we practice physical exercise, to take care of our pelvic floor recommended by MAMIfit:

• Activates the pelvic floor muscles. Activa de manera voluntaria los músculos del suelo pélvico ANTES y durante los ejercicios de fuerza. El objetivo es que el suelo pélvico trabaje inmediatamente antes de levantar, bajar, empujar o tirar de cualquier carga y durante ese movimiento. Normalmente es más fácil activar el suelo pélvico cuanto menos abiertas estén las piernas.
• Good posture – elongation. Don’t forget to stretch your body as much as possible to activate the core and better manage the increase in pressure during exercises. As if you wanted to grow 1cm, elegant attitude, look for the sky with your head.
• Release the air when you perform the most exertional movement. Never block your breath during an exercise! This further increases the pressure on the pelvic floor. You should not be in apnea doing an exercise, you should always breathe. Release the air at the moment of most effort.
• Avoid lifting very heavy loads. Be cautious with the loads you want to move. Keep the weight within a manageable range. Remember that if you overweight you will have to block your breathing and that is not good for taking care of your pelvic floor. Increase the load gradually, start with a lighter load, and pay attention during the exercise to reduce the risk of injury.
• Rest and recovery are VERY important. Rest for a couple of minutes between each set of exercises you perform, this gives your muscles (including your pelvic floor muscles) time to recover before your next job. And it is essential to introduce rest days, to recover for the next workout.
• Avoid exercises that increase abdominal pressure in an exaggerated way and with a lot of impact. Look for alternatives to these exercises and add Hypopressive work to your routines to compensate for increases in intra-abdominal pressure and reprogram the abdominal girdle appropriately.
• Consider your menstrual cycle. Schedule workouts taking into account the phases of the menstrual cycle. In the weeks of weakest pelvic floor (pre-menstrual and menstrual phase) the exercises should be gentler.
• Be careful if you’re tired or injured. Your pelvic floor and deep abdominal muscles may not work as effectively when you’re tired, sick, or have back pain.
• Reference pelvic floor physiotherapist. Receive abdomino-perineal exams regularly, especially if you perform physical activity and/or if there is any dysfunction. And remember, pelvic floor dysfunctions in the initial stages do not usually cause symptoms, so nothing better than good prevention.

The best advice… Practice exercise that is right for you by following these tips and enjoy this beautiful stage of your life!

By Naiara Celades. Director MAMIfit Barcelona