strong moms · 2019-09-21 · strong moms restoring strength and health after baby shari berthold,...
TRANSCRIPT
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Strong Moms Restoring Strength and Health After Baby
Shari Berthold, DPT
Victoria Hurwitz, DPT, WCS
Amy Vandermark, DPT
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Objectives • Discuss changes your body goes through during
pregnancy and the postpartum period.
• Define diastasis rectus abdominis, perform a self-test, and safely progress core strengthening
• Describe the pelvic floor, possible problems after birth, and how to exercise the muscles.
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Why Are We Here? • Low back and pelvic
girdle pain is estimated to occur in 56 – 72% of women who are pregnant.
• 1/3 have persistent low back pain after delivery
Clinton S, et al. Pelvic Pain in the Antepartum Population. 2016. http://www.drdauber.com/wp-content/uploads/2014/07/Dauber-website-pregnancy-pain.jpg Ostgaard HC. Postpartum low back pain. Spine. 1992. Jan 17(1)53-55.
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Why Are We Here? • Over 25 million
Americans experience urinary incontinence.
• 1/3 experience urinary incontinence after delivery. www.nacf.org Huebner, M. The impact of pregnancy and delivery on urinary incontinence. International Journal of Gynecology and Obstetrics. 2010, Sept Vol 110(3);249-51.
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Why Are We Here? • HALF of all women have
at least one pelvic floor disorder.
Nygaard I, et al. Prevalence of symptomatic pelvic floor disorders in US women. JAMA, 300(11), Sept. 2008
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Postural Changes During Pregnancy
Fabmoms.in
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Changes After Delivery • Loose connective tissue
– Neck/shoulder pain – Low back and pelvic
girdle pain – Leg and foot pain
• Stretched or separated abdominal wall
• Loose joints • Stretched pelvic floor, tissue
damage to pelvic floor (episiotomy, tears, bruises)
• Postural changes
• Hormone fluctuations
• Weight Changes
• Breast Changes
• Surgical Scars
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• Proper posture and body mechanics
• Protect your joints
• Recover abdominal wall
• Recover pelvic floor strength
• Get help early if struggling
Recovery After Delivery
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Postural Correction
Correct standing posture Proper baby-holding
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Body Mechanics with Baby Care
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Wikihow.com
Gettyimages.com
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• Your core muscles include:
– Lower abdominals
– Deep back muscles
– Pelvic floor muscles
• A strong core helps:
– Posture
– Prevent back pain
– Prevent incontinence or pelvic organ prolapse
Your Core
Cordmama.com
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Diastasis Rectus Abdominis
Anatomy Testing Position
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Functions of the Pelvic Floor • Support: your organs including your bladder, uterus,
and rectum
• Sphincter: assist in stopping and starting the flow of urine and passage of gas and stool
• Sexual: help with your sexual response and orgasm
• Stabilize: provide stability to the spine and pelvis
Pittsburgpelvichealth.wordpress.com
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Pelvic Floor Problems • Weakness
– Urinary Incontinence
– Fecal Incontinence
– Pelvic Organ Prolapse
– Pelvic and Back Pain
– Difficulty achieving orgasm
• Nerve Damage
– Pain
– Weakness
– Lack of sensation
• Tears or episiotomy
– Painful intercourse
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Risk Factors in Childbirth for Pelvic Floor Problems
• Vaginal Delivery
• Instrumental Delivery
• Abnormal Presentation
• Prolonged active second stage (>1hr)
• Birth weight over 8 pounds
• Higher maternal age at first baby (>35)
• 3 or 4 births, more than 2 C-section
• Weaker collagen
• Third degree tear
• Episiotomy
• Pre-pregnancy obesity
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Proper contraction of pelvic floor
• Squeeze and lift • Pick up a marble with your vagina • Imagine that you are in a
crowded room and you are trying to hold back gas
• Suck water up a straw into your bladder through your vagina
• Stop your urine flow
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Pelvic Floor Contraction
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Power
Endurance
Timing
Quick Hold Knack
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Pelvic Floor Exercise Progression
• Pelvic inversion (bridge, wedge)
• Supine
• Sit
• Stand
• Dynamic and functional
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Bracing Options
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4mdmedical.com Medco-athletic.com Luckyfeetshoes.com
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Scar management
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Picture from: Navina.ca Picture from: Bodypoets.wordpress.com
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Physical Therapy Can Help!
• Posture and body mechanics training
• Manual therapy (joint alignment, massage, scar mobilization)
• Exercise
• Pelvic floor rehabilitation
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UPMC Susquehanna Rehab Locations
• Costello Center Physical Therapy
– Shari Berthold, DPT
• Williamsport Hospital
– Victoria Hurwitz, DPT, WCS
• Muncy Valley Hospital
– Amy Vandermark, DPT
*Contact your physician for a referral*
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