Physiotherapy, rehabilitation

Examination of abdominal and pelvic floor muscles for all women who have given birth, recommended within the first 12 months after childbirth. Examination will be performed by an experienced physiotherapist specialised in women’s health.

WHEN IS IT RECOMMENDED?

• You feel that things are not quite as they used to be since giving birth.
• You want to start exercising but are unsure about what you are allowed to do and when.
• You experience discomfort that is embarrassing to talk about (incontinence, insensitive sex, etc.).
• You no longer understand what is happening to your abdominal muscles.
• You want your body back and want to feel good about yourself but are unsure where to start.

Postnatal screening is designed to answer all these questions. The target group is certainly not limited to first-time mothers. You are welcome to come for a screening after your second or third child as well. The screening is intended for all women who have given birth who want to pursue conscious recovery after childbirth, strengthen their trunk muscles and prevent/treat concurrent issues such as:

• diastasis recti;
• altered stomach shape (progressive bulging during the day) after childbirth, potential umbilical hernia, epigastric hernia;
• stomach not responding to exercise;
• desire to train your stomach following a c-section, but you are feeling discouraged or cannot feel your muscles;
• various pelvic floor issues – occurrence of incontinence (including when doing sports), prolapses (anterior/posterior vaginal prolapse, uterine prolapse, etc.);
• sensation of pain in the genital region after childbirth (when resting, moving, during intercourse or even during gynaecological examinations);
• no sensation and discomfort during intercourse; or
• pain in the pelvic area, lower back, stomach.

During the first appointment, the physiotherapist for women’s health will examine your abdominal and pelvic floor muscles (ultrasound, palpation, electromyography, etc.) and your body as a whole. Together, you will prepare an action and/or therapy plan based on your wishes and goals.

WHAT IS INCLUDED IN THE APPOINTMENT?

1. Assessment of abdominal muscles with ultrasound

We use ultrasound to measure the distance between the abdominal muscle bundles – to confirm whether this is within the norm or to diagnose diastasis. We also assess the situation of tissue/collagen fibres and the activation level of deeper layers of muscles. After the assessment, the physiotherapist will use ultrasound to teach you how to activate your muscles correctly. This is essential for regaining body awareness and learning exercises and for training to be effective.

Please note! After childbirth, there may be a gap in your abdominal muscles. Being able to fit 1-2 fingers (either testing yourself or with the help of a friend/trainer) between your abdominal muscles does not necessarily refer to diastasis. Using ultrasound, we can accurately tell if that gap is within the norm or if you are experiencing diastasis and need restorative treatment.

2. Assessment of pelvic floor muscles with ultrasound and EMG

If your main concern is with pelvic floor disorders, the first appointment may also include a vaginal assessment of the pelvic floor muscles (with a finger or EMG, ultrasound). An individual exercise programme is then prepared based on the results.

The aim of biofeedback training is to find the right muscles, learn effective training techniques and become aware that flexing pelvic floor muscles is a real workout, not just holding it in when you need to urinate. The image on the screen is very informative for the patient (a small electrode is first inserted into the vagina – this process does not hurt). If you are experiencing issues with muscle sensation or have nerve damage, we also use muscle stimulation.

3. Training therapy and recommendations

If you have no specific complaints, the physiotherapist will give you recommendations for postnatal training and day-to-day activities. However, in case of various issues with pelvic floor and abdominal muscles, a lot of emphasis is put on exercises and you should perform them consistently throughout the recovery period (three months as a minimum). Exercises will change as your performance improves.

Main goals:

• Restoration of muscle feel.
• Restoration of muscle coordination.
• Restoration of muscle strength and smooth transition to regular training, if requested.

Please note! For the best results, it is recommended to see a physiotherapist for women’s health repeatedly.Ideally, book three appointments every 4-6 weeks. This will help maintain consistency and motivation during the recovery period.