Postpartum Abdominal Wall and Pelvic Floor Muscle Dysfunction: Related Complications, Physical Therapy, and Safe Return to Exercise

Part I: Abdominal Wall and Pelvic Floor Muscle Dysfunction and Related Complications

Abdominal wall and pelvic floor muscle dysfunction is common in pregnancy as well as in the postpartum stage. However, once a mom is postpartum, she is always postpartum and abdominal and pelvic floor problems can continue for years. As many women can attest to, problems with these muscles can cause pelvic girdle and low back pain, pelvic organ prolapse, urinary and fecal incontinence, and rectus diastasis abdominis. This raises the questions, “What can go wrong with our abdominal wall and pelvic floor muscles during pregnancy and after delivery?” “How does the new mom safely return to exercise and fitness after childbirth?”

To have a better understanding of postpartum barriers for safely returning to exercise, let’s first review our anatomy. The top picture is looking at our belly while the bottom picture shows a side view:

Pelvic Guru.com

By OpenStax College - https://cnx.org/contents/FPtK1zmh@8.108:y9_gDy74@5, CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=64291130

Pelvic Floor Muscle Dysfunction: Associated Pelvic Girdle, Low Back, Buttock, and Hip Pain and Stress Urinary Incontinence

May is Pelvic Pain Awareness Month, in which organizations strive to raise and improve public awareness of issues in the area of chronic pelvic pain. As a physical therapist with a special interest and years of experience in the treatment of patients with pelvic girdle related pain, I hope you find that this blog article increases your knowledge of the role our pelvic floor muscles play in pelvic girdle, pelvic, buttock, low back, and hip pain and stiffness and stress urinary incontinence (urinary leakage).

Men and women have a pelvic floor. It is not really a floor, but a collection of muscles, ligaments, nerves, tendons, blood vessels, fascia, and connective tissue at the bottom of the pelvis. Several layers of muscles make up our pelvic floor muscles (“PFM”). Some of these muscles connect the tailbone to the pubic bone while others spread outward and connect to pelvic bones and the hips. Thoracolumbar fascia connects these muscles to the low back. The deeper layer of muscles supports the vagina, bladder, uterus, and rectum. The outer, or more superficial layer, surrounds the bladder, vagina, and anal openings.