Learning how to self-assess will keep track of your healing progress and act as a guide to ensure you are working out at the correct level for your recovery.
In the Postnatal After-birth Training program you will be asked to self-assess your abdominals to ensure you are ready for the next series of exercises.
WHAT ARE YOU ASSESSING?
- Your separation or Diastasis Recti – depth, width and length. Any greater than 2 fingers is considered dysfunction and rehab must continue.
- Your pelvic floor integrity/dysfunction - weak or dysfunctional pelvic floor muscles (PFM) symptoms include Light bladder leakage (LBL), stress urinary incontinence, faecal incontinence, and pelvic organ prolapsed
- Look in the mirror – what is the appearance of the skin? Is there mottling?
- Safely get down on to your back (side first then roll over) with your knees bent, head down.
- Begin the feel down the Linea Alba by gentle pushing into it with your index finger and middle finger together. Beginning at the sternum and go all the way down to just above your pubic symphysis. What is the integrity of the connective tissue? Is there tone and resistance or can you push your fingers through.
- Starting with your two fingers pushing into the Linea Alba just below the sternum – Nod your chin and lift your head a little off the ground. Do not try and engage your abdominals – leave them relaxed. Can you push fingers through the tissue? Is there room to add a finger or two? If so repeat exercise with the additional fingers. Less than two fingers is considered normal – two fingers or more is considered significant and dysfunctional.
- Move down the body repeating the exercise above for each of the following sections – a little above the belly button, on the belly button, just below the button and just above the pubic synthesis.
Be sure to make a note of the measurements so you can keep track of your progress, core connection and how fast you can heal your diastasis.
HOW DO YOU SELF-ASSESS YOUR PELVIC FLOOR INTEGRITY?
This is a lot more complicated than self-assessing your separation, but you are also probably more aware if you are having issues here.
- Can you stop the flow when you urinate?
- Do you have stress incontinence? When you sneeze, cough does pee come out?
- Are you able jump without any pee coming out? Try a star jump for example.
- Are you able to control the urge to pee for a reasonable amount of time?
- Are you able to control the urge to poo for a reasonable amount of time?
- If you place your finger in your vagina, can your muscles grip around it?
It is 100% normal to suffer from some form of pelvic floor dysfunction in the first 6-10 weeks after labor. As the PFM are thinking muscles it’s hard to know exactly how much they are improving unless you are consistently asking yourself these questions and keeping note.
If you are still suffering from any of the above symptoms after 10 weeks of the program, or 3 months after childbirth – please see a postnatal physiotherapist and talk to your Physician.
*One thing to note – if you are able to hold your pee but at as soon as you put the key in the door, turn the corner to home etc – you have an uncontrollable urge to pee – this is a behavioural issue with your bladder – NOT your PFM. Try instead to control this urge and force yourself to do a task before allowing yourself to pee.*