Authors

María de los Ángeles Carrasco García

Position

Matrona del Hospital Miguel Servet, Zaragoza.

Contact email: macaga5555@gmail.com

Abstract

Introduction: pelvic floor dysfunction and abdominal rectus muscle diastasis are frequent disorders in postpartum that commonly go unnoticed by healthcare workers. Pelvic floor weakening can have an impact on woman's sexual health and cause urinary or fecal incontinence, prolapses, or sexual dysfunction. Restarting everyday life with a flaccid and impaired abdominal musculature results, in turn, in posture disorders, low back pain and pelvic floor distension. There is a lot of controversy among healthcare workers on physical exercise over the postpartum period. Thus, it is relevant to highlight the most important physical activities in the first weeks of recovery after delivery.
Purpose: promoting physical exercise during postpartum period as well as pelvic floor exercises in daily routine in order to prevent pelvic floor disorders such as urinary incontinence or prolapses.
Methods: development of a whole program of physical activities adjusted for postpartum period after an evaluation to detect a potential muscular disorder.
Results: first of all, it is most relevant that women learn Kegel exercises and perform such exercises daily; this is the most effective prevention and treatment for urinary incontinence. Once the perineal wound has healed, exercises to activate deep transversus muscle are started. Later on, at week eight, midwife should evaluate contraction ability of pelvic floor and abdominal diastasis. If no impairment is shown, progressive cardiovascular activity should be started with 15 min/day, stimulation of lower and upper limbs, and core exercises to allow a good pelvic stability to be achieved. On the other hand, if a diastasis or pelvic floor dysfunction is found, a more comprehensive and longer-term perineal rehabilitation program must be continued before any physical activity that could result in an increased intraabdominal pressure is started.
Conclusion: a complete evaluation of pelvic floor and abdominal muscles is required to be able to give advice on physical exercises to be performed during postpartum period and to help women to be aware of the relevance of pelvic floor exercises to be integrated into any activity.

Keywords:

abdominal rectus; rectus diastasis; pelvic floor; postpartum; exercisesprevention

Versión en Español

Título:

Ejercicio físico y recuperación postparto

Bibliography