Many women already know how important their pelvic floor is, and those who don’t find out after giving birth. And most women, even those in their twenties, won’t compromise on their quality of life, and work to strengthen the pelvic floor muscles which become damaged over many years and after childbirth.
Pelvic floor area rehabilitation is much more than just squeezing the muscles and hoping problems will be resolved. Usually, more intensive treatments are needed. Yet the good news is that the pelvic floor is largely made up of muscles so it can get stronger and return to its normal state. How do you do this in an efficient, healthy way?
Recently, there have been numerous research advances in pelvic floor rehabilitation which allows doctors and specialists to offer a wide array of solutions which provide effective solutions for any woman suffering from pelvic floor problems.
"Pelvic floor rehabilitation is a whole new world, there are different types of problems and different degrees of severity."
Dr. Benny Feiner, gynecologist and urogynecological surgeon
"The pelvic floor isn’t a disease, it’s part of the body, and after birth different problems appear in its structure and function," explained Dr. Benny Feiner, a gynecologist and urogynecological surgeon who specializes in pelvic floor rehabilitation at the Noga Clinic, located in Shaare Zedek hospital in Jerusalem.
Pelvic floor rehab after childbirth includes various treatments for pelvic organ prolapse, which is manifested by muscle weakness and loose connective tissue which supports the organs. Laying on the bottom of the pelvis, there is a delicate functional dynamic in the area that allows, for example, the bladder to fill up and empty efficiently.
Feiner explains that while maintaining good urinary control, the vagina is an organ through which the newborns emerge, and after birth it should return to normal muscle tone so that it supports the internal organs and allows for normal intercourse.
He adds that “the origin of the digestive system is in the anus and damage to the area following births can create symptoms that severely impair quality of life like constipation, fecal or gas leakage, urgency to pee and difficulty in holding it in, etc.
Feiner says that now there a wide range of advanced pelvic floor rehabilitation treatments after births:
1. Robotic surgery
Surgical rehabilitation of the pelvic floor by a minimally invasive method. The field of pelvic floor restorative surgery has advanced greatly so it’s more accurate with good results as it improves and corrects pelvic organ support over the years at a high success rate. Surgery with a robot called "Da Vinci" is minimally and allows organs to be supported in such a way that it restores them to pre-birth condition while preserving functions like filling and emptying the bladder, having sex and proper bowel/intestinal function. In specific cases, surgical treatment with this method can also be done for women who want to have more kids.
2. Vaginal laser treatment
This innovative medical treatment isn’t a surgery, and is short and painless. Research on it is advancing; results indicate good treatment efficacy with few side effects or complications. The treatment is for conditions like vaginal dryness and pain during intercourse, continuous urinary incontinence, frequency and urgency of urination, and repairing loose vaginal tissue in women after childbirth.
3. Electromagnetic chair
A groundbreaking innovation for pelvic floor treatments without needing to undress. This element is an obstacle, since some women are quite modest. A series of five-minute painless treatments of a few minutes is equivalent to years of physiotherapy treatments. Clinical information on this device is still being analyzed.
Innovations in pelvic floor physiotherapy treatments
Feiner adds that new research is constantly underway today, like using stem cells to restore natural tissue and allow regeneration, but it takes years from conception to becoming a treatment which passes a lengthy clinical research and approval process to ensure effectiveness and safety.
Pelvic floor rehab physiotherapy begins with an exam to assess the pelvic floor and treatment consists of two key elements: lifestyle change suggestions and active strengthening of the pelvic floor.
Today physiotherapy treatments require the lifestyle changes, treatments and training are adapted for each woman’s physiological makeup and changing lifestyle, explains Yifat Kemer, pelvic floor physio at Noga.
She adds that telling a woman to lie down and squeeze won’t work, since women don’t have any spare time. They’re caring for the new baby, running the home, caring for other kids and then they return to corporate work. Today physiotherapy is integrated into a woman’s daily routine. We see a lot more young women after birth with pelvic floor prolapse; treatments today are focused and effective.
"After the tests and diagnoses we instruct women on exercises to for while folding laundry, making salad, or breastfeeding. Best practices are given for peeing or defecating, and lifting kids. Women who want to resume working out should wait for six weeks and receive guidance on restring pelvic muscle tone while exercising.
Progress in convenient tech accessories for home use1. biofeedback devices
Small home biofeedback devices come with vaginal electrodes and connects to an app. You can connect the electrodes at home and watch the monitor to see pelvic floor contraction and release. You should buy this device after your needs are assessed and a rehab specialist has guided you.
2. Hypoallergenic silicone supporter
Very comfortable for daily use, especially suitable for young women after childbirth, fixes prolapse and is good for women to use when working out. Physios can tailor silicone accessories to patients.
3. Vaginal weights:
Small customized weights with different strengths which are used for 15 minutes a day while standing or exercising. The weights strengthen pelvic floor muscles, facilitate closing and lifting, and prevent sagging. A physio tailors weights for each woman.
Holistic muscle therapy
Physio treatments will help when performed correctly. Advanced pelvic prolapse requires multiple treatments if natural ligaments that support the uterus have lost elasticity and strength following a traumatic birth or multiple births. Feiner states that Noga combines rehabilitative treatment with physical therapy before and after surgeries for the best results and maintenance over time.