Friday, January 29, 2010
The transversus abdominus muscle (TA) plays a very important role in pelvic floor (PF) rehabilitation and function, but most explanations for controlling continence don't mention any exercises other than kegels.
Why is this? Have our media outlets failed us by over-simplifying the meth...
Great post! Why is this information not shared with women BEFORE they have babies? I may have thought twice about it had I known then what I know now! Ok – no I wouldn’t. However, the fact is – even with all of those ideas for ‘fixing’ the issue – there is 1 that I think can’t be fixed - and it's mine.
During childbirth, both my children (2 years apart) got stuck in my pelvis – so the forceps were used to get them out. Unfortunately, the ’specialist’ who delivered them butchered me. So, 6 episiotomies (4 corrective surgeries) later, according to my latest OBGYN (who performed this last corrective surgery) – I now have no pelvic floor left.
I won’t go into details about what each surgery involved – and what each specialist said about the 1st one who’d butchered me – but suffice it to say, my birth stories are the the ones that everyone crosses their legs in sympathy for.
I wouldn’t change a thing – I love my children (10 and 8 yrs) and they are worth every bit of what I’ve gone through. What’s amazing is, I’ve now suffered from incontinence for years – and only just realized recently that I was incontinent. I suffer from the stress incontinence – the sneezing, laughing, coughing one. It’s so much easier to deal with now that I know what it is.
My question is this - knowing that bit of information about me - and the fact that I dont' do kegals - because I completely forget about them till I'm reading something about them and then start doing them - would strengthening my TA help? Am I able to strengthen my TA when I have no pelvic floor left?
I would agree - where is this information for women having babies??? We need to progress to the point where physical therapy exercises are as common for pelvic floor recovery as they are for the patient who has undergone knee surgery. Some studies have shown that our pelvic floor muscles are stretched up to 3x their original length during late term pregnancy and delivery and then you add in some tearing and cutting of those same muscles??? Rehabilitation is a must!
Thanks for sharing your story - I would venture to say that you have some pelvic floor muscles left b/c you suffer from stress incontinence and not complete loss of bladder control. That is a positive! You would probably benefit from a visit to a women's health physical therapist to get you started on a thorough strengthening program for your pelvic floor and surrounding musculature. If you have insurance restrictions then working with an "at home" program would be your next step. A good rehabilitatation program for your pelvic floor muscles should include 1. Learning how to perform a 2 step kegel - that is squeezing the muscles and then elevating your muscles and holding for 8-10 seconds. 2. Learning how to find and how to hold neutral spine posture to give better support to your pelvic floor and give a light tension to those muscles. 3. Learning how to strengthen the other muscles of the abdomen and pelvis that assist and enhance our pelvic floor contraction. Our TA muscle is very important in that when we pull it "up and in" it automatically engages our pelvic floor. The more you learn about your body the better off you will be - best of luck! -Tasha Mulligan MPT, ATC, CSCS