If you’ve had a baby and struggle with incontinence, diastasis recti, prolaspe, or any other sort of discomfort, get yourself to a pelvic floor expert ASAP!
If you’ve given birth (or are getting ready to), chances are you’ve heard the term ‘pelvic floor‘. I’d heard about the pelvic floor for years when doing Pilates, and yet I never really gave it much thought until after I had my first baby and started noticing some…uh…inconsistencies down there.
“The pelvic floor muscles stretch like a hammock across the pelvis and help to hold the uterus (womb), bladder and bowel in place. These muscles also act like a control valve around the urethra. They tighten when you do something to raise your abdominal pressure (e.g., coughing) to prevent any urine from leaking. They relax when you want to pass urine. Up to 30% of women suffer from some degree of urinary incontinence at one time or another following childbirth.”
I’d guess that it’s more than 30% to be honest – I feel like every mama I know has a story about peeing/sneezing/jumping on trampolines, etc. While I didn’t encounter any issues after my first baby, I suffered from painful Diastasis Recti and Pelvic Prolapse (which I’d never even heard of!) following pregnancy #2.
It was then that I delved into Singapore’s tight-knit network of postpartum physiotherapists, and began to discover that strengthening the pelvic floor (via Kegels, of course, but also many other exercises) basically sets the tone and can help improve function throughout the entire body.
Postpartum movement is a finicky thing, but these experts really know their stuff (I think far better than OBGYNs, to be honest). Over the past six months, after working with Kelly from UFIT, I’m happy to report that my DR has subsided and my overall pelvic floor function has improved as well. If you’re in a similar boat, mama, here are the top pelvic floor experts in Singapore. They’ve even shared some of their top tips; read on if you’d ever like to sneeze in peace again…
The Experts: Monica Donaldson and Tamara Gerdis
Originally from Brazil, Monica has 15 years of physiotherapy experience and began her career in the United Kingdom. She can assess and treat a wide variety of pregnancy and post-natal conditions, and can also assist with breastfeeding problems like mastitis and blocked ducts.
South African Tamara also worked in the UK and Australia prior to moving to Singapore. A mother of two, she holds a graduate certificate in Continence and Women’s Health Physiotherapy, and she’s also written some great articles for Sassy Mama. Bonus points for a super clever name at this women’s health-focused physio studio!
Tips (and what you can expect): “Strength, although very important, is one aspect of overall pelvic floor function. A woman can have strong pelvic floor muscles and still have pelvic organ prolapse, stress urinary incontinence or painful intercourse. On the other hand, a woman can have weak pelvic floor muscles but good overall pelvic floor function. Nevertheless, there is good scientific evidence that improving pelvic floor strength in many women can reduce all of these issues.
“Our approach starts with education: a thorough explanation of the anatomy and function. If a woman is comfortable and consents to having an internal examination (that involves 1 or 2 fingers inside the vagina, and should never be painful), I assess the performance of the pelvic floor muscles, i.e. how much does it squeeze. I am looking at endurance (how many seconds a woman can hold a muscle contraction and how many times she can repeat before the muscle gets tired), timing of contraction (how many times she can quickly squeeze/life the muscles, such as during a sneeze or cough), and coordination with other muscle groups (i.e. bracing the tummy muscles can increase pressure on the bladder and pelvic floor).
“When the muscles are significantly weak and there is poor function, a woman may need electrical stimulation to ‘kick start’ the muscles. This can take a few weeks of using a small machine linked with a vaginal probe that sends electrical impulses to contract the muscle.”
“Try doing your specific pelvic floor strengthening just before you go to bed, and work the muscles to the point of fatigue. Use your ‘quick lifts’ as soon as you feel a sneeze or a cough coming on. Contract and ‘lift’ your pelvic floor muscles as you go from a sit to stand position, as you lift the groceries or push/pull/lift a load (eg, a child from a car seat). But most importantly, make sure you breathe as you do all of the above!”
Physio Down Under, 318 Tanglin Road, #01-30 Phoenix Park, Singapore 247979, www.physiodownunder.sg
With a professional, international team, PhysioActive has been providing specialised care for expectant and post-partum mamas, as well orthopaedic, neurologic, and sports rehabilitation, for over decade. They have five convenient location all over the island – including Raffles Place, Orchard, and East Coast – and offer services including massage, dry needling, electrotherapy, and much more in addition to rehabilitation exercises.
The Expert: Leah Kieffer
Lead heads up PhysioActive’s four-person women’s health team, which offers treatment across their four clinics. Originally from Canada, she holds multiple degrees and certifications in women’s/pelvic health and pre- and post-natal coaching.
Tips: “With a background in musculoskeletal physiotherapy, I see a lot of women with lower back pain and hip pain who have associated pelvic floor dysfunction. It’s advantageous to treat from both perspectives to offer more holistic solutions for pain.
As a pre- and post-natal coach, I can teach appropriate exercises for women both during and after their pregnancy. I just really love helping this population, and it is my goal to educate women so they can make the best decisions for themselves (and get help)!”
With a practice conveniently located right on Orchard Road, PhysioFocus takes a tailored approach for the individual and her presenting concerns. utilizes realtime ultrasound imaging and (if required) neuromuscular electrical stimulation to help motor control and, if need be, strengthening. It’s all about learning how to coordinate the use of the pelvic floor, beginning with activation and then progressing into functional day-to-day activities.
Edwina trained in Australia and Canada and her specialties include ergonomics and women’s health. She is also trained in clinical Pilates. She’s currently undertaken a PhD in Physiotherapy, and her research focuses on Diastasis Recti and Postpartum Health. Anna, originally from the UK, specialises in spinal, hip and pelvic pain injuries.
Tips: “Start by coordinating your breath! Start a pelvic floor contraction (squeeze!) with a breath out and see if you can then hold the contraction whilst completing a breath cycle.”
“It’s often a coordination issue, rather than a strength issue. However, both cause incontinentce AND both can be sorted to return your quality of life! Also, men have pelvic floors, too!”
PhysioFocus, 583 Orchard Road, #07-01 Forum Office Tower, Singapore 238884, Tel: (+65) 6734 8151, www.physiofocus.com.sg
The Expert: Danielle Barratt
With over 18 years of physio experience, Danielle has worked in both the UK and Australia in addition to Singapore. She has a post-graduate certificate in Clinical Physiotherapy (Continence & Women’s Health) and is the only Manutention Manual and Patient Handler Trainer in Singapore. Her passion is the prevention and management of chronic pain both pre- and post-pregnancy.
Physio Asia Therapy Centre, 360 Orchard Road, #05-02 International Building, Singapore 238869, Tel: (+65) 6736 1128, www.physioasia.com
The Moving Body Group
The Expert: Aparna Shah
With nearly two decades of experience under belt, Aparna has a particular interest in issues relating to the spine, sacroiliac joints (i.e. the pelvis), knees, and shoulders. She holds a masters in health sciences, and works out of The Moving Body’s Bukit Timah and East Coast locations.
With everything from bootcamp classes to physiotherapy and nutritionists, UFIT offers a completely holistic approach to wellness. It’s got heaps of tailor-made services for both Prenatal and Post-Natal mamas.
The dedicated Prenatal Programme in particular offers weekly expert seminars covering topics like nutrition, exercise science, and even psychology to help mamas figure out what’s best for them, their bodies and their babies. The programme also includes weekly group exercise classes, a personal training session with an antenatal qualified trainer, and the all-important pelvic floor muscle assessment. Not to mention you get to meet other pregnant mamas to share your special journey!
At UFIT I worked with Kelly McGinnity, who specialises in women’s health and actually has experience working with mamas in a maternity ward. I had a really positive experience working with her to solve my diastasis recti and would highly recommend her to any mamas looking to solve postnatal issues. She’s extremely thorough (in sharp contrast to my prior experience with an OBGYN and another physio covered by my insurance), attentive, and responsive, whether answering my questions over email or checking my form during exercises. –Kate
Tips: “A lot of women think if you don’t have problems with your pelvic floor muscles, you don’t need to exercise them. But the pelvic floor muscles are like any other muscle in the body – if you don’t exercise them, they become weaker, especially as women go into perimenopause. Doing pelvic floor exercises three times a day is the best way to ensure that you stay dry and prolapse-free in the future!”
6 Raffles Quay, #14-02, Singapore 048580, Tel: (+65) 6532 2025
1 Fusionopolis Place, #01-37, Singapore 138522, (+65) 6265 6643
The Experts: Mary Rizkalla and Rabia Shah
The Women’s Health team at Urban Rebab works with women both during and after pregnancy, treating ailments like lower back and hip pain, Diastasis Recti, and incontinence. Treatments include Myofascial release (deep tissue massage), manual lymphatic drainage, and core strenghtening exercises. Every patient is different, but on average about six sessions are required to properly treat a health issue.
Urban Rehab, 391B Orchard Road, #25-07 Ngee Ann City Tower B, Singapore 238874, www.urbanrehabphysio.com