There are three compulsory courses after childbirth
Rectus abdominis repair, pelvic floor muscle repair, pelvic repair.
Does this have to be done?
Is there a sequence of the three major repairs?
Let's take a look at the order in which postpartum rehabilitation should be.
1. Pelvic repair
After ten months of pregnancy, the pelvis will change to varying degrees (even more so for mothers who have a normal birth) and the changes in the pelvis will also affect the waist and hip.
After childbirth, a woman's pelvis will relax, which will bring obvious changes to the body. The lower pelvic opening widens, which flattens the buttocks; the hip joint is tilted inwards, widening the hips; the pelvis becomes loose and the waist is bent badly; the legs below the knee are twisted and become O-shaped legs; the deformed pelvis makes the abdominal muscles loose and the bones become loose.
Rectus abdominis repair
The rectus abdominis muscles are located on either side of the midline of the anterior wall of the abdomen, and are band-shaped muscle tissues that are narrow above and below, starting from the pubic symphysis and the pubic crest, and ending in front of the sternal sabre and the 5th to 7th rib cartilage.
It has the effect of flexing the spine, lowering the chest, maintaining abdominal pressure, and fixing the position of the organs. At the same time, it also plays an important role in coughing, defecation, activity and so on.
Mechanism of rectus abdominis detachment:
The separation of the rectus abdominis occurs due to the relaxation of the abdominal muscles after childbirth, the tension of the abdominal wall decreases, but it cannot quickly return to its original position and form, and excess excess flesh will accumulate and protrude in the abdomen.
Self-test mode:
In the supine position, with both hands on the chest and head and shoulders gently lifted off the bed, as in sit-ups, the abdominal muscle gap is measured with a ruler (or finger) and evaluated at 4.5 cm above and below the umbilicus, ≥ 2 cm indicates the presence of rectus abdominis separation.
Pelvic floor muscles
Pelvic floor muscle refers to the muscle group that encloses the pelvic floor, which is like a hanging net, and the organs such as the urethra, bladder, vagina, uterus, and rectum are tightly suspended by this "net" to maintain a normal position in order to exercise their functions.
So the pelvic floor muscles are very important, because once this net becomes loose, many organ functions in the mother's body will be affected. As a result, corresponding dysfunctions such as urinary and urinary incontinence, pelvic floor organ prolapse, etc.
Next, the relationship between postpartum rectus repair, pelvic repair, and pelvic floor repair is explained in detail.
What exactly does Pelvic Repair repair repair?
Bones: They don't get bigger and smaller, and even after production, they don't get bigger, and they don't shrink because you do "pelvic repair."
Joints: the joints that make up the pelvis are able to move slightly, known as "micro-motion joints", once these joints are misaligned and separated, it will make you feel unbearable pain and difficult to sit and lie down, do you think that the slight changes in the joints can cause the pelvis to become larger? Not really.
Ligaments and muscles: during pregnancy, the pelvic floor muscles have been damaged to varying degrees, due to changes in hormones, weight, body circumference and abdominal volume, the pelvic floor muscles are in a continuous state of compression, will gradually relax, coupled with the gradual enlargement of the uterus so that the pelvic floor muscles are stretched and weak, and the process of childbirth will further cause damage to the pelvic floor.
That is, whether it is a vaginal birth or a caesarean section, pelvic floor muscle repair is required after childbirth.
Whether it is pelvic floor muscle repair or pelvic repair, their core is centered on the repair of the pelvic floor muscle, and pelvic repair also needs to correct pelvic misalignment, and the main target of correction is ligaments and muscles, not the reduction of bones.
Pelvic floor muscle repair tightens the otherwise loose muscle ligaments between the pelvis, thereby promoting the reduction of the pelvis. After pelvic repair, it effectively supports the organs in the pelvic cavity, reduces the pressure on the pelvic floor to a certain extent, and assists the recovery of the pelvic floor.
Therefore, pelvic repair and pelvic floor repair have mutual influence and mutual promotion, and pelvic repair should include pelvic floor repair, rather than simple pelvic orthostatic in the narrow sense.
The conclusion is that the pelvic and pelvic floor muscles can be repaired at the same time after childbirth.
What is the effect of rectus abdominis repair on the recovery of the pelvic floor?
As mentioned earlier, the rectus abdominis muscle has an important role in maintaining the pressure of the abdominal cavity, the abdominal cavity is a closed environment, and the space of the abdominal cavity of the rectus abdominis muscle contraction becomes smaller, and the abdominal pressure increases accordingly.
Increased abdominal pressure will further increase the pressure on the pelvic floor, for postpartum mothers, the pelvic floor muscles have become loose and weak, and the pelvic floor is subjected to long-term sustained pressure, which will increase the burden on the pelvic floor.
At the same time, increased abdominal pressure will also squeeze the organs in the pelvic cavity to move downwards, and weak ligaments and muscles cannot effectively fix the position of the organs, and swelling and sagging occur.
Therefore, if there is both pelvic floor problem and rectus abdominis separation problem after childbirth, rectus abdominis repair should not be carried out blindly. If there is a simple pelvic floor problem, abdominal shaping (e.g., sit-ups, plate support) should not be performed prematurely.
So when is it possible to do rectus abdominis repair and abdominal shaping? It is recommended to wait until the pelvic floor muscle strength reaches level 3 or above, at which point it is safer.
Summary:
1. After childbirth, the repair of the pelvic and pelvic floor can be carried out at the same time, and the two have a positive effect of mutual promotion.
2. Rectus abdominis repair and abdominal shaping should be cautious, and it is not too late to do it after the pelvic floor muscle strength ≥ level 3.
3. Repair sequence: pelvic floor muscle repair & pelvic repair, and then rectus abdominis repair.
Do you understand the relationship between the three? Here is another point to emphasize: postpartum psychological rehabilitation!
After the mother experienced a painful birth, the sudden decline in estrogen, physical fatigue, and just switch roles to take care of the baby, the time for self was greatly reduced. In addition, there are some psychological disorders that cannot be resolved in time, and new mothers often feel aggrieved and even sad and cry for a small matter.
Most mothers develop these symptoms within a week of giving birth and are able to recover on their own, but some may develop postpartum depression.
Therefore, it is very important for the family to give the new mother enough understanding, care, consideration and care. At the same time, the psychological adjustment of the postpartum mother herself is also extremely important.