Physical activity is recommended for pregnant women both in the form of endurance training (with positive effects on the cardiovascular system, musculoskeletal system, and digestion) and strength training, provided it is without complications. It is also described as an element of primary prevention of lumbar pain, urinary incontinence and general well-being of the future mother and child [1]. So, should you exercise your pelvic floor muscles during pregnancy to prevent possible postpartum discomfort? It is important during this period to choose the physical activity that the woman did before pregnancy. There are several important elements that distinguish exercise during pregnancy from that before conception… including the intensity or avoidance of the rectus abdominis muscle – an increase in its tension increases the pressure in the abdominal cavity, which can cause pressure on the uterus and its premature contractions [2]. In this context, it is important to note that only 1% of physicians in Poland recommend physical exercise to their patients, and they are usually left alone with the decision or selection of appropriate exercises (which absolutely should not be the case) [3].
Pregnancy itself undoubtedly affects the pelvic floor muscles, fascia and nerves in the perineal area. And if they are weakened (or overly tightened) before pregnancy, their stretching (and often damage) can lead to urinary incontinence, sensory disturbances, organ deterioration, or chronic lumbar pain. These adverse symptoms occur in 50% of women who give birth naturally, which is unfortunately confirmed by diagnostic tests with magnetic resonance imaging or ultrasound [2]. Scientific studies demonstrating the efficacy of pelvic floor muscle training for the prevention of urinary incontinence are abundant. However, not all of them have scientific value (for various reasons) and are therefore rejected in reviews. The most common studies focus on the effects of pelvic floor exercises during pregnancy for the prevention of urinary incontinence and on the effects of these exercises after birth on existing dysfunctions. The conclusions from the scientific articles show the positive effect of pelvic floor training on urinary incontinence, with short-term effects being particularly common.
Norwegian scientists published important reports in 2021, from which we learn again that moderate (intense) physical activity, which includes pelvic floor muscle exercises, has an impact on the occurrence of urinary incontinence in the puerperium, especially in women who already reported this problem during pregnancy. The authors emphasized that pregnant women should be physically active while exercising the pelvic floor [4]. If pelvic floor training and GENERAL CONDITION are done systematically [5], it brings long-lasting effects.
Grzegorz Jędrzejewski
References:
- Gałązka I., Kotlarz B., Płóciennik A., Czajkowska M., Stawicka K., Jenczura A., Mazurek M., Naworska B. Aktywność fizyczna kobiet w ciąży- czynniki wpływające na podejmowanie lub ograniczenie wysiłku fizycznego. Zdrowie Dobrostan, 2, 2013
- Torbe B., Torbe A., Ćwiek D. Aktywność fizyczna kobiet w ciąży o fizjologicznym przebiegu. Nowa Medycyna, 4, 2013
- Worska A., Szumilewicz A. Intensywność ćwiczeń w ciąży w rekomendacjach z różnych krajów – praca przeglądowa. Rocznik Naukowy, AWFiS w Gdańsku, 2014 r., t. XXIV
- Johannessen H. et al., Regular antenatal exercise including pelvic floor muscle training reduces urinary incontinence 3 months postpartum-Follow up of a randomized controlled trial. Acta Obstet Gynecol Scand. 2021 Feb;100(2):294–301
