Did you know? Perineal rehabilitation can also be initiated before childbirth, a French Riviera physiotherapist

Sometimes misunderstood and underestimated, the rehabilitation of the perineum is however essential for the health of young mothers. Cassandre Leleu Lambert, masseur-physiotherapist in Cagnes-sur-Mer and vice-president of the order of physiotherapists of 06, sheds light on this subject.

First of all, what is the perineum?

It is a group of diamond -shaped muscles, located between pubis and coccyx, which forms a real hammock of support for organs such as bladder, uterus and intestines. In women, he plays an important role in maintaining these organs, urinary and anal continence, as well as in sexuality, by modulating sensations during intercourse. In humans, the perineum also supports the bladder and rectum, controls continence, and intervenes in sexuality by helping to maintain erection and control ejaculation. Whatever sex, the perineum is therefore essential for posture and proper functioning of the body.

Why is perineal rehabilitation so important after childbirth?

Pregnancy and childbirth exert strong pressure on the perineum, which can distend or damage it. This rehabilitation makes it possible to restore the tone of the perineum, to deal with possible scars and to prevent disorders such as incontinence, constipation or organ descent (prolapse). Perineal health is therefore of major importance, far beyond the postpartum period, and throughout life. Note that perineal rehabilitation is 100% covered by social security during the three years following childbirth, which facilitates access to this essential follow -up.

Should we consult even without symptoms?

It is the doctor who directs towards a physiotherapy management, and it is strongly recommended to consult to make a personalized assessment, even if no symptoms are present.

Does she also concern women who gave birth by Cesareanus?

Yes, absolutely. Even without childbirth by low way, the weight and pressure of the uterus during pregnancy impact the perineum. A postnatal assessment makes it possible to determine the specific needs of each woman, regardless of the method of delivery.

Can it be done during pregnancy?

Absolutely. We don’t always think about it, but perineal rehabilitation does not only concern postpartum. Some pregnant women already have disorders such as hypertonicity, difficulties in contracting or releasing the perineum, problems of sensitivity or constipation. In these cases, the gynecologist can prescribe sessions before childbirth to learn to better manage contraction and muscle relaxation and adapt lifestyle. The objective is to prevent complications, prepare the perineum for childbirth and improve daily comfort, without waiting for postpartum to act.

During pregnancy or post-driving, how many sessions are necessary?

It is very variable. It all depends on the initial state of the perineum, the experience of pregnancy and childbirth, and the objectives of the patient.

What are the methods used?

Manual rehabilitation allows the physiotherapist to carry out an initial assessment and to support the patient in the awareness of her perineum, by working in particular on mobility and relaxation. Added to this is the use of biofeedback, a technique which, thanks to a probe connected to a screen, makes it possible to visualize muscle activity. The physiotherapist then guides the patient through different exercises, in an elongated position, seated or standing. In some cases, electrostimulation can complement these approaches by gently stimulating muscles, while encouraging full awareness. Perineal rehabilitation takes into account women in its entirety, also integrating postural aspects and lifestyle advice adapted to daily activities.

Can we practice exercises alone at home?

Each woman being different, it is essential to start with a balance sheet carried out by a professional. This avoids frequent errors, such as soliciting bad muscles or adopting unsuitable techniques. For example, the “stop pee” method is not recommended: voluntarily interrupting the urine jet can disturb the proper functioning of the bladder, prevent its complete emptying and promote urinary tract infections. After this evaluation, personalized exercises can be practiced at home, provided of regular monitoring. This guarantees that the movements are well carried out and that rehabilitation remains effective and without risk.

What activities should be avoided as long as rehabilitation is not completed?

Avoid the race, the jumps, the wearing of heavy loads, the abdominals type Crunch, everything that increases the pressure on a weakened perineum. The resumption of sport must be progressive and validated by a professional.