At Medfemina, we are committed to the highest quality of patient care, which is why we undoubtedly acknowledge the importance of a postpartum functional body assessment by a certified gynaecological physiotherapist. This is the second necessary consultation next to the postpartum gynaecological consult.
Postpartum functional diagnostics assesses a woman’s body after childbirth in terms of postural changes, analysing postural patterns, ranges of mobility, muscular tension disorders, pelvic floor muscle abnormalities, muscle weakness, musculo-fascial imbalances.
A woman’s body undergoes enormous changes during pregnancy: deepened curvature of the spine, changing breathing pathways, a change in muscle tension in the body – to name a few. What is more, posture, habits, professional career and the course of pregnancy and childbirth can significantly alter the function of muscles, ligaments, fascia and the work and statics within the pelvic floor muscles. During a functional postpartum diagnosis, our physiotherapist will meticulously assess the patients’ bodily work functions.
What does postpartum diagnostics include?
- Medical interview with the patient
- Analysis of body posture and everyday behaviours
- Evaluation of the respiratory pathway
- Examination of the abdominal integuments (palpation, functional tests)
- Examination of abdominal integuments using ultrasound equipment
- Pelvic floor muscle examination (per vaginum, per rectum and using ultrasound)
- Post C-section and perineal incision examination
- Review and proposal of physiotherapy plan.
- Introduction to initial therapy.
Medical interview with the patient
This is the first and essential element with which we begin our collaboration. It is extremely important that the patient is able to provide us with as much detailed information as possible, such as the course of the pregnancy, the course of labour and the puerperium, the type of birth, the number of deliveries, pain, physical activity before and during pregnancy, the type of professional career (sedentary or mobile). We will also inquire about micturition, defecation and urinary complaints such as urinary incontinence. The more information we obtain from the patient, the more and more accurately we are able to help. The interview is intimate, conducted in a relaxed atmosphere with full confidentiality and respect for the patient. We respect the situation if the patient does not want to talk about something.
Analysis of body posture and everyday behaviours
The analysis of body posture, in a standing position, will give us an answer as to what your mobility patterns are, what your habits are, how your abdominal prelum behaves, the curvature of your spine, how your feet and the rest of your body are positioned. We will try to find the ideal posture possible for your body, see how it reacts. We will check the ranges of movement in your joints, which can help us to define your needs and get your post-partum body back to function and fitness. Please remember that our daily posture, and the way we walk, sit, carry ect. is of great importance in the process of therapeutic success, healing and tissue contraction – it is the paramount element during the consultation.
Breathing examination (respiratory pathway)
Examining the way you breathe (respiratory pathway), whether it is correct or is it disturbed, is another essential piece of the whole puzzle. We treat the body as a whole, therefore we always observe the breathing habits. The way you breathe affects your abdomen, the tension in your pelvic floor muscles, your posture and central stability.
Examination of the abdominal integuments (palpation and ultrasound)
During this examination, we conduct palpation examination of the tension of your abdominal tissues, we carry out functional tests to determine the work of your abdominal muscles, the contraction of linea alba, semilunar folds and assess how your abdominal muscles interact with your pelvic floor and diaphragm. Then, using ultrasound equipment, we also examine the functional work of your abdominal muscles. Ultrasound also allows us to accurately assess the distention of the rectus abdominis muscles and the behaviour of the muscles in relation to each other at rest and during contraction.
Pelvic floor muscle examination (per vaginum, per rectum and using ultrasound)
This is the most extensive examination and the most important that we carry out in our practice. The first examination takes place per vaginum and, if necessary, with the aid of ultrasound equipment. This examination provides information about whether: pelvic floor muscles have too much tension or perhaps they are weak, if asymmetries occur, if there is a lowering of the reproductive organs, if there is soreness, if you are able to contract the pelvic floor muscles correctly and what is the correlation of pelvic floor muscle tension with abdominal prelum, breathing and other muscles in your body, and if the anterior and posterior vaginal walls are working properly. Biofeedback or palpation examination is applied here. If you are activating your pelvic floor muscles incorrectly or are unable to do so – we will teach you how to do this correctly – this is a very important stage for you, requiring focus, attention and concentration on the task. This stage ensures correct activation of your pelvic floor muscles already after the first consult. The pelvic floor muscle training will be adapted to the conditions your muscles are currently in.
Post C-section and perineal incision examination
This is a visual and palpation examination during which the degree of tissue mobility, pain level and the behaviour of the fascia and scar when standing (your typical posture) are measured. The patient is taught how to care about and massage the scar. The area for the massage will depend on the degree of change, the time since surgery and the patient’s personal capabilities.
Review of the consultation and therapy plan
Once the examination is complete, we move on to a review of the consult. We will outline what is good, what should be improved and where, according to our assessment, you should start. We will provide you with precise and clear guidance on the ergonomics of your everyday life. We will also prepare for you the first exercises along with the instruction to do them at home. If necessary, we will also apply Kinesotaping. If you decide to continue working with us and would like to get back into shape after childbirth with our help, we will present you with an action plan so that you know clearly what we plan to do, how to work, and at what frequency. After each consult, you will always receive a set of exercises to practise at home, but first we will master them together. We need to be sure that you do the exercise correctly.
How to prepare for the first consult?
- An hour before the consult, patient should drink about 500 ml of water. The full bladder makes it easier to perform an ultrasound examination of the functioning of the pelvic floor muscles.
- Previous tests, consultations and hospital discharges may come in handy during the consult.
- The consultation lasts 60 minutes.
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