Originally posted on sue croft physiotherapist blog:
Having a baby is a magnificent experience. Seeing the combination of you and your partner’s genetic pool, nurturing them, watching them stumble and grow into beautiful big people is a wonderful life experience. It’s just a shame about the collateral damage for women’s pelvic floors following a vaginal delivery. Nerve compression, levator avulsion, prolapse, urinary incontinence, faecal incontinence, difficulty with bowel evacuation, and finally our topic for today, loss of sensation. It is actually a wonder so many of us have a go at it! You’d think women don’t talk.
Every week I see a number of patients who present complaining of poor sensation in their pelvic floor. Poor sensation manifests itself in a number of ways – decreased sexual awareness, including loss of the ability to orgasm; no messages of impending faecal emptying including solid and gas; no feeling of lift or squeeze in the pelvic floor muscles despite some muscle activation, which means no feedback to the brain. One of my patients who had quite a reasonable muscle contraction and yet could not feel anything moving described it beautifully – that it was like a blind spot when driving a car. Many women have quite a disconnect between the pelvic region and the brain – disconcerting to say the least.
Some of the strategies to improve sensory awareness include ways to deliver feedback to the brain such as via a mirror - try positioning yourself so you can see the pelvic floor in a mirror and then firstly draw in at your low tummy and look for co-contraction of the anus and slight in-drawing around the vagina. Then do a pure pelvic floor contraction and look for more significant lift. And then put the two together and see the enhanced activation. And then it’s a “OH YEAH!!” moment for the brain.