Pelvic PT as Preventative Care

Our healthcare system tends to focus on reactive care. Meaning we don’t seek out help until there is a problem. In general, coverage of care by insurance companies is also reactive in nature.

Instead, we should focus on preventative care. This is what the definition of “healthcare” should be. It should focus on keeping us healthy, rather than reacting to a problem once it is there.

When it comes to pelvic health, this is even more true. The number of people that say to me "I wish I knew about this sooner” is astounding. This tells me that in general, women dont know enough about their bodies as young girls, and that carries over into pregnancy, postpartum, peri menopause and menopause.

Understanding our bodies is key when it comes to prevention and it is also key when it comes to empowerment during all of the various stages of life.

Preventative care can help to support and even prevent things like incontinence, prolapse and other pelvic conditions. Preventative care can also allow women to understand their bodies during pregnancy and prepare for delivery, rather than waiting until there is an issue postpartum.

Of course, we cannot prevent all of these things but understanding that help exists in the form of pelvic health can also allow for women to seek out help as soon as there is an issue rather than living with it before finding help.

C-section Recovery

A cesarian birth is major abdominal surgery and the recovery after this surgery is not something to be taken lightly.

During a c-section, 7 layers of tissue are cut through and abdominal muscles are stretched in order to get the baby out. This takes some time to recover from and also scar tissue can form after this surgery.

Often we focus on the scar that we can visibly see, but we also need to address scar tissue at the deeper layers of tissue. Which is where pelvic PT can really help. Scar tissue can form at the facial layer, muscle layer and around organs as well. Which can impact core strength, pelvic floor strength and mobility in the low back and the hips as well.

Here are some of my tips when initially recovering from a c-section. This is the first 4-6 weeks post-operatively.

1.) Use a pillow to support your incision when getting out of bed and going from sitting to standing.

2.) Focus on abdominal breathing to allow the pelvic floor and deep core to start to engage

3.) Pay attention to a pocket of swelling above the scar. If you notice this area getting more swollen, then it means you probably did too much. So slow down a bit and take more time to rest.

4.) Around 4-6 weeks postpartum, make an appointment with a pelvic PT.

We can still notice pelvic floor dysfunction after a c section. And can lead to things like incontinence, prolapse and pain with intercourse. So even if you think your recovery is going well, it is important to get some individualized guidance and exercise/recovery recommendations to allow you to recover to your full potential. Everyone is different, so just saying take it easy and easing back into exercise means so many different things for different people. An individualize approach is key!

Pelvic PT after Loss

This is a subject that is near and dear to my heart. And is often not talked about enough.

If you have experienced miscarriage or stillbirth, your body needs to recover from this loss. Pelvic floor physical therapy can be beneficial to work on improving pelvic floor strength and mobility, and recover postpartum.

Your body has gone through a lot after this experience and having the proper recovery is very important. For the physical healing, but also the emotional healing that needs to take place after an experience like this.

Pelvic floor physical therapy might address any physical trauma, which might include perineal tears and address the healing in that area through massage and exercise. Common postpartum symptoms such as incontinence, pelvic pain, low back pain and hip pain are also things that can be addressed in physical therapy post loss. As well as cesarean recovery and scar healing. Even if you do not have any physical pain, working with a trauma-informed pelvic floor physical therapist can help to aid in your physical recovery and be part of the overall healing process.

It is important to have a team to help you recover after experiencing loss, and pelvic PT can play an important role in this.

Can Stress Impact the Pelvic Floor?

We all know that long term stress can impact our bodies in a negative way. Stress can lead to long term issues when it comes to our mental health with anxiety and depression. It can also impact our physical health such as cardiovascular issues.

But did you know that long term stress can also impact your pelvic floor health? When you are chronically stressed, you begin to hold tension in your body. This might look like tightening your shoulders or your jaw. You often will begin to hold this tension in other areas of the body, including your pelvic floor.

Tension in the pelvic floor might look like frequency of urination, urinary urgency, pain with intercourse, and pelvic pain. Often, there is also tension in the surrounding areas such as the hips and lower back.

Addressing not only the physical muscle tension in the pelvic floor and surrounding areas, as well as lifestyle and stress management are important components of addressing chronic stress and muscle tension in the body.

It is important to get to the root of the issue and address not just the physical but also the mental and emotional aspects of stress and muscle tension.

If you find that you are having some of these pelvic floor symptoms, its time to see a Pelvic PT. I am happy to help!

Is Incontinence Normal?

The short answer to this question is no, it is not normal. However, it can be quite common especially after having children.

Many women experience incontinence after having children while doing activities such as jumping, running, sneezing and laughing. And it can be quite embarrassing so we tend to laugh it off as something that is just normal after having kids, and just “part of life”.

However, although it is common, it is not necessarily normal and not something you have to live with.

Incontinence can happen due to weakness in the pelvic floor muscles, and a lack of coordination and strength in the pelvic floor and core muscles. These muscles need to work together to stabilize and support the internal organs. But often that support and ability to sequence together, can become dysfunctional during pregnancy and postpartum. We can work on improving the strength and stability of these muscles to allow them to support those internal organs well, and can reduce and eliminate incontinence.

However, incontinence does not only occur if you have had children. Many women experience incontinence even without having children. This can be due to weakness in the pelvic floor as well that maybe has occurred from sports, weight lifting etc.

We can also notice incontinence and urgency with a significant amount of tension in the pelvic floor. So working on improving mobility and relaxing the pelvic floor can help with this. Which might be the opposite of what you would think.

There are many ways we can improve incontinence, but the great news is that it is not something you have to live with!

Is Pelvic PT more than just kegals?

When you think of the pelvic floor and you think of exercises for the pelvic floor. The most common thing that comes to mind is the kegal exercise. Which is essentially a pelvic floor contraction, or the muscles you use to stop the flow of urine.

Most women think that they need to do more legals to help prevent leakage, prolapse, and also make intercourse more pleasurable.

Women have even been told that doing kegal exercises during pregnancy will help with delivery. Which is far from the truth. The pelvic floor needs to essentially just get out of the way during delivery, not engage more.

Kegal exercises are not the only answer to pelvic floor issues and are often the opposite of what we need to do.

More often that not, women are holding a lot of tension in the pelvic floor. And so focusing on relaxation of the pelvic floor can really help with a lot of symptoms. It can even help with urination issues such as increased urinary frequency, urgency and even incontinence.

And the other piece of this is that we want the pelvic floor muscles to work in coordination with the core and the rest of the body during functional movements. And so doing only kegal exercises in isolation is not always helpful, but rather doing more function based exercises such as squats and deadlifts can help engage the pelvic floor more and more functionally than kegals alone.

So if you are having pelvic floor issues whether it is incontinence, urgency or pelvic pain. Don’t just go online and purchase pelvic floor weights or pelvic floor trainers, but get assessed by a Pelvic Floor Physical Therapist to find the best treatment for you.

What is Diastasis Rectii?

Diastasis Rectii has gotten a lot of publicity lately. And I am so glad that more people are talking about this common condition that occurs during pregnancy.

Diastasis Rectii is the stretching of the abdominal muscle, the rectus abdominus. In between the rectus abdomenus is the linea alba, which is connective tissue. During pregnancy, as the uterus grows the linea alba stretches to make more space for baby. Most women will experience some stretching, and separation of the rectus abdominus muscle due to this stretching.

This is no reason for concern, your abdominal muscles did not rip apart and you did not do anything wrong during your pregnancy if this happens.

At 4 week postpartum, 60% of women will continue to experience this separation of the rectus abdominus. In general, this will heal on its own at about 12-16 weeks postpartum.

However, pelvic floor PT can help to improve this condition much sooner and specific exercises can assist with bringing those two side of the rectus abdominus back together.

Some common symptoms of Diastasis Rectii include:

1.) A feeling of weakness in the abdominal area

2.) a “pouch” in the abdominal area

3.) Low back pain

4.) Urinary incontinence

5.) Pain with intercourse

Although diastasis rectii is very common and no cause for alarm, this is something that we want to address to help engage the pelvic floor muscles and core muscles properly. This separation can lead to issues such as back pain, pelvic organ prolapse and chronic pelvic pain. Addressing this early is key, and core stability work can even start during pregnancy preventatively.

However it is also never too late to address diastasis rectii, and can be improved many years postpartum.

If you think you might have diastasis rectii, scheduling an appointment for a pelvic floor physical therapy assessment is key in getting the help that you need!