When to see a pelvic floor physical therapist

If you don’t know what a pelvic floor physical therapist is, you are totally not alone. This is partially due to the culture that we live in. When it comes to prenatal care, there are some pretty great measures taken to ensure that we have the safest and most healthy pregnancies as possible. But, after baby comes? Waaa-waaaah. 

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Despite childbirth being one of the most traumatic experiences that the human body undergoes, there is shockingly little being done to help postpartum women regain healthy function of their bodies again. In fact, postpartum problems are written off as being normal and something that we as moms should just expect and accept, like a rite of passage.

Our mission is to challenge that position and help give you all of the information and confidence you need to seek help for these issues….because help exists and healing can happen!

This is where a pelvic floor physical therapist comes in. A pelvic floor PT has special training in evaluating and treating your pelvic floor muscles, they understand the relationship of the pelvic floor to the rest of the body and how one area of dysfunction in one part of the body can indicate a pelvic floor issue or vice versa. Best of all, they have your best interest, health and function in mind.

Here are some indicators that you may want to seek out a pelvic floor physical therapist in your area:

1. You pee your pants when you sneeze, laugh, jump, lift heavy, etc.

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Despite what you may have been told by your mother, sister or best girlfriends, incontinence is common, but it IS NOT normal. It’s a sign of a larger issue. 

Many women believe that a weak pelvic floor is the cause of incontinence issues, but this isn’t always the case. It can be an indicator of a whole system breakdown among the diaphragm, transverse abdominus, multifidus and pelvic floor muscles. Kegels are not always the answer, and, usually, they’re not enough.

2. Your insides end up on the outside.

Pelvic organ prolapse (POP) is something that women find themselves faced with after pregnancy childbirth.  POP is when one or more pelvic organs droop down in towards the vagina and/or rectum. The severity of POP ranges from a slight descent where the organs stay within the body to full blown prolapse where organs are actually sliding out of you body. There are many kinds of prolapse, but the most common are the prolapse of the bladder, rectum or uterus. 

Signs of POP include, but are not limited to, a feeling of heaviness and/or downward pressure in the pelvic area, pain or pressure in the lower abs and/or vagina, a bulging out of the vagina, a feeling of things “falling out,” or actually seeing things falling out of your vagina.

This information is not meant to scare you, but rather to educate you so that you know how to best relate this information to your healthcare provider and care for you body the best way possible. It is totally treatable! 

3. Sex hurts.

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If this is you, you are not alone. In fact, a study published by BJOG, An International Journal of Obstetrics and Gynecology, shows that nearly 9 in 10 women experience pain the first time they have sex after childbirth, and almost ¼ of these women reported still experiencing painful sex 18 months later.

A lot of times, painful sex after childbirth is an indicator of a hypertonic pelvic floor. Hypertonic pelvic floor dysfunction is when the pelvic floor muscles are overly tense, inflexible or even spasm. A hypertonic pelvic floor can make sex pretty painful….which leads to anxiety about intercourse…which leads to more tense muscles and more pain. Not the way we wanna go!

An important note is that one can have a hypertonic pelvic floor whether their pelvic floor muscles are strong or not. Kegels are not enough. Our pelvic floor needs to be able to not only fully contract, but also fully relax.

4. You back, hips, knees and/or pelvis hurt.

Pelvic and low back pain during pregnancy are are pretty common. All of the changes that happen to our core, pelvic floor and posture don’t just go away after the baby comes out. 

The pelvic floor muscles play an important role in stabilizing your low back muscles. When it comes to lumbopelvic stability, the right timing and magnitude of the core and pelvic floor muscles is necessary for these muscles to be able to do their job properly, and without pain.

A pelvic floor PT can help you assess and address the pain you’re experiencing and get you back to doing the things you enjoy.

5. You had a baby, no matter how your baby was born.

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These issues do not just happen to women who have had vaginal deliveries. Not only does a woman who’s had a cesarean experience postural changes from the weight of her pregnancy and downward pressure on her pelvic floor muscles, but a c-section is a MAJOR surgery. The scar from the incision is on the surface, but it goes many layers deep. 

Rehab is very important after having a c-section. And, issues that can present following a c-section go beyond the scar itself. A lot of women experience painful sex, the need to urinate frequently, pelvic, groin or low back pain or digestive problems, to name a few.

When it doubt, get checked out!

Many women just live with issues and symptoms like the ones described above, accepting them as normal, while others are too embarrassed to bring them up! Your regular OB that gave you the all clear at your 6-week check up isn’t trained to look for or ask about these specific issues. Take a step toward advocating for yourself by finding a pelvic floor PT in your area. Use this locator tool if you need help finding one.

Being a mom does not mean that you are sentenced to life with pain, underwhelming sex and pee pads. To identify and treat the issue, you need an integrated approach with a good team -- your pelvic floor PT, your OB, a trainer who specializes in pre and postnatal exercise and YOU! (And possibly others depending on your unique situation.) If you’re experiencing any of the symptoms listed above, we urge to get the help you need so that you can have the quality of life you deserve.



P.S. We feel really passionate about getting mamas and mamas-to-be the information they need in order to prevent and heal from core and pelvic floor issues. If you’d like more information on how we coordinate with your physical therapist to get your strong and capable email us at info@thepushfitness.com