Let’s be honest. There are a lot of things no one tells you about that happen to your body during and after pregnancy. Pelvic pain, leakage, and that “something’s not quite right” feeling are often brushed off as just part of being a mom. But what if those things are not normal? What if they’re treatable?
At ABQ Mom, we believe moms deserve to feel strong, supported, and informed. So we asked pelvic health experts Susan Law-Godat, DPT, PRPC, and Chelsea Rizk, DPT, from Lovelace Women’s Hospital Outpatient Rehabilitation to get the scoop on everything pelvic floor. From what it is and how it works to when you should see a specialist, here’s what every woman needs to know about this vital part of her health.
What even is pelvic health physical therapy, and why would someone need it?
How does pregnancy and childbirth impact the pelvic floor?
What are some common signs that someone may have pelvic floor dysfunction?
Many new moms assume pelvic floor issues are just part of life after childbirth. Why is that a misconception?
At what point should a postpartum woman seek pelvic floor therapy?
What are some red flags that indicate someone should see a pelvic floor specialist instead of just doing online exercises?
Lots of online advice exists on DRA (Diastasis Rectus Abdominis), which is laxity over the attachments of the abdominal muscles. Frequently, that advice seems overly aggressive and may increase the problem, rather than helping you fix it. Bulging or sinking of the abdominal tissue with exercise or movement is definitely a red flag. We give you information on self-assessment with exercises that you can use for the rest of your life to make sure your exercises are safe.
Pelvic floor dysfunction is often much more complicated than “just do some kegels and you’ll be ok.” If you try doing some exercises and problems worsen, you have pain, or things fail to improve, come and see us!
If you have tearing with delivery, especially 2nd degree or above, it’s a good idea to see us to avoid future issues. Persistent pelvic pain is definitely something I would see a pelvic floor therapist for because figuring out what’s going on in your own body can be pretty difficult.
What are some common myths about pelvic floor health that you’d like to debunk?
I really don’t like the idea that just doing kegels is the solution. If it were that easy, everyone would be just fine. Sometimes it’s that simple. Sometimes it takes an investigation into other parts of the body, lifestyle, posture, etc.
There is a misconception that a tight pelvic floor is desirable. However, like any other muscle group in the body, pelvic floor muscles are only healthy when they have the ability both to stretch and to contract. Your ability to do both impacts your sexual function and your enjoyment, and your partners’ enjoyment of intercourse. Tight pelvic floors cannot either relax or contract fully, causing problems like pain with intercourse, leakage of urine or feces, and decreased ability to enjoy intercourse.
What does a typical pelvic floor PT session look like?
What should someone expect at pelvic floor therapy?
At your first visit, you can expect the following: history of your symptoms, such as OB/GYN, dietary, bowel, bladder, sexual, exercise, and general medical history. You can also expect a physical examination via external and/or internal vaginal or rectal exam. The vaginal or rectal exam is similar to a gynecological exam or prostate exam except that we only use one single gloved finger to assess, rather than an instrument such as a speculum. This does not have to be done on the first day and can be stopped at any time. Our priority is that you feel comfortable.
Other assessments may include abdominal muscle function, postural assessment, ROM of the lumbar spine, flexibility, and strength of the lower extremities (hips, knees, and ankles).
At follow-up visits you can expect the following: exercise to promote muscle length, motor control, strength, endurance and coordination of your pelvic floor directly and indirectly through the surrounding muscles; manual therapy to address specific muscle tightness or dysfunction; use of modalities such as Electromyography (EMG) with biofeedback, ultrasound or electric stimulation; last, but certainly not least, EDUCATION!
Can pelvic floor therapy help women who are years postpartum or even approaching menopause?
How does the pelvic floor relate to core strength and overall posture?
What are some simple exercises or daily habits that can help maintain pelvic health?
Many women feel embarrassed or hesitant to talk about these issues. How do you help create a comfortable environment for your patients?
What is one thing you wish every woman knew about their pelvic health?
Is there anything else you’d like to mention?
We also work with people with chronic digestive complaints, diarrhea, constipation, IBS, etc. We see men with prostate problems, pelvic pain, incontinence, and abdominal dysfunction (DRA). At Lovelace Women’s Hospital Outpatient Rehabilitation, we are all physical therapists who have trained on the whole body but have done additional education in order to specialize in pelvic floor.
Lovelace Women’s Hospital also offers surgical care, when needed, for pelvic issues with urogynecologist Dr. Brook McFadden. She sees women experiencing pelvic organ prolapse, urinary incontinence, accidental bowel leakage, and more.
To schedule an appointment at Lovelace Women’s Hospital Outpatient Rehabilitation or learn more about pelvic floor therapy services, call 505-727-4620.
