Unless we have a specific reason to, most of us probably go about our lives without giving our pelvic floor much thought—and when we do, the bulk of our attention generally focuses around the Kegel.
In fact, I didn’t think too deeply about the pelvic floor for quite some time, either. Even back during my undergraduate education as a kinesiology student, when I worked at a personal training studio with pregnant women. Back then, prenatal and postpartum exercise classes included hill repeats, stroller running with babies, planks, push-ups, plyometrics drills, and more crunches than I could count.
I thought we were really helping these women. Sure, we were helping in some ways, but I can’t help looking back on this approach and feeling that we were also hurting them by prescribing exercises that, after the stress of pregnancy and birth, can interfere with postpartum recovery.
Years later—having focused my Master’s degree in kinesiology and my subsequent career on the unique physiology and exercise needs of pregnant women and new mothers—I understand that there is a whole lot more to having a “strong pelvic floor” than bootcamp workouts and Kegels. What’s more, that pelvic floor is far more critical than most women (and even well-intentioned trainers!) realize.
I recommend all pregnant and postpartum women see a pelvic floor physical therapist. In fact, even if you’re not pregnant or postpartum, If you’re training hard, lifting weights, running, or playing sports, it’s a worthy endeavor to see a pelvic floor physical therapist simply to ensure your pelvic floor and core are functioning well.
Specifically in pregnancy and postpartum however, so many changes are happening to the body on a physiological and hormonal level, that it can greatly affect how the core and pelvic floor muscles are responding to daily life and to exercise. You might be experiencing:
Still, even if you feel fantastic post-baby and your pelvic floor feels like it’s “back to normal,” the stress of pregnancy and birth alone can affect the strength and endurance of your core and pelvic floor muscles, which could lead to some of those issues down the road.
Don’t wait for pain or “symptoms” to determine whether or not you make an appointment.
Working with a pelvic floor physical therapist is a fantastic education about your body and sets you up for good long-term core and pelvic floor health, and the benefits go much deeper than education.
My pelvic floor physical therapist, Gayle Hulme, PT, WHPT, encourages all women to have an assessment by a women’s health physical therapist. Physical therapists like Gayle, who specialize in women’s health, provide hands-on/manual techniques, exercises, and education to help optimize pelvic floor control and postural alignment. In addition, women’s health physical therapists are specially trained to perform a vaginal and rectal exam, “the gold standard for evaluating the pelvic floor and organs,” says Gayle.
Working with a women’s health physical therapist is beneficial at any point during your pregnancy. These specially-trained physical therapists can help you prepare your bodies for labour and delivery, and help you recover from a vaginal or C-section delivery. During pregnancy, your physical therapist can help treat the aches and pains you may be experiencing, such as low back pain or discomfort in the front or back of your pelvis. Additionally, the therapist can perform internal (vaginal) manual, gentle massage and stretching type work on your pelvic floor muscles to help prepare your body for the birth of your baby.
At your postpartum appointment your physical therapist will perform a vaginal and anal internal exam to assess your pelvic floor muscle function, test the strength and endurance of your pelvic floor, ensure you’re able to do a Kegel properly, and check for areas of tightness in the pelvic floor that are causing pain or weak muscles. Your therapist can also check your diastasis recti to gauge how it’s healing and give you specific exercises that will help strengthen your abdominal and pelvic floor muscles.
It’s recommended that you visit your physical therapist at about six weeks postpartum, although you can absolutely go sooner if you like. (My first appointment postpartum was at five weeks.) If it’s been weeks, months, or even years past that for you, get in as soon as you can!
Anyone who has ever been pregnant—at anytime—will benefit from working with a pelvic floor physical therapist for at least one session, to better understand her body.
You can make an appointment with a pelvic floor physical therapist in much the same way you would with a traditional or general physical therapist. That is to say, in most cases, you don’t need a special referral. Just call and make an appointment. If you have physical therapy coverage, a women’s health or pelvic health physical therapist is likely included in that coverage. Check with your insurance provider to make sure, and then simply make an appointment with the physical therapist of your choice.
To find a women’s health or pelvic floor physical therapist in your area, search any of the websites below looking for terms such as “pregnancy/postpartum,” “pelvic,” or “women’s health” under specialty or area of practice:
Canada: http://www.physiotherapy.ca/About-Physiotherapy/Find-a-Therapist-Directory
US: http://www.womenshealthapta.org/pt-locator/
Australia: http://www.physiotherapy.asn.au/APAWCM/Controls/FindaPhysio.aspx
NZ: http://physiotherapy.org.nz/about-physiotherapy/find-a-physio/
UK: http://www.csp.org.uk/your-health/find-physio/physio2u
If nothing comes up in your area, try a general search on the Internet using one of the following terms: “pelvic health,” “pelvic floor,” “women’s health physical therapist” or “women’s health physio” as well as the name of your city.
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