Have you seen a Pelvic Floor Physical Therapist? 

Prior to getting pregnant I had never heard of pelvic floor physical therapy. I honestly didn’t even know what my pelvic floor even was!  Today, when I talk to other women of all ages about pelvic floor PT, it’s no surprise that other women aren’t familiar either. “That exists?!”.....The answer is YES! And working with a Pelvic Floor PT can improve your quality of life in huge ways. In countries like France, pelvic floor physiotherapy is standard of care. Women are automatically given pelvic floor “re-education” sessions following childbirth. Here? Most don’t even know it exists. Without care some women may live for years in pain, fear of peeing their pants, avoid exercise classes or social events, refrain from sexual activity, or have worsening symptoms with future pregnancies. But, there is help!  

What is a Pelvic Floor Physiotherapy?

To start, here are some terms for the field that are all related: 

• Pelvic Physical Therapy
• Pelvic or Women’s Physiotherapy
• Women’s Health Physical Therapy or Women’s Health PT
• Pelvic Floor Physical Therapy
• Pelvic PT
• Urogynecologic Physical Therapy
• Women’s / Men’s / Pediatric Pelvic PT

Pelvic Floor physiotherapy focuses on the prevention and treatment of pelvic floor dysfunction. Both women AND men can experience pelvic floor issues, but women are at a higher risk due to our anatomy and extra load placed on the body during pregnancy and childbirth. Pelvic Health PT's provide education and treat the pelvic floor and core muscles in a way that supports the whole body and proper function. In my personal experience, nothing was treated in isolation. Everything is connected, and a pelvic floor PT really helps connect the dots. “Kegels” have become a bit of a buzz word for pregnant and postpartum women trying to “cure” pelvic floor problems. But for a large majority of women, doing pelvic floor contractions may be doing more harm than good. Some men and women have a “hypertonic pelvic floor,” or muscles that are too tight. This type of pelvic floor dysfunction often relates to urgency, frequency, constipation, and pain with insertion. For a muscle to be functional, it must be able to contract and relax. As an example, if we hold a bicep curl all day eventually the muscle tires out. 

When should you see a Pelvic Floor PT?

I recommend ALL pregnant and postpartum women see a Pelvic Floor PT. For reference, below are common conditions they treat:

Prenatal 

• Education and preparation during pregnancy to prepare for labor and delivery and decrease the risk of postpartum complications
• Treatment of pregnancy-related pelvic girdle pain, including pubic symphysis and sacroiliac joint pain
• Bowel and bladder issues (eg. incontinence, urgency, constipation or pain)

Postnatal

• Postpartum proactive check-ups and pelvic floor rehabilitation for optimal recovery prior to returning to pre-pregnancy workouts
• Perineal tearing
• Diastasis Recti – abdominal separation
• Urinary urgency, frequency and incontinence
• Bowel incontinence or constipation
• Pelvic organ prolapse
• Pelvic pain 
• Prolonged discomfort or pain with intercourse

What should you expect during your visit?

Your first visit will typically begin with a detailed history of your current symptoms and past pregnancies, labor/delivery, injuries, pain, and bladder and bowel function. Nothing is off limits here and I encourage you to be as open as possible. This is then followed by a physical assessment, which may also include an internal exam. The internal exam allows the PT to assess the pelvic floor, check for prolapse, and examine the muscle tone and any scar tissue. I encourage you to go with the assessment you are most comfortable with. You do not have to have an internal assessment, especially during your initial consult. You will also typically be provided with at home exercises and "homework" to complete in conjunction with your visits, such as breathing. Every PT has their own approach. To date, I have seen three and my experiences were very different at each of them. 

Find a PT Near You

Below are a few resources to locate a Pelvic Floor PT in your area. Happy to help you find one! 

• Find a Pelvic Rehab Practitioner 
• Women’s Health - Find a Physical Therapist
• Pelvic Guru
• Ask for a referral from your doctor

And if you are looking for a great resource from a Pelvic Floor PT, I recommend my favorite podcast, To Birth and Beyond. As always, feel good mama <3xoxo,Erica