Why New Moms Should Consider Pelvic Floor Therapy

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What Is Pelvic Floor Therapy?

Pelvic floor therapy is the work to target, strengthen, and balance the muscles that make up your pelvic floor, which supports the uterus, bowels, bladder, and rectum.

Pregnancy and childbirth can have quite an impact on the muscles of the pelvic floor, and they can become stressed and weakened as a result. Living with a weak pelvic floor can cause long-term discomfort and complications. Pelvic floor therapists are physical therapists who can help treat pelvic floor issues.

How Pelvic Floor Therapy Can Help

We spend a lot of time and energy thinking about how our bodies change from pregnancy and childbirth—stretched abdominal skin, stretch marks, weight gain, swollen hands and feet, and more. But not many of us think about what might happen inside our bodies, and the impact this can have on our overall health.

Many women experience postpartum symptoms such as back aches, urinary incontinence, pelvic pain, and painful intercourse—all of which can be linked back to pelvic floor dysfunction (the inability to relax and coordinate the pelvic floor muscles).

In other countries, it's common for a new mom to see a pelvic floor therapist within the first few weeks after she has a baby. “In the United States, new moms are not sent to a pelvic floor physical therapist, and that's one reason they suffer for many years with pain, leaking, and weakness,” says Isa Herrera, a licensed physical therapist and founder of Pelvic Pain Relief.

“In other countries like France, pelvic PT is prescribed to all women, and these women rehab their bodies and their pelvic floor muscles much easier.” The fact that all new moms are screened for pelvic floor issues in France, and given therapy if needed, points to how prevalent the issue of pelvic floor weakness and dysfunction is—and the need for all mothers to have options for healing and strengthening their pelvic floors.

Conditions Treated by Pelvic Floor Physical Therapy

Not every woman is aware of symptoms she related to a dysfunctional pelvic floor. Yet many issues that we tend to think of as common or even normal postpartum experiences can be linked to problems with the pelvic floor muscles. Other conditions, such as vaginismus and endometriosis, may also be treated with pelvic floor physical therapy.

Some common symptoms of pelvic floor dysfunction include:

  • Frequent urge to urinate
  • Painful urination
  • Incontinence
  • Difficulty completing bowel movements
  • Constipation
  • Pelvic pain
  • Pain or discomfort during sex
  • Low back pain
  • Pubic bone pain
  • Sciatica
  • Diastasis recti (separation of the abdominal muscles, which is often related to pelvic floor weakness)
  • Prolapse of the pelvic organs (bladder, uterus, or rectum)

Do You Need Pelvic Floor Therapy?

There’s quite a bit of pulling and stretching of muscles and skin that must happen to accommodate your growing baby and allow you to give birth. The hormones of pregnancy, childbirth, and postpartum can also have a profound effect on your body.

Many women find their bodies return to normal within a few weeks or months after giving birth. Yet many women—especially if they have multiples, experienced traumatic births, or birthed several children—may need rehabilitation for their pelvic floor muscles.

Most pelvic floor therapists recommend waiting four to six weeks postpartum to explore your options in terms of pelvic floor rehabilitation. You may need to see a pelvic floor therapist sooner if you experienced a deep tear or other injury during childbirth.

If at six weeks or so, you are experiencing symptoms such as urinary or fecal incontinence, prolapse, pelvic pain, or any of the symptoms mentioned above, consult with a pelvic floor therapist.

However, it’s important to note that pelvic floor therapy can be helpful at any point postpartum. Women can benefit from it even years after having a baby! 

Your OB/GYN or midwife may be able to provide you with an initial evaluation, and then recommend a pelvic floor therapist for you to see. Many pelvic floor therapists will work in conjunction with your doctor or midwife. You can also search for a pelvic floor therapist at the International Society of Sexual Medicine.

What Does a Pelvic Floor Therapist Do?

You’re probably wondering what exactly happens if you see a pelvic floor therapist. Many moms might even feel uncomfortable about sharing their symptoms or starting treatment for pelvic floor disorders.

Don’t worry—you are not alone, and pelvic floor therapists are experienced both at helping you feel better, and also making the experience as comfortable as possible.

That said, you should always interview a pelvic floor therapist before your first visit to be sure you understand what the visit will entail and that you feel comfortable with the therapist.

Typically, after an initial consultation, examination, and medical questionnaire, there are a few main things your pelvic floor therapist will work on you with during a session:

  • They will educate you about how your pelvic floor works, and how to get in touch with your own body and musculature.
  • They may discuss lifestyle choices that can affect your pelvic floor and the organs surrounding it, including proper exercise techniques, food and drink intake, and bowel and bladder habits.
  • They may teach you different breathing techniques such as diaphragmatic “belly” or “chest” breathing.
  • They will likely teach you exercises to perform daily at home to help relax and strengthen your pelvic floor; massage techniques may be discussed as well.
  • Some providers use biofeedback sensors or low-grade electrical currents to teach you pelvic floor awareness and how to engage your pelvic floor muscles properly.
  • Some therapists may provide pelvic floor massage to help relax and balance your pelvic floor muscles.

How to Do Pelvic Floor Exercises

When most people think of pelvic floor exercises, they think of Kegels, a tightening and toning of the pelvic muscles. The great thing about Kegels is that they are something you can do at home—even while you are just relaxing and hanging out.

The truth is, though, many of us aren’t doing Kegels quite right, which means we may not be getting the full benefit from them. In fact, according to some pelvic floor therapists, incorrectly performed Kegels can do more harm than good.

“Often people just squeeze their butt or abdomen and that is not correct,” explains Dr. Rachel Gelman, MD, who is the pelvic floor health expert for Intimina.

“Kegels are an exercise that involves contracting and then relaxing the pelvic floor muscles. To do one correctly, a person would think about trying to stop the flow of urine or try to think about not passing gas,” she says. “If they inserted a finger into their vagina they would feel the muscles contracting and lifting. No other muscles should contract.”

How to Do Kegels Correctly

  • When you’re preparing to do Kegels, make sure you empty your bladder.
  • Locate the correct muscles—they are the same ones you use to stop the flow of urine.
  • Squeeze these muscles for 10 seconds.
  • Release and relax the muscles for another 10 seconds.
  • Continue this pattern about 3 times per day, for about 10–15 repetitions each.
  • Make sure you are breathing freely while doing Kegels—don’t try to hold your breath
  • Make sure not to squeeze your buttocks muscles, your abdominal muscles, or the muscles of your thighs.

Keep in mind that visiting a pelvic floor therapist in person can help you understand this exercise more fully, as well as other exercises that may suited to your particular pelvic floor issues.

A Word from Verywell

The idea that women are supposed to magically bounce back to their old selves following pregnancy and childbirth is a myth. Many moms need a little extra care to help gain strength and balance in the postpartum period.

Because postpartum issues like pelvic floor weakness and dysfunction are often taboo subjects, many women end up dealing with things like leaking urine, prolapse, back pain, and sexual pain for years before opening up about their struggles or seeking help.

It can sometimes feel impossible to find the time to address something like your pelvic floor health. But taking the time for you is just as important as caring for anyone else.

It’s important to understand that these problems are actually very common, and there is nothing wrong with you if you are experiencing them. There is compassionate and effective help available to restore your body to full health. Even if it’s years—or decades—since you’ve had a baby, you can benefit from pelvic floor therapy. You deserve a body that feels good, works well, and allows you to live a full and healthy life.

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