Common not Normal: Postpartum Pelvic Floor PT
Common but not normal. How to reconnect with your body and build back your inner strength in the postpartum period.
My crotch hurts. My boobs are exploding. It’s so hard to breathe. Don’t you dare touch me with your “uterine massage.” I will never get back to running ever again. I remember these feelings all too clearly from delivering my son almost 12 years ago. And then they just sent me on my way with this little human to take care of on top of it. The postpartum period can be a shocking awakening on so many levels, but one thing many women don't always anticipate is just how weird and foreign your body can feel afterwards. So much attention is shifted to your new baby that oftentimes the mom is left just thinking, “well, this is just how it’s going to be now” or “I’ll deal with it later when I have more time and energy.”
But guess what, it doesn’t have to be.
There are SO many things that are common but not normal following the arrival of your new little ones. Things like:
Peeing a little when you cough, sneeze or mis-step
Feeling frumpy, weak and like your core got lost by the wayside awhile ago
Months after delivery, being still completely exhausted and just feeling “off”
Coming up with reasons why you don’t need to have sex because it freaking hurts!
Feeling pelvic pain or pressure after carrying your baby or going for a walk and worried if there might be something wrong down there
Feeling like you need to run to the bathroom every time you see one
Nagging lower back or neck pain that just won’t go away
Wanting to get back into a workout routine (or start one for the first time) but not really knowing what is safe or what isn’t
And the list goes on. It can be so confusing and overwhelming to begin taking care of a newborn (and possibly other older kiddos on top of it) that we often put ourselves on the back burner. Unfortunately, while many of the initial postpartum physical challenges do heal on their own with some time, in many cases, things such as urinary incontinence (aka peeing your pants), pelvic pain or even diastasis recti (separation of your abdominal muscles) may continue to persist forever if they are not addressed.
The good news? You don’t have to live with any of this!
Seeing a postpartum pelvic floor physical therapist can be life changing to help you overcome these frustrating and embarrassing symptoms and guide you back to feeling like you.
But that sounds weird and time consuming, what do they even do?
A postpartum pelvic floor physical therapist is a Doctor of Physical Therapy who has had additional training in the pelvic floor and needs of the postpartum woman. A visit with this specialist will include many things but should always include:
A chance for you to sit down and share your story and your goals
A thorough review of your health history, pregnancy, delivery and postpartum recovery
A full physical assessment of things like your posture, alignment, breathing, rib mobility, flexibility and strength, diastasis recti assessment and many other areas
A conversation about the pelvic floor muscles (the muscles that create a bowl on the bottom of your pelvis that are the bottom part of your core and provide stability to your entire body) and, if you’re comfortable with it, an assessment of these muscles to check your coordination, strength and any tightness that may be affecting your symptoms
Assessing your scar mobility if you have one
And a whole lot of education on things like bowel and bladder health, breath and posture training, how to manage pressure in your body, core stability and everything else you need to help guide you to your health goals.
At New Heights Physical Therapy, we go a step further and want to know about ALL areas of your health, including things like nutrition, gut and hormonal health, your sleep routine (tough with a newborn!), your stress management tools, your community support and connection and your long term vision for your health. Because you are more than just some strength and flexibility numbers and all of these things go hand in hand. Ultimately, we want to help get you back to feeling like YOU. And possibly most importantly, we help to take the overwhelm out of figuring all this out.
Because there is definitely an overwhelming amount of confusing and conflicting opinions out there. From “just do kegels and you’ll be fine” (fun fact, kegels often make leaking worse!), to “don’t do anything for six weeks but then you can jump right back into your workout routine” to “never do these exercises again if you have an abdominal separation,” I’ve heard it all. Throw on social media and well-meaning friends and family advice and it’s totally confusing to know what to actually do.
Working with a pelvic floor postpartum physical therapist takes the guesswork out of it and gives you someone to walk beside you on this journey. And the sky's the limit as to what you can accomplish. Maybe you just want to have the energy and strength to crawl around on the floor with your toddler or you think it would be fun to not have to cross your legs every time you sneeze or maybe you want to get back to higher level exercise like CrossFit and marathon training. By learning to connect with your core and pelvic floor muscles and improve upon some common postpartum changes with posture and breathing, you will start to feel an inner strength that maybe you've never even felt before. Then we build on that, layer by layer. We make sure that all those other areas, like nutrition, sleep and stress, are being talked about and guide you to create specific action steps that will also build upon each other to move you towards your health vision. Starting from the ground up, with someone who knows and understands this journey, will help you get there.
Being a mother is one of the proudest things I’ve ever been able to call myself and I wouldn’t trade it for the world. But we don’t need to trade in our old selves for this new identity. Getting the strength, knowledge and support that you need to build back your physical and inner strength will allow you to fully become the best mother (and everything else you get to call yourself) that you can be.
Want to learn more?
We offer 50 minute complimentary Discovery Sessions to give you the time and space to share your story, ask questions and see if we’re a good fit (and if we’re not, we love showering you with resources to the person that might be).
This blog was originally written for and featured on the Lake Country Newborns blog by our very own Dr. Megan Wiley, PT, DPT, WHC. “Lake Country Newborns offers professional postpartum overnight and daytime support for baby and family during the first year of life. Find rest and relief as you recenter during your fourth trimester and beyond.” They are an amazing additional resource for our Lake Country Mamas!
