Women Benefit from Seeing a Physical Therapist Early in Postpartum Period

We believe all women should have a postpartum pelvic exam and a supportive treatment plan with guidance from a specialized physical therapist. This is usually initiated 6 weeks after vaginal birth or 8 weeks after cesarean birth and should absolutely be a standard of healthcare in the US (another much longer blog post, perhaps?).

New moms have numerous physical postpartum concerns. Whether it is a urinary or bowel concern, a sense of pelvic heaviness/pressure, perineal discomfort, diastasis recti, pain with sex or even back pain, these can all be symptomatically overwhelming. And often these are the symptoms that can fall through the medical ‘cracks’ with standard postpartum care.

Ginger Garner sums this up with a beautiful blog where she quotes Robyn Lim, a maternal health advocate.

“All too often, the only postpartum care an American woman can count on is one fifteen minute appointment with her doctor, six weeks after she has given birth. This six-week marker ends an arbitrary period within which she is supposed to have worked out most postpartum questions for herself. This neglect of postpartum women is not just poor healthcare, it is abusive, particularly to women suffering from painful physical and/or psychological disorders following childbirth.”

So, hopefully we can agree that a skilled pelvic examination 6-8 weeks postpartum should be a standard for women’s health and wellness. However, I have also seen the value supporting women even earlier in the postpartum period.

We believe new moms greatly benefit from early access to a pelvic physical therapist for general postpartum education.

We believe, with early postpartum support and education, (and with continued guidance beyond 6 weeks), women can become more mindful of postures and behaviors that exacerbate symptoms. Small bits of immediately applicable information help women feel supported and confident that they can have a positive impact on their postpartum body.

We believe it is important to provide a safe, open and supportive environment where new moms get extended one-to-one time with a specialized health care provider (that’s us!). Because of this, we are able to screen and make early referrals as necessary for any other medical concerns.

We believe (and know!) that women want reliable and individualized postpartum medical information sooner rather than later and seeing a pelvic physical therapist is certainly a safe and cost-effective resource. A recent client of mine was referred in her early postpartum period, about 1 week after giving birth. She had numerous concerns about the physical sensations she was experiencing in her newly postpartum bod. Here is what we discussed!

1. Standing postural education to reduce pressure in her abdominals and pelvis

2. More appropriate ways to hold and wear baby to promote postpartum healing

3. How to breathe correctly, which is essential for increasing blood flow, circulation and gentle mobilization to perineal scar tissue

4. Education on how to reflexively activate the deep core in order to support her core/pelvic organs when picking up her baby, transitioning sit to stand, and protecting diastasis recti if present

5. Recommended baby-feeding postures to reduce strain on her neck, shoulders, abdominals and pelvis

6. Water intake and output goals to decrease urinary urgency, frequency and incontinence concerns

7. Positioning on the toilet and behavioral techniques to ease pain with bowel movement.

8. How to slowly and easily move back into exercise

The above education is a partial glimpse into the information pelvic physical therapists can provide for women, which is information all should have access to! Daily I hear “I wish I would have had access to this information sooner” or “Why didn’t I know about this?” or even worse “Why did I just suffer through this for so long?” My opinion continues to be that early postpartum education, specific to each woman’s unique concerns, can help a woman feel more empowered and supported when navigating her newly postpartum body.

All women’s bodies are unique. If you would like to know more about how the above relates to your specific condition, email me here. Please also follow us on Instagram or join our private Facebook Group for a ton of free support on common women’s health concerns.

Next Blog: Congrats! You’ve Been Cleared to Return to Exercise in the 4th Trimester

Pelvic Rehab for Mom: Just as necessary as knee rehab for athletes

Seeing a physical therapist after spraining an ankle or sustaining an ACL injury is a fairly common practice for athletes and weekend warriors. There is a fault somewhere in the athlete’s system. It needs some TLC. If the athlete wants to obtain pre-injury level of activity (ie return to football or marathon running), physical therapy is important. Most people would concur, no questions asked.

And then there is diastasis recti, perineal tearing or c-section scarring. And hip pain, low back or SI joint pain. Women have just gone through 9 months of carrying and growing a baby. And the marathon or ultra marathon of labor and delivery. And yet, at our 6 week follow-up (6 weeks!?) we are told all looks good. You can resume life. And for some women, this is true. But for MOST women, it is not.

Many women continue for months (even years!) to experience pain with intercourse, pressure/heaviness in the pelvis (anterior or posterior wall prolapse), sneeze pee, pain with bowel movements and difficulty restoring pre-baby physical function. There is a fault somewhere in the woman’s system. It also needs TLC. Every woman deserves therapeutic guidance when it comes to reclaiming her body. After all, we wouldn’t blindly let an injured football player figure out his own rehab or even worse let him return to the game without any rehab.

WHY SHOULD POSTPARTUM PELVIC REHAB BE ANY DIFFERENT?

I have good news. There is a specialized physical therapist just for you, to help you navigate the aftermath of being postpartum. I believe every woman should see a specialized physical therapist after the arrival of baby (or even before). I believe every woman should know this is even an option.

All women’s bodies are unique. If you would like to know more about how the above relates to your specific condition, email me here. Please also follow us on Instagram or join our private Facebook Group for a ton of free support on common women’s health concerns.

Next Blog: Women Benefit from Seeing a PT Early in Postpartum Recovery

Why Kegels might not eliminate urinary incontinence

As a Pelvic Health PT, I’ve been at odds with the over-prescription of Kegels as a silver bullet ‘cure’ for all things wrong in the pelvis, specifically urinary incontinence (UI). This could be a much longer blog post, but I stuck to the top 3 reasons why I think Kegels are generally ineffective.

1. Urinary incontinence may come from weak pelvic muscles, but not all weak muscles need strengthened. Let’s look at a bicep muscle. It needs to contract AND release. It will be weak if it cannot easily contract and it will also be weak if it cannot fully release! The same is true for the pelvic muscles, and the latter situation is much more common believe it or not! It’s important to understand which category your pelvic muscles fall into in order to effectively address it!

2. Kegels don’t replicate function. Pelvic muscles never work in isolation, so why train them that way? We are taught to do them in the car while at a stop light. And repeat over and over throughout the day. One thousand bicep curls don’t help you much with a half marathon. So an isolated contraction isn’t actually what is required when you bend to lift your toddler or when you perform burpees at the gym. We need to focus on functional re-training our core system to optimize results. 

3. Many factors can contribute to UI. It’s just a sign that something is off somewhere in the core system. Let’s also take into account standing and sitting posture (alignment matters!). How about if someone has diastasis recti? What about a prolapse? How about someone who constantly grips their tummy muscles or who truly has a weak transversus abdominus? This list goes on….

The best way to assess all the factors that contribute to UI specific to you would be to see a Pelvic Health PT. You can also access all of our Online Programming, right from the comfort of your home!

All women’s bodies are unique. If you would like to know more about how the above relates to your specific condition, email me here. Please also follow us on Instagram or join our private Facebook Group for a ton of free support on common women’s health concerns.

Next Blog: My Response to NPR’s article ”Flattening the Mummy Tummy”