Pelvic Floor Physical Therapy

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Pelvic Floor Physical Therapy

We Want You To Know About Pelvic Floor Physical Therapy

Our case and praise of pelvic floor physical therapy and why every mom should have access to it. 

What is Pelvic Floor Physical Therapy and Who Should Seek It? 

Pelvic Floor Physical Therapy is a subspecialty of physical therapy that focuses primarily on the pelvic floor and surrounding areas including the hips, core, and low back. 

While it is commonly understood that anyone who has issues with leaking urine will see a Pelvic Floor PT, that’s just the tip of the iceberg. We also treat pregnancy (pain and preparation for labor), painful bladder, painful intercourse, bowel dysfunctions (especially constipation), diastasis recti, pudendal neuralgia, and other nerve entrapment issues. 

Should I see a Pelvic Floor PT while pregnant?

Yes. If you have pain, double yes. Early care is always better care when it comes to pain. There is this societal idea that being pregnant means you should accept pain, and assume it’ll go away after giving birth. Around 85% of women, however, report continued pain throughout their first postpartum year. 50% report pain three years later. 

PT also works to lengthen and prepare the pelvic floor for labor; essentially helping to mitigate the risk of tearing and pain. Afterall, your pelvic floor has to stretch up to 300x its length when giving birth! While the body knows how to give birth, if you’ve been hanging onto a tense pelvic floor for the majority of your adult life from stress – then your body won’t automatically lengthen the pelvic floor on its own. 

Do I need Pelvic Floor PT after a C-section?

Pelvic Floor PT isn’t just for your pelvic floor, it’s also for all the surrounding areas. A C-section cuts into 7 layers of skin, muscle, and soft tissue. It is the only major surgery performed in the U.S. where we don’t automatically have a referral to a rehab specialist. 

Sometimes C-sections aren’t planned. There are case scenarios where mama was pushing for 8+ hours before the C-section was ordered. All of that internal pressure and pushing on the pelvic floor has residual consequences. MRI studies have also shown that just by being pregnant your pelvic floor undergoes changes in its structural integrity, so you don’t even have to push to experience pain or leaking. 

What is Pelvic Floor PT like for Postpartum?

Everyone is unique, so each individual session will be tailored to meet your specific needs. The standard with postpartum care, though, is to help your core and pelvic floor rehabilitate and be able to adapt to your new life challenges. There is a myth, or sometimes ‘recommendation’, that you shouldn’t lift more than 10 pounds after giving birth or having a C-section. However, getting up out of a low chair is the equivalent of lifting 15lbs from the floor, and coughing or sneezing is the equivalent of lifting 35lbs from the floor. It is more important to focus on safely healing and strengthening the body than it is to avoid activity, and that’s where PT can help guide you. 

What is the First Step Readers Should Take To Start Their Pelvic Floor and PT Care? 

It is recommended to have at least one visit with a physical therapist prior to giving birth. If you’ve had a pain-free pregnancy thus far, you can start looking in your second trimester to see someone in the early third trimester. Early third trimester is a great time to learn pelvic floor relaxation for birth, and learn how to start healing within the first six weeks postpartum at home. If you’re experiencing any pain or leaking, however, don’t wait until your third trimester. Try to get seen sooner so the pain or symptoms don’t persist. 

You can see any PT without a referral, or ask your OB, midwife, or doula to connect you with a PT if you don’t have someone in mind. Since referrals are no longer required in Colorado, you can more easily shop for a PT that fits your needs and aligns with your goals. Our practice offers complimentary 20 minute phone consultations so you can interview us and ask us any questions about how our style of pelvic health PT can benefit you.

About the author: Caroline Gamwell, DPT

Caroline Gamwell, DPT is a Doctor of Physical Therapy specializing in Women’s Health and Orthopedics. Dr. Gamwell earned her doctorate at Northwestern University in Chicago, IL with a focus on chronic pain rehabilitation. Dr. Gamwell owns Worth It PT, LLC, a boutique physical therapy practice based in Denver, CO focusing on all things Women’s Health. She holds post-graduate certifications in Pelvic Floor Physical Therapy, as well as in treating pregnant and postpartum athletes. Her passions lie with helping others embrace body changes throughout the decades, whether it’s pregnancy and postpartum or simply aging well. | @worth_it_pt