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What is the pelvic floor?
When the muscles are tight, a person may experience pain within the pelvis, difficulty emptying either the bowels and/or bladder, pain or inability to tolerate intercourse, marked pain during gynecological exam, abdominal pain and more. During pregnancy, as with many other areas, there are numerous changes that may occur. Combined with the stress these muscles undergo during delivery – even with cesarean sections – it is inevitable for the muscles to need a little TLC afterwards.
What is pelvic health physical therapy?
The goal of pelvic physical therapy is to restore the length, function and activation of these muscles in a more optimal fashion. This will allow for more unrestricted participation in all of life’s activities – including jumping on trampolines.
What to expect for the first visit?
To adequately assess the pelvic floor muscles, a brief internal assessment is performed to determine if these muscles are tight and/or weak. The physical exam helps us adequately identify contributing factors to your symptoms and from here we develop your personalized treatment plan. An internal assessment is not necessary at every treatment. Most often there may be 1-2 assessments needed, depending on what the primary problem is and how well someone can contract the muscles.
A treatment table, sheets, and all other treatment equipment is brought to your house by the therapist. All you need to provide is yourself and maybe a pillow to rest your head on during the exam. Each following visit varies depending on the findings from the initial exam but commonly contains a variation of stretches, strengthening exercises and loads of information!
If a patient is experiencing vaginal, rectal or lower abdominal (bladder) pain, routine internal assessments are the most effective method for treatment. However, even diagnoses that are in large part involving the internal muscles benefit from working on external structures such as the thighs, abdomen, glutes or back.
How often do I need therapy?
If you are experiencing significant orthopedic aches and pains, it can be worthwhile to be seen two times per week until we get things better managed. As you get better, we schedule you less frequently until you feel you have all the tools you need to succeed and are feeling better overall.
I've done Kegels before and they never worked for me.
NOTE: The common misconception that pelvic physical therapy is only about Kegel exercises is untrue. Although exercising the pelvic floor muscles is important, there is much more to optimizing function. Finally, it is important to be assessed by a therapist to determine if Kegels are appropriate for you as someone who is experiencing pain or has muscles that are already tight, strengthening these muscles may be counterproductive and cause more problems.
Benefits of therapy after delivery.
For the vast majority of women, if they don’t retrain those muscles to functioning in the proper alignment and positions again there can be lasting implications. Worse yet, symptoms may only begin to arise much later in life. The truth is, that if we don’t focus on the correct recruitment and activation pattern we will continue to reinforce the dysfunctional movement and stability patterns that are developed through the slow 9-month progression of postural changes called pregnancy.
Even women who are not experiencing symptoms benefit from participating in a couple sessions of pelvic health physical therapy. Countries who offer pelvic health services as a standard of practice to postpartum women have a decreased rate of incontinence, prolapse and many other pelvic floor issues throughout the lifespan. Just as other muscles need to be exercised routinely to maintain wellness, the muscles of the pelvic floor need to be exercised consistently as well. As we age, our muscle fibers decrease in quality as well as quantity. You may not have any symptoms at the moment, but as the muscles age symptoms can then begin to appear.
The strain of pregnancy and delivery is followed by sleepless nights feeding and/or nursing the newborn in poor postures and adding stress to the shoulders, neck, back, etc. Pelvic health therapy after pregnancy isn’t just for the pelvis. It’s for the whole body and about restoring the alignment and efficient movements of each woman so they can return to their normal activities.
But what if I "only" had a cesarean section?
Unfortunately, our bodies don’t just bounce back to their normal function. We must relearn and retrain the muscles to function properly again. Without coordinated training, you will continue to move within the abnormal strategy. Additionally, your abdominal wall was cut through which can greatly impact the strength and recruitment of these muscles.
Is it normal to have leakage after having kids?
This is especially true with jumping, coughing, sneezing, etc. However, this is a large misconception. It is very common for this to occur, but it is not normal. Nor is it normal to leak gas. Pelvic health physical therapy helps to strengthen and address any other contributing factors to assist with improving the control to sphincters of the bowel and bladder.
What other diagnoses can pelvic health physical therapy address?
As you can tell, there is an array of symptoms that may occur and that pelvic health therapy can address including, but not limited to, the following:
Diastasis Recti Abdominis
General weakness following pregnancy
Hip, low back, shoulder pain and/or headaches
Irritable Bowel Syndrome
Pelvic Organ Prolapse
Urinary / Fecal Incontinence
Urinary Urgency / Frequency
Vaginal pain or tightness
When is it appropriate to start pelvic physical therapy after delivering?
For internal pelvic floor assessment and treatment, it is best to wait until your six-week check up to get the all clear from your provider that things have healed well. Prior to that six-week checkup, we can discuss several strategies and techniques to optimize healing and improving bowel or bladder function that are commonly affected after delivery.
What if I'm menstruating?
Do you take insurance?
Regardless of your network status, we will check your benefits so you are aware of what your cost estimate will be. For out of network plans, this means that we will do our best to determine your potential for reimbursement. Any reimbursement from insurance would be made directly to you by your insurance company. We are happy to also assist you in completing the necessary forms to receive reimbursement at no additional charge.
For all appointments, payment is due at the time of service.