I went to pelvic floor therapy & this is what happened

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(Does that cover photo make you jealous/nervous/wonder if she’s a mom and if she’s wearing a pad or regretting her choice to jump? No? Just me? Okay… SO ANYWAY!)

I’m 70 months postpartum.

Yes, your math is correct - that’s nearly 6 years. It was nearly 6 years ago that I gave birth to a 9 lb baby boy. And from henceforth, my pelvic floor was never quite the same.

6 years ago, and really, up until fairly recently, the “sneeze pees” among moms have just been kind of a fact of life. Our moms had to cross their legs when they sneezed and “it’s just always been this way, honey. Just you wait and see” they would tell us while trying to psych us up for motherhood. Great news during cold and flu season too, eh? Leaky eyes, leaky boobs and leaky bladders would be our bright futures as moms! It’s the price we all must pay. And so, I paid my dues, I carried pads in my purse, and I never EVER jumped more than necessary! Because, this is the way (Did you read that in your best Mandalorian voice too, or am I the only nerd around here?).

Except, as it turns out, it’s not.

We’ve known for a long time (centuries? A millenia? Two? Since the dawn of time?) that muscles heal. They regain strength and can be just as good, if not better than before an injury. So why has it taken so long to apply that knowledge to our everyday lives as moms? Why do we assume that pushing an average sized baby out vaginally means game over for the muscles down there? Why has it taken so long for this to become normalized as postpartum care? I really don’t have the answer for that, but I sure am grateful that it is now and I will and do shout it from the rooftops (or rather, HIGHLY recommend it in my Facebook groups when it’s pertinent. And when it’s not. Because you know, everyone should know. I know you’re asking about nursery color schemes, but have you found a pelvic floor therapist yet??)

So let’s get to the part you all came here for - my personal experience with pelvic floor therapy. I’m going to de-mystify pelvic floor therapy for you. Let’s walk through this together!

*** First of all, let me throw out this disclaimer: Everybody’s physical therapy experience will be different. Just like how a therapist treats one knee injury may not be the same for another, the same goes for pelvic floors. For that purpose, I will not be sharing the workout routines and exercises that I was given. All I’m wanting to do here is shed some light on what to expect from a visit and the outcomes that I’ve seen thus far (I’ve been going for 2 months).

Setting up my appointment

In order to see a physical therapist, you need to be referred by your primary care provider. In my case, my chiropractor was able to write up a Rx to see one because he’s awesome like that (My suspicion is that most chiropractors who are awesome, are also awesome like that). He wrote it up, faxed it in and I called to set up an initial appointment.

First Visit

The first visit is always the scariest regardless of what service you are going for - OB, dentist, eyebrow wax - physical therapy is no different. I was nervous but was determined to fix the issues I was dealing with! I am physically active, I do Taekwondo and have 2 growing boys - I need to be able to run and jump and jump kick and sneeze without my bladder leaking! 

The first 30 minutes of my appointment was a lot of answering questions - My history, my health, my births, my postpartum experience, my sex life, where and if I feel pain, what I’d like to see changed. She then did a physical assessment of my abdomen and pelvic floor - yes, she had to physically touch the muscles to figure out what was working and what wasn’t. But I will say this - she asked my consent and made it completely optional! Yes, had I optioned out it may have been more difficult to figure out which muscles needed work, but she was very respectful of my feelings and let’s be honest, after having babies my sense of privacy has changed a lot (lol).

Once she assessed my muscle function (physically felt the vaginal muscles with a gloved finger and had me tense and release them) and saw what was going on, she walked me through some simple exercises to activate and deactivate the muscles appropriately. Did you know that muscles that are always “on” are basically useless and can cause a lot of pain? Flex your bicep and have someone poke it - you’ll see what I mean! 

So I had a few things going on. But the main ones were that I had muscles that had been basically in spasm for goodness-knows-how-long, I did, in fact, had a mild form of diastasis recti (the dreaded ab separation) and therefore, my abdomen muscles were not engaging at all! Which explains why after over a year of regular exercise and taekwondo, I have not been able to do push ups without modifying. *lightbulb moment*

The overall process of that first visit felt like one big “AHA moment”, and I saw improvements pretty quickly! I went home that day with my little list of simple exercises and started to notice little things here and there. I noticed that sex wasn’t uncomfortable and that my bladder actually felt empty after peeing (I know, TMI, but if you’re reading this, then I suspect you are probably also dealing with issues like this! Solidarity, fam. I got you!). I think the biggest part for me was that I was cognitively aware of those muscles and had a heightened sense of body awareness. Because of that, I was able to hone in and focus on what needed to be done in a very thoughtful and purposeful way.

One Month Later

I have been going weekly and every week, I get a new “level” of exercises to do for the week. They have been a challenge and I could just do the list and call it a workout - but I build it into my workout. What had I noticed one month in? I could  jump and sneeze without bladder leakage if my bladder was empty. Before, I would leak even if I had just used the restroom. My abdomen was tightening when it was supposed to and I could actively engage it.

Two Months Later

It’s similar to the first month, except we are working on building strength now. I’m very aware of my muscle grouping, which is such a weird thing to say, but when I work out or doing a series of kicks and jumps in class, I am able to activate the appropriate muscles and don’t feel an urgency to pee. Isn’t life grand?

So that’s where we’re at. I’m not a pelvic floor therapist, but if you have any questions about this or if you might think this is something you’d like to try, check out our directory to connect with some amazing physical therapists here in Kansas City!

Happy jumping/sneezing/laughing/BEING, moms!

Mary