And why we all probably need pelvic floor therapy
During my pregnancy with my first baby, I spent the better part of around 7-8 months just reading about childbirth. (Interpret that as I was scared to death of having to push a very big baby out of a very small space. How in the world does that physically happen!?) In all of my reading, one of the many things that stood out to me was the importance of pelvic floor muscles and strengthening them for birth and then healing them after…and also how the United States wasn’t just “behind” in getting women this training and recovery help, but most doctor’s offices weren’t even discussing these needs at all! It seemed to me that European countries were leading the way in placing emphasis on the mother’s body and recovery…and the US…well, for lack of better terms, just didn’t seem to care. Emphasis for postpartum care in the US has always been placed on the baby’s health, and baby alone. (And you can read that as I agree that the baby’s health is of utmost importance…I just think the mom’s health should be kind of important and cared for too. Especially new moms who don’t know any different.)
Moms Are Left Out.
In the United States, babies are born and examined right away, continuously examined during the hospital stay, are checked out out by a pediatrician two days after birth, two weeks after birth, two months after birth, and so on. The moms…the ones with dinner-plate sized wounds on their uterus, stitches in their very most sensitive places, hormonal imbalances, and sometimes even prolapsed organs due to carrying big babies and/or pushing too hard during delivery….well, we get seen about six weeks postpartum and are usually told it’s ok to resume a workout routine, intercourse, tampon use, and whatever else we did before the physical trauma of birth. (Read that as “physical trauma of birth.”)
Your Pelvic Floor Needs ONE YEAR. Recovery needs to be MANDATORY!
Unless you also get checked out by a women’s health physical therapist, you may be told that “everything looks fine” ; however, it actually takes one year for the pelvic floor (the muscles that hold up your reproductive system, your bladder, that growing baby you gave birth to) to completely heal post birth. So for most women who get told at six weeks postpartum to “resume normal activity” (especially in the gym), these women can be wreaking havoc on muscles that haven’t healed yet and certain exercises can actually do even MORE damage than to themselves than childbirth did! (That’s what happened to me!) A basic OB or Midwife visit isn’t assessing your pelvic floor health. Now, this doesn’t mean you can’t workout after being cleared from your doc – it just simply means that you need to be working out in a way that’s healing your pelvic floor and possible diastasis recti (the splitting of the abdominal muscles), instead of working out in a way that may prolong your recovery. (It also wouldn’t hurt to make an appointment with a pelvic floor specialist 6 weeks postpartum.)
I sincerely want to emphasize the dire importance of the mother’s healing after delivering a baby – whether vaginal or c-section birth. I’ve been trying to help women and men in the fitness / nutrition world for over a decade and after experiencing healing from childbirth, I’ve learned SO much more than I ever imagined I could about the woman’s body. All of us, (women and men) have these muscles (our pelvic floor muscles) that get ignored in the fitness world. (Yes, IGNORED. I’ve been teaching fitness classes for over 10 years and am certified in more than 10 core areas of fitness, and I’ve NEVER been taught ANYTHING about the pelvic floor.) And these muscles are usually the ones that are causing a lot of women to have low back pain when working out, incontinence issues – especially when running and jumping, and organ prolapse – even for heavy lifters who haven’t experienced childbirth! And when these muscles don’t get the attention they deserve, they get weaker over time and the conditions get worse. Especially for women who’ve given birth.
After laboring 23 hours and almost an hour and a half pushing with the force of a freight train to birth my daughter, I did in fact push out that large (8 lb) baby out of a small space – ha. I didn’t understand the depth of my damaged (or maybe non-healed) pelvic floor, however, until many months later when I tried to resume my normal workout routine.
Sure, I experienced that routine checkup at around six weeks postpartum. I was told that I wasn’t fully healed yet (I had some “stitches issues”) and to take it easy, and that I was basically cleared for yoga and light walking/stretching. When I felt better, I could start working out again. That was it. That’s all I was told. Everything else “looked fine.”
Unlike many women who are super into fitness, I waited almost five months before I headed back into the gym. I started doing CrossFit again, and because I had been doing a lot of power lifting for years before having my baby girl, I also wanted to resume heavy lifting.
My strength came back quickly and after only a few weeks of training, I was deadlifting over 250+ pounds and front squatting – I think – somewhere over 150 pounds. I don’t say this to sound strong or cocky – just to let you know what I “thought” was fine to do. If my body could lift it, I should lift it, right?
I remember deadlifting one day … I think I was trying to pull 265 off the ground. And I also remember that something just didn’t “feel right” in my pelvic floor area when I was straining to pull the weight off the ground. I mean, I had done this same thing for YEARS and had always been fine….here I was six months postpartum (assuming that was PLENTY of time for my insides to heal), and yet something felt off.
The next thing I knew, I was peeing when I was jumping rope. A little at first, but over time, it became a lot. And it started out just with jumping rope but the more I worked out the worse it got. I started leaking when box jumping AND running. I actually thought that the more I exercised, the better (or stronger) I would get. But nope – I was getting worse!
One of my mom-friends convinced me to seek out a pelvic floor physical therapist. She had been seeing a local PT – the same one another mom-friend recommended – so I decided (after a lot of hemming and hawing) that I should go as well. (I mean, I KNEW it was the right thing to do and was advocating this help for all mommas, but when it came down to MY own health, I was kinda freaked out to go.)
So I went. And it was seriously one of the best decisions of my life.
The first thing I learned from Dr. Brittany Wilmoth was about pelvic floor muscle atrophy. We all know that if “you don’t use it, you lose it,” right? In the fitness world, we’re taught that the older we get, the more muscle mass we start to lose if we’re not strength training. And muscle loss is the number one contributor to falls (and hip replacements) past the age of 65. So you’ll always find me trying to push strength training on my clients. It’s literally life and death!!
Well the same goes for the pelvic floor muscles. You know, the group of muscles I was never ever taught about until now. If we don’t properly train our pelvic floors, they lose the strength to hold our organs in place. I had weakened my pelvic floor during childbirth, and that power lifting I did (when my body wasn’t ready for it) didn’t strengthen my pelvic floor – it actually further weakened my pelvic floor muscles. (And no – strength training definitely isn’t the wrong thing to do – I just learned that I was bearing down on my pelvic floor (literally pushing it lower) – not learning how to brace it properly while lifting heavy things. This is one of those things you learn in pelvic floor PT.) And so the more I was running and jumping (read that as “POUNDING on the my pelvic floor”) the worse the condition was getting (read that as “the more I was peeing my pants”) because I didn’t know how to activate and brace those muscles properly.
We Can Strengthen Our Pelvic Floors!!
Brittany helped me realized that over time, without proper training, just like any other muscle, our pelvic floor starts to get weaker and we lose more and more control. This is why my ladies I train seem to have more incontinence issues the older they get. Especially ladies who have birthed babies! (C-section or vaginal – it doesn’t matter!) The pelvic floor only gets weaker over time. So we have to strengthen it just like all other muscles. A good pelvic floor PT teaches you exactly how to do this…and no, it’s not just by doing kegels.
I also learned from Brittany that after I birthed my baby, my muscles retracted back into place tighter than they should have. I’m not sure how to explain this other than saying, imagine you just did a hundred squats and your legs are super sore and the muscles feel tight. You need to stretch them, right? Well my pelvic floor birthed a baby (read as “it felt like I spent an hour front squatting 300 pounds) and my muscles were SUPER SORE/TIGHT post workout! 😉 Except, I didn’t know this, and I didn’t stretch them.
So for me, my muscles were too tight, and were sitting lower than they should have been – causing incontinence issues (among other TMI issues).
Here’s the thing I want you to get out of all of this: ALL OF THIS COULD HAVE BEEN AVOIDED IF I HAD JUST GONE TO A PELVIC FLOOR PT POST BIRTHING MY BABY!!!
And one more thing you need to get out of this article: It doesn’t matter how far postpartum you are – six weeks or 30 years – pelvic floor PT CAN HELP YOU.
Stop Feeling Like You Can’t Be Helped.
Most women feel doomed to pee their pants for eternity and honestly feel like physical therapy just won’t cut it for them. (Trust me, I’ve been working with these women for years. And you may be one of them!) Even I was one of those women. I thought I’d go in and hear the doc say, “You’re pretty screwed up and need surgery to fix this damage,” but I was amazed. AMAZED. After two sessions with my doc, I stopped peeing when I worked out. Other areas of my life improved, and it only took 8 sessions with her before I was released. EIGHT sessions and I was my old self again! I had put this off for over a year, and meanwhile it only took four weeks, two 30-minute sessions per week (read as ONLY ONE MONTH) of work to get me feeling right again.
Guys, if that isn’t encouragement, I don’t know what is.
So what’s the experience actually like?
I think this is why most women don’t seek pelvic floor help – like me, they just get freaked out by the idea of internal manipulation. The thing is, I’ve been to several gynecologists, I’ve seen several midwives, I’ve had a baby, and seeing my PT was not any more awkward than any of those moments. To be honest, it was probably the least awkward of all of them. I mean, I’ve only seen Dr. Wilmoth so I can’t speak for all PTs, but Brittany was absolutely wonderful. The room was comforting and inviting, low lights – not the bright hospital/doctor’s office type lights that glare at you, and Brittany was way friendlier than most doctors I’ve ever had conversations with. She listened to me and really “heard” all that I was telling her. She’s a mom too, and she understands not just the body, but the emotions, the fear, and she has experienced it herself as well! She completely removed all my fears from the situation and made me feel super “at home.” Well, as much as can be in this type of situation! Dr. Wilmoth and I chatted about kids and husbands, work and dinner plans, and anything else we had in common – all while she did her work. I laughed at stories she would tell me and I genuinely had a good visit – every single time I saw her. I like to think of my visits with her as “the most awkward experience that I didn’t mind attending” each week.
I Felt Better After EVERY Visit!
Do you know how you feel when you have a super tight muscle or back pain and you go and get a massage and feel SO MUCH BETTER when you leave? It’s pretty much like that. At least for me. I had tight pelvic floor muscles that were actually pulling on my low back (especially when I worked out), and Dr. Wilmoth worked to release the muscle/tension and that would actually transfer over to easing my back pain. Yes, it’s awkward, but it’s NOT painful, and every single time I left her office, I felt worlds better. I seriously think every woman needs a little pelvic floor therapy – learning about these muscles – how to control them, use them, brace them, strengthen them, and stretch them – this is beyond useful stuff!!!
Pelvic Floor Physical Therapy Even Helps Low Back Pain!
Like Dr. Wilmoth tells all her patients, “Everything is connected, from the nipple to the knee,” so when you have issues within those areas, it could in fact be tied to pelvic floor issues. And I’ve found that from working with women for over 10 years, many women who’ve had children struggle with low back pain – no matter what they do, how much they stretch, or who they see to try and fix it. According to Dr. Wilmoth, 85% of all low back pain can be fixed externally, but 15% of cases (such as mine) are connected to internal pelvic floor work. Every time I work with a mom who has low back pain – I now refer them to pelvic floor PT. I’m even happy to report that as I now enter my second trimester with my second baby – my low back actually feels pretty good!!!
It’s Time to Stop Normalizing Discomfort and Things Like “Peezing” (peeing when you sneeze).
Our pelvic floor muscles are not muscles to ignore and just succumb to saying things like “Oh I had kids so I pee when I sneeze now,” like it’s no big deal and not an issue. Ladies – this is SO fixable. Our society is awesome at normalizing these things and making funny mom memes about it, but what if we worked to reverse this “norm”? How about normalizing postpartum pelvic floor health and spreading the word that peezing doesn’t have to be an issue anymore?? You know what else our society is really good at doing? Standing up for women’s rights. I hate to get on a pedastool here but ladies, it is YOUR RIGHT to be able to obtain proper care and treatment postpartum. If we’re going to stand up for all the things we deserve, it’s about time our bodies get the credit for what it’s capable of – growing and birthing HUMANS – and we more than deserve a little TLC, education, support, and physical therapy in order to continue to be the awesome women that we are.
You don’t have to go to the gym and pee when you jump or run.
You don’t have to return to exercise 6 weeks postpartum without a clue on how to activate your pelvic floor.
You don’t have to feel embarrassed about your issues.
You DO deserve proper care and treatment.
If you’re lucky enough to live in the beautiful Shenandoah Valley, you HAVE to go see Dr. Wilmoth. Her office is Valley Pelvic Health & Physical Therapy, located in Staunton, VA (only about 5 min off of I-81) and her friendly personality will make any awkward scenarios as comfortable as they could be. Follow her on Insta at @brittanyswannwilmoth.
I’ve personally gained so much strength from my sessions with Dr. Wilmoth, but more than that, I’ve gained knowledge and wisdom and the ability to pay it forward. So if you’re reading this still – chances are you may just need a visit with a pelvic floor PT. If you struggle with incontinence, diastasis recti, or any type of pelvic floor / vaginal / low back discomfort – you OWE it to yourself to find a specialist in your area and make an appointment. I PROMISE you it will be worth it. And honestly, what could it hurt?? Nothing!
Let’s do this ladies. Let’s heal our pelvic floors and turn around the stereotype that just because we’re moms we have to succumb to pad-wearing, pants peeing, embarrassing discomforts that get in the way of life. We GIVE life to humans — we shouldn’t have to comprise our own lives anymore!
People to Follow to Learn More:
If it weren’t for Dr. Brittany Wilmoth, I wouldn’t be heading into my second pregnancy aware and taking charge of what I need to do this second time around. Follow her and these other women who teach me something new EVERY.SINGLE.DAY.
- Dr. Brittany Wilmoth, PT, DPT @brittanyswannwilmoth
- Dr. Sarah Duvall, DPT CPT @drsarahduvall
- Expecting & Empowered, @expectingandempowered
- Tracy Sher @pelvicguru1
- Marcy Crouch, PT, DPT, WCS @thedowntheredoc
- PelvicHealing.com PT @pelvichealing
- Sara Reardon PT @the.vagina.whisperer
And Don’t Miss This Opportunity!
If you’re local to the Shenandoah Valley, Dr. Brittany Wilmoth is coming to my bootcamp (StrongFigure Bootcamp in Harrisonburg, VA) to do a FREE pelvic floor talk with my members. If you’re interested in coming to this event, please click “Attending” on this FB Event Page! This event will give you a chance to talk with Brittany, ask questions, even be assessed for diastasis recti.