“You look great! You’re all cleared and can resume your normal activities!” Have you heard this before? If you were referred to a pelvic floor physical therapist after having a child, hats off to your provider! *Clap! Clap!* Many women wonder when they should see a pelvic floor physical therapist, and many don’t even know they exist!
At her 6 week check up following the birth of her second child, a mama reported to her provider that she didn’t have any issues and felt great. Her provider said everything looked great and she could go about her regular activities, start having sex if she’d like, and that she didn’t need a further appointment unless she felt she needed to.
Going back to her first pregnancy, she had occasional low back pain. One day while bending over to pick something up off the floor, her back went out putting her out of commission for several days. She also had significant SI (sacroiliac) joint pain. All of which she attributed to pregnancy. She saw a physical therapist, but one that did not specialize in pregnancy/postpartum. When she finished her OB appointments, her OB would extend a hand to help her sit up and would notice a line down her belly that would pop up. She asked the doctor what this was. She said it was normal and not to worry about it.
Fast forward to after baby #2. Mom started running to train for a 5k and had groin pain and significant pubic symphysis pain, to the point she couldn’t scoot a shoe over with her foot without excruciating pain.
Could these symptoms have been avoided? Most likely.
That mama was me! I had gone through so much during my pregnancy and postpartum period and had no idea that these things shouldn’t be happening. No one told me!
I’m sharing this brief part of my story to tell you that the above issues are common, but do not need to happen. It could have all been prevented or significantly reduced during my pregnancy and after, had I known to see a pelvic floor physical therapist postpartum. I could have avoided these issues and prevented future issues I would have!
So when should you see a pelvic floor physical therapist during pregnancy and postpartum?
- The earlier the better – this is to start preparing your body to be ready to carry a baby and all the changes that are about to occur, to prevent injury or pain, and ease discomfort.
- It’s great to learn how to prepare your perineum, how to push efficiently, and what positions are optimal for you during labor and delivery when your in your third trimester.
- Pain – Neck or upper to lower back, hip, pelvic pain (SI joint/pubic pa
in), belly button or abdominal pain
- Peeing all the time, or leaking a little bit (or a lot)
- Heaviness or feels like something is falling out of your vagina
- 6 weeks after birth (or even consider having a check in with your pelvic floor physical therapist within the first couple weeks via telehealth)
- Pain – Neck or upper to lower back, hip, pelvic pain (SI joint/pubic pain)
- Peeing all the time, or leaking a little (or a lot), or difficulty peeing (pushing your pee out, stopping and starting urination, pain)
- Pain with Sex
- Heaviness or feels like something is falling out of your vagina (Prolapse)
- Constipation or Bowel leakage
This list is not exhaustive, yet covers a majority of issues you should be aware of and know there is hope for you!
We, collaboratively, as a profession are urging providers and moms to refer to pelvic floor physical therapists during pregnancy, especially if there is pain involved, but always after childbirth – vaginally and caesarean.
Be your own advocate and ask to see a pelvic floor physical therapist. Even if you aren’t having any issues, you will be helping yourself in years to come from issues like incontinence, back pain, prolapse, pain with sex, and pelvic pain. Be proactive, not reactive. Just think about why you exercise. You may run to be healthy, but we know that it helps to prevent heart disease, among other comorbidities. We can do the same for our core and pelvic floor.
A pelvic floor physical therapist specializes in treating pelvic floor dysfunctions by assessing your pelvic floor muscles to see how they are functioning. In addition to this, they are also assessing how you move in general, your breathing pattern, abdominal and hip musculature, as well as your back, hip, and pelvic mobility. There is a lot that goes into an initial assessment and your treatment and plan of care will depend on your goals and physical examination findings.
If you have not seen a pelvic floor physical therapist and are thinking it’s too late…please know it’s not too late. There is hope for you! We often hear from women that they are going to wait until they are done having children, however, we recommend not doing so. You may be able to prevent future issues and have better pregnancies and deliveries by being proactive.
Please share this message with other mamas you know as we need to normalize going to see a pelvic floor physical therapist and want to help you live the best life possible!