My Journey to Pelvic Floor Physical Therapy

When passion meets profession, it is awesome. Over the past couple years I have become passionate about treating women with pelvic floor issues, especially during pregnancy and postpartum. As a physical therapist, and a mom of two young children, I’ve not only experienced my own pelvic floor issues, but have had the privilege of treating women with theirs. Treating the pelvic floor is a unique specialty in physical therapy. Let me tell you about my journey.

Pregnancy #1

My husband and I were so excited to be pregnant with our first child. I did tons of research on how to care for a newborn. We got the baby’s room ready, bought all the clothes and took all the classes. I couldn’t wait for her to arrive! That’s it, right?

Like most moms, by the end of pregnancy I was quite uncomfortable and ready for the baby to arrive. My excitement exceeded any nervousness regarding labor and delivery. I got an epidural – pain during labor was very tolerable. Then it came time to push. The staff helped me onto my back. It was then I realized I hadn’t done any research on labor and delivery! No one ever educated me on how to push. “Just push like you’re pooping,” the nurse told me. But what exactly did that mean? It seemed like the wrong time to be trying to figure this out!

I pushed for 3 HOURS. It was discouraging and exhausting to push for that long. It felt like the biggest workout of my life. I was lying on my back that whole time, and didn’t know I could try other positions. I thought that everyone gave birth on their back, especially if you had an epidural. After what felt like a very long time, I finally got her out! Hazel Noel had arrived!

My Pelvic Floor Pain

Once the epidural wore off, I realized I had pretty significant tailbone pain. That pain even overpowered any perineal discomfort from stitching up my third-degree tear. As my body recovered, my tailbone pain was not getting much better. I asked a few of my physical therapy friends for tips. I did some stretching, and one of my friends dry needled my hip muscles. Finally, after about 6-7 months, my tailbone pain gradually went away. A long time to endure pain that might have been lessened or eliminated had I known proper labor and delivery techniques.

Knowing what I know now, I would have diagnosed myself with a tight, or hypertonic, pelvic floor. During labor and delivery I did not know how to relax and lengthen my pelvic floor. Instead of relaxing my pelvic floor muscles to allow my uterus to push my baby out, I was forcefully bearing down into a tight pelvic floor. My pelvic floor muscles were then very angry for a long time. I definitely should have seen a pelvic floor physical therapist.

Pregnancy #2

While I was pregnant with my second child, I knew I wanted a different labor and delivery experience. I equipped myself with research on the pelvic floor, labor, and delivery. My pelvic floor physical therapist friends gave me tips on positions and breathing. I wanted my experience to be better!

I spoke with my OB ahead of time about laboring and pushing in different positions – specifically lying on my side or on hands and knees. The plan was still to get an epidural. I knew that I needed to try different positions that would allow my pelvis, especially my tailbone, to be mobile as I gave birth. My OB was very open to it and even wrote my position preferences in my chart, just in case a different doctor had to deliver my baby. Our conversation empowered me to voice my opinions during labor and delivery on what was going to work best for me.

Judah James arrived much more quickly! I only had to push for 20 minutes – I lied on my side, relaxed my body, and breathed as I pushed. There was no pain afterwards, and I barely tore!

My Pelvic Floor Weakness

I was so excited at how much better I felt immediately after having my son. No pain, no difficulty having bowel movements (it was horrible after having my daughter), and I could move around so much more easily. Now, however, I had a lot of difficulty performing Kegels and felt so weak. It took me several weeks until I was able to perform a Kegel. Even then I couldn’t get a very good contraction and wasn’t able to hold it for more than 1-2 seconds.

I worked a lot on my pelvic floor, core, and hip strength over the next several months. About 6-7 months postpartum with Judah, I felt ready to get back into running. I slowly progressed my running speed and distance. No leaking or heaviness, and I ran my first postpartum race!

About 10 or 11 months postpartum, I dropped in for a workout at a local gym. The workout involved much more jumping and hopping than what I was used to. For the majority of the class I felt like I was going to pee my pants! It made me so anxious the entire workout. After that, I knew my pelvic floor strength was not where it should be. Time for this physical therapist to get some physical therapy of her own!

My Pelvic Floor Physical Therapy

I began seeing a friend of mine who is a pelvic floor physical therapist. She was able to assess my pelvic floor – something that I really couldn’t do myself. As suspected, I still had pelvic floor weakness, especially in the backside of the pelvic floor. She guided me in strengthening my pelvic floor, legs, and core, worked on tightness in my scar, and progressed me through some plyometric exercises (jumping, hopping). Fast forward a few months and that feeling like I was going to pee my pants during jumping is barely existent! (I have a little bit of work to do yet, but the progress is encouraging.)

My Passion for Treating the Pelvic Floor

Seeing how smoothly my labor, delivery, and postpartum recovery went with my second child made me a little frustrated – why did no one educate me about what to do the first time? I saw my OB more times than I can count during those 9 long months of pregnancy. My husband and I took the 2 birth prep classes through the hospital. I thought I was prepared. The focus, however, was primarily on the health of the baby, but not on the preparation for delivery. Delivering a baby has been likened to running a marathon. No one would run a marathon without training!

I realized this is an area that is very lacking in the traditional healthcare system. Most women are not coached on how to prepare their body for labor and delivery and then actually how to labor and push. Furthermore, what to do postpartum. Often we are left to figure things out on our own. Many women with leaking or heaviness postpartum are told that it is just a normal part of life after having kids. But it is not!

This sparked my passion in learning more about the pelvic floor, pregnancy, and postpartum care so I could help fill this gap. I want women to feel empowered with knowledge so they have a comfortable pregnancy, successful labor and delivery, and easy transition from 4th trimester back to their daily activities and exercise of choice. If you are interested in preventing or solving pelvic floor issues or want to have a pleasant labor and delivery experience, I would love to help!