DO I NEED POSTPARTUM PHYSICAL THERAPY?
MILLIE SCHWEKY PT, DPT, CPT
CONGRATULATIONS! YOU HAD A BABY. YOU READ ALL OF THE BOOKS ABOUT WHAT TO EXPECT WHILE YOU WERE PREGNANT, YOU WENT DOWN THE RABBIT HOLE OF YOUTUBE VIDEOS PREPARING YOU FOR LABOR AND DELIVERY, AND PERHAPS YOU EVEN TOOK CLASSES WITH A DOULA. NOW YOU ARE MOVING ON TO BABY BOOKS AND PREPARING YOURSELF FOR THE EXCITING CHALLENGE OF PARENTING. THIS IS ALL AMAZING AND YOU ARE GOING TO BE THE BEST PARENT FOR YOUR CHILD.
While many women take the initiative to educate themselves on these topics, it is less common that we learn about what to expect during the postpartum period, commonly categorized as the first year after giving birth. Due to the shortfall in postpartum education, most women have questions about what feels normal after giving birth. We go to our six-week check-up and get the “all clear” for activities such as exercise and intimacy, not knowing that things are probably going to feel a bit different.
The female body can take up to eighteen months to fully heal from the miraculous trauma that is pregnancy and childbirth. Growing a mini human is taxing, and can change the body, permanently in some cases. This is where a pelvic floor physical therapist can help. What most people don’t know is that there are physical therapists who specialize in treating the pelvic floor, a muscle group located inside of our hip bones, which have a lot of different functions. These include bowel and bladder control, core stability, organ support, circulation, and sexual function. This muscle group is very important because it is the bridge between the muscles of our hips, core, and back, and has a direct impact on how our bodies perform. Pelvic floor muscles are just like any other muscle in the body. They can be weak, tight, injured, or overused. This means they should be treated just like any other muscles, with proper care and attention.
While pelvic floor therapists can treat a wide variety of diagnoses, one patient population that we commonly treat are women who are pregnant and in the postpartum period. Have you ever had one of the following thoughts?
“I was taking an exercise class and I completely leaked through my leggings, I’m embarrassed to go back.”
“My core feels so weak and my stomach is pooching out. No matter how hard I work out and eat right, it will not change. I feel like my body is broken.”
“When I do my errands I feel like there is something falling out of my pelvis, and it gets worse when I use the restroom.”
“My husband and I are frustrated because we can’t be together the way we used to before we had kids. I wish this pain would just go away.”
While these issues are common, it does not mean that they are normal. Because the female body was designed to carry and give birth to babies, it is easy to assume that the aches and pains that come along with it are just a part of the process. Oftentimes, these common complaints and discomforts can be resolved through a series of pelvic floor therapy visits.
Let’s focus on my patient, Sophia. Sophia came into the office five months after having her second child. She was experiencing leaking urine every time she coughed, sneezed, laughed, or jumped. She was also concerned about the bottom of her belly which seemed to cone when she did exercises, resulting in a “mom pooch.” After evaluating her, we found what we needed to work on in order to get rid of her symptoms. Sophia was dealing with stress urinary incontinence (urinating during certain activities) and diastasis recti (a separation between her abdominal muscles) since she had her first child, and was finally getting the help she needed. After six weeks of consistent visits, Sophia learned how to breathe in an optimal pattern, she improved her posture and muscle strength, we worked on stretching and relaxing the muscles that were tight, and she adapted to doing core exercises with proper form. Sophia is no longer scared to laugh with her friends in case of a leak, is starting to go back to dance cardio classes, and is able to wear fitted clothing without worrying about her belly sticking out.
It is important to know that there is help available and that there are many women who have been able to resolve their symptoms through working with a pelvic floor specialist. When it comes to these conditions, you may be embarrassed to talk about them. It is very common for people to be disconnected from this part of the body as it is an extremely personal area. Because of this, pain and dysfunction in this region can be easier to ignore than to focus on. We owe it to ourselves to get the help we deserve. Patients have a lot to gain from trying pelvic floor PT, as it poses less risk than surgery or other medical treatments.
If you are experiencing any of a following, you may benefit from pelvic floor physical therapy:
• Urinary, fecal, or gas leakage while laughing, coughing, sneezing, or jumping.
• The sudden urge to use the restroom.
• A visible separation between the abdominal muscles, or “mom pooch.”
• Pain during intimacy.
• The feeling of something falling out of your pelvis.
• Scar pain after a C-section or vaginal birth.
There is no need to suffer in silence. You can take charge of your health and well being, and live the life you deserve. Pelvic floor PT can help you transform into your best self and improve quality of life. Reach out to a pelvic floor specialist to help you get back to feeling and looking like the best version of yourself.
Millie Schweky, PT, DPT, CPT is a doctor of physical therapy specializing in pelvic health for women. She practices at Forward Physical Therapy in Brooklyn, NY. As a runner, strength trainer and mother, Millie understands what it takes to return to safe exercise after giving birth and is passionate about helping her patients return to their favorite activities as quickly and safely as possible.
