Becoming pregnant is an amazing process. The body is an incredible machine where at the successful end, you have actually made a human being. For the woman and her body, it is a fantastic journey. It can also be incredibly nauseating, incredibly sweaty, incredibly uncomfortable and maybe even downright painful. Many musculoskeletal pains and problems can appear. New Dimensions Physical Therapy is here to help!
Nothing is “normal” or “easy” about being pregnant.
As a physical therapist, and specifically a pelvic health therapist, our opinion is that every pregnant/postpartum woman should be evaluated by a pelvic health physical therapist after the 6 week check up with her delivering obstetrician or midwife.
What happens internally as a baby grows inside your body?
Your organs are all shifted, creating pressure everywhere. Your ribs expand significantly, your breasts engorge, your upper body posture changes creating significant pressure at the low back, bladder and perineum.
The extra weight being carried creates extra pressure to our hips, knees and feet.
The feet can expand up to one width and one full size during pregnancy that may not return to its previous during the postpartum period.
Is it worth it? Absolutely!
However, there is an astounding lack of information guiding the pregnant and postpartum woman on how to take care of her own body.
You may have many questions that your doctor just won't or can't answer, like:
How can I get rid of that rib flaring and return to my old bra size?
How can I get relief from that neck and low back pain that improves as I move around during the day, but seems to be chronically part of my life now?
Will this hip, knee and foot pain ever go away?
My episiotomy (or C Section) scars still hurt, even though my doctor says they have healed.
What about the urinary leakage? Will my pelvic floor muscles ever regain their strength?
Perhaps you may be experiencing pelvic organ prolapse from the downward pressure of the bladder, uterus and rectum. Who is in charge of rehabbing these muscles and watching for prolapse prevention?
Who can I discuss all these issues with, when my ObGyn tells me everything is “normal”?
The Pelvic Health Physical Therapists at New Dimensions PT!
Specific pelvic floor muscle strengthening is not happening during your spinning, Pilates or yoga class. Bo, a research physical therapist, in 2015 determined that the only exercise that can get your pelvic floor stronger is specific pelvic floor exercises. There is some carryover when going to the gym, but you can’t be sure if you are strengthening your vaginal pelvic floor or maybe it’s actually your rectal pelvic floor muscles that are contracting. It is difficult to distinguish which muscles are actually kegeling (or contracting) as you cannot really feel the difference or separateness of each compartment, however, an assessment by a pelvic health physical therapist can shed some light on which muscles are actually working. The muscles can be continuous from one opening to the other but the “compartments” (anterior or front for vaginal and posterior or back for rectal) have different purposes and each may function independent or compensate for the other. Patients who have had a long birthing process (long stage 2 labor), or a lot of stitching, or and still have a tender episiotomy tear can have muscle compensations within their pelvic floor muscles and not even know it. It would be the same as rehabbing your quadricep muscle after falling down the stairs, sustaining a tear, having it surgically repaired, and then never going for physical therapy or rehabbing it in some way. Episiotomy scars need attention and care. They may need some soft tissue work or manual stretching because scars get tight while they were healing. So why would the pelvic floor muscles be any different? They have expanded and lengthened, may have slightly torn, be stitched up and they need rehab! Pelvic health therapists specialize and take extra continuing education about special conditions along with pelvic muscle training. Some gynecologists are assessing pelvic floor muscle activity, but for the most part they are looking for pathology/disease/infections/birthing babies - and they are dealing with those important things. Physical therapists deal in musculoskeletal and neuromuscular problems.
You can gain good information by reading our blogs, watching our physical therapy tweaks on basic gym exercises in our video sections but nothing replaces a physical therapy consultation and personalized care. Seeking the care of a pelvic health physical therapist can be of great benefit throughout your entire life. Just a few visits can make a huge change in how you feel which can reactivate muscles that forgot how to work and can change compensations of inappropriate muscle firing. These muscles normalize bladder and bowel continence and increase sexual satisfaction.
Come visit us at New Dimensions Physical Therapy offices or have us visit you in the comfort of your own home.