Pelvic Floor PT: What it is and What to Expect

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Pelvic floor what?! If it wasn’t for my background as a yoga teacher and doula, I would have no idea what the pelvic floor is, let alone where to find it. So, before we talk about pelvic floor therapy lets clear up any confusion.

The pelvic floor is the group of muscles between the tailbone and the pubic bone. It supports the bowel, bladder and vagina. It is also connected to the proper functioning of the hips, pelvis, lower back and abdomen. The “core”, for instance, includes the pelvic floor.

Over the last few years, it seems like it’s become more common to hear about pelvic floor therapy, but I’ve found it’s still pretty common for a lot of mamas to be a little unsure about what to expect, so I thought I’d share with you my experience with pelvic floor therapy.

XO,

Emily

What is it?

Pelvic Floor Physical Therapy is a specific type of physical therapy (PT) designed to work on a variety of conditions related to the pelvic floor and the other regions of the body connected to it.

Women of all ages will utilize this type of PT, but you’ll find it most commonly used around childbirth – both in preparation for and healing afterward. 

I struggled with a condition called diastasis recti, where my abdominal muscles separated during pregnancy. Other common reasons would include pain during sex or in the lower back/hips/pubic bone regions, leaking & incontinence, weakness or being overly tight in pelvic floor muscles, bladder or bowel issues, organ prolapse and even general wellness.

Although every therapist will be different, here’s an idea of what to expect when you go.

Breathing

In pelvic floor PT, I started with the breath first. My doctor explained that I need to be able to take proper inhalations and exhalations in order to practice the exercises she would give me.

In this case, I used my breath to relax and engage my pelvic floor and abdomen, as well as to engage muscles for proper posture. 

My second PT session started with me standing in front of the mirror and breathing to watch where my breath was in my body and redirecting it to my abdomen.

Another common practice is to do kegels with the breath so that you are activating the pelvic floor during breathing.

My doctor said a lot of women are surprised to find that a great deal of their session is dedicated to working on the breath first before introducing any movement.

It can be hard to surrender to a session where I “don’t get much done,” but I reminded myself how important the breathing component is first. This is your first step in the healing process and will prove to be the most effective.

Physical Therapy

The physical therapy component here consists of targeted exercises that vary depending on your condition, as well as other healing modalities like massage, stretching, hands on adjustments and increased postural awareness. 

Most of the time with pelvic floor PT, techniques will work to strengthen the transverse abdominal (while doing those breathing kegels), which runs around the torso like a belt.

This could look like something as simple as laying on your back on the floor with your knees bent and squeezing a ball between your legs.

Massage and stretching would likely focus on areas of the low and mid back to loosen those muscles that take the extra burden from the weak abdomen and pelvic floor.

Mom hack: Be sure to wear comfortable clothing that allows for freedom of movement. Avoid rompers or jumpsuits in the event that you need to access your back or abdomen for any massage.

Internal Exam

Although an internal exam isn’t typically the first thing done at pelvic floor PT, it is something to be aware of.

There is really no other way to make an accurate assessment of the health of the pelvic floor without feeling and seeing.

To perform an internal exam, you’ll lay on your back with your knees apart and your feet together.

First, a visual assessment of the pelvic floor and regions surrounding it like the vulva, clitoris, opening of the vagina and anus will be performed.

Then, with a gloved hand, the therapist will insert one finger up through the opening of the vagina and complete an internal exam by moving their finger along the pelvic floor muscles. They may also ask you to relax or tighten the muscles while inside.

This may seem awkward and uncomfortable, but just like any other part of the body, my doctor explained that she needs to see it and feel it to get a better sense of what’s going on and how it can be helped.

And don’t worry, it doesn’t happen every time! Generally, once in your first couple of sessions and possibly in later sessions to assess progress.

Making the Appointment

Ready to make that appointment now? Whatever your situation might be, I think pelvic floor PT is a must. Keeping your pelvic floor healthy is crucial to your overall health and body wellness.

Here are my top 3 favorite therapists in the East Valley:

Looking for more recommendations on postpartum care and doulas? Check out our recommendations here.

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Just relocated from Los Angeles in 2019, Emily now lives in Tempe with her husband, toddler son, Oskar, her four furry babies and the baby on the way (due in April 2021). Coming to Arizona only weeks after the home birth of her son, she's just now finding her tribe (and favorite spots!) in the East Valley. Although mostly a stay-at-home mom, Emily still works with a small number of clients as a prenatal yoga teacher, birth doula and most recently expanded her business as Clean Beauty Consultant with Beauty Counter in anticipation of her second son's arrival, adjusting her work to fit more with motherhood. She is passionate about clean, healthy living and supporting women in having happy and empowering lives. Emily loves to relax and steal moments of self-care after bedtime by reading good books, enjoying a great show or turning her bathroom into a spa for the night. You can almost always catch her out a park pre and post nap-time chasing after her very active toddler.

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