You are pregnant and you leak urine when you cough or sneeze. You ask your medical provider about it and they tell you that’s a normal part of pregnancy and there’s nothing you can do about it.
You are a couple months postpartum and are having pain with sex. Your medical provider tells you to just have a glass of wine and relax.
What are these two medical providers failing to tell you? That in both of these situations, there is help, and you don’t have to live with these symptoms!
Pelvic Floor Physical Therapy
As a pelvic floor physical therapist, I can’t tell you how many times my patients have told me they didn’t know pelvic floor physical therapy exists or that there is treatment for their symptoms.
I am here to tell you: Help is available for all pregnant and postpartum women!
Common Issues
Here is a brief description of common pregnancy related issues that can be treated with pelvic floor physical therapy.
Round ligament pain:
You have two round ligaments in your body, one on each side. The round ligament functions to support the uterus. During pregnancy, the round ligament stretches which can cause sharp, jabbing pain in the groin area on either side of your body.
Your pelvic floor physical therapist can provide myofascial release to the muscles surrounding the round ligament, gentle stretching and strengthening to reduce this pain.
Diastasis pubic symphysis (SPD):
The pubic symphysis is the joint that connects your two pubic bones at the front of your pelvis. During pregnancy, laxity of the ligaments that support the pubic symphysis can cause pain and instability in this area. A pelvic floor physical therapist can give you exercise/movement modifications and gentle strengthening to help improve stability and reduce pain in the pubic symphysis during pregnancy.
Sacroiliac joint (SIJ) pain:
Your SIJ connects your tailbone to your hip bones in the back of your spine. This joint can also become lax during pregnancy due to weight gain and postural changes. Your pelvic floor PT can give you postural adjustments and perform gentle joint mobilizations to help reduce SIJ pain.
Urinary incontinence:
The growing baby inside of you adds extra pressure to the bladder and pelvic floor, which can contribute to leaking with activities that increase intra abdominal pressure such as coughing, sneezing and running. This is also very common postpartum, but don’t let anyone tell you that it just comes with having babies, because that is not true. Urinary incontinence can be mitigated by learning how to manage pressure with a pelvic floor PT.
Pain with sex:
Pain with sex is never normal but can be common during pregnancy and postpartum, especially if you are breastfeeding (usually due to decreased estrogen).
Labor and Delivery Preparation:
You also don’t have to have anything wrong to see a pelvic floor PT! A pelvic floor PT can prepare you for labor and delivery preparation to optimize your birth. This includes labor positions, pushing and breathing techniques, and perineal massage to reduce the risk of tearing. Did you know that you don’t have to deliver while lying on your back? Your pelvic floor PT can tell you more.
Postpartum, a pelvic floor physical therapist can treat diastasis recti (separation of the abdominal muscles), pelvic organ prolapse, urinary incontinence and C-section scar mobilization. Mobilizing any scar areas is important to help optimize the function of the abdominal and pelvic floor muscles. Scar tissue in these areas can reduce muscle function.
Additionally, your pelvic floor PT can help with core and pelvic floor strengthening and return you to exercise safely. Your abdominal muscles have been stretched for 9 months and your pelvic floor stretches 1-3 times its resting length, so it’s extremely important to rehabilitate both of these muscle groups after having a baby, regardless of delivery method.
Time for Treatment
So the next time someone tells you it’s normal to pee your pants when you jump on a trampoline after having kids, you now know that although this is a very common symptom, it is never normal and treatment is available.
