Bladder control, sexual dysfunction, pelvic and lower back pain are common symptoms of pelvic health issues. But pelvic health shouldn’t be something we think of only when there’s a problem. Being proactive about pelvic health can help to avoid many long term problems. For expectant mothers, working on improving pelvic health during pregnancy can not only help during labor and delivery, but also in the postpartum period.
Find out more about the Train4Birth program from Dr. Monika Patel DPT, CSCS and how you can improve your pelvic health during pregnancy.
When my employers first asked me to specialize in pelvic health, well, I wasn’t so sure. At the time, I’d just finished my year-long orthopedic fellowship through the Institute of Advanced Musculoskeletal Treatments (IAMT) with some of the top manual therapists in the country.
All these thoughts and reservations went through my head- I didn’t want to specialize “too soon.” I’d just finished with 4 years of intensive learning and I wanted a “break.” I didn’t want the “emotional strain” I’d heard about when working in this field. I didn’t know exactly what it would involve. And, I was really super-super shy about anything remotely reproductive related and didn’t think I had the courage to talk to people about it.
So, I politely declined for 2 years and continued on with my mostly orthopedic caseload.
Until, I felt a pull.
Do you ever have those moments where something just keeps re-occurring in your life until, finally, you listen?
It was like that with pelvic health in my career. I decided to listen to what my employers had to say about how my skills might match the field they patiently had in store for me. There are so many times that we have to make decisions for ourselves or our families that we aren’t always sure of, that it felt almost nice to have a professional track with mentorship and guidance presented promisingly.
So, I decided to shadow a pelvic health therapist and was really amazed at all she knew and what she could help people with that literally no other healthcare provider could. Even midwives and OBGYNs don’t necessarily know the pelvic floor musculature by name or how movement or pregnancy truly affects the pelvis.
The therapist I shadowed did an internal mobilization of a soccer player’s coccyx that had gotten dislocated with a harsh fall. That teenager was unable to walk in the clinic herself without a wheelchair, never mind play her favorite sport, and was able to walk out of the clinic, independently, and pain-free following the 2 minute mobilization.
I was hooked.
As soon as my year long-training commenced, I was able to help people who’d had incontinence for 20+ years. I helped people who had stopped going out to have dinner with friends for fear they’d laugh too hard and leak regain confidence, control, and strength and actually join a supper club.
I was able to help men who’d been catheterized after prostate cancer regain their ability to pee again independently (which is linked to pride).
I was able to help a mother who had sustained a grade 3 tear during delivery of her baby heal postpartum without a trace.
And, just as my employers predicted, I loved it.
It felt refreshing, rather than daunting, to talk about the things less talked about and topics often ignored for far too long in the medical world. So, I decided to delve into another yearlong program in pelvic health. The pelvis really is such a keystone to the entire body’s musculoskeletal system that it started to seem negligent to ignore approaching any and all patients with this knowledge.
Sure enough, not only did the people I could serve expand, but the rate at which I was able to get anyone with, for example, low back pain better greatly improved. The body is so interlinked and if you, our your healthcare team, ignore the pelvis, that’s like running a race without ever tying your shoes.
What Does a Pelvic Health Physical Therapist Do?
You might wonder what else a pelvic health physical therapist knows or could help you with. Here’s a quick glimpse:
- How to help prevent, identify, and treat the three (really four) main kinds of incontinence: stress, urge, frequency and/or a mixture of any of the above.
- How to help protect and activate the 4 muscles that make up the deep core so that they all work together with good and almost subconscious coordination to avoid.
- How to palpate all the ligaments and the 35 muscles that attach to the sacrum.
- How to palpate and check function of all 3 layers of the pelvic floor.
- How to assess the pelvic floor for internal trigger points.
- How to teach people good bowel, bladder, and sexual function habits.
- How to care for the pudendal nerve, the nerve that extends out from the sacrum and is in charge of innervating bowel and bladder structures.
- How to make pregnancy, both pre and post partum, a much less fear-based experience.
Gosh, and so much more.
When it comes to postpartum care, countries like France literally subsidize what they call “perineal re-education”. (There’s a great essay by write Claire Lundberg called “The French Government Wants to Tone my Vagina”) because they know that even if women feel okay after birth, the inhibition of their pelvic health during pregnancy can cause (expensive and timely) issues down the road. So, it’s better for the overall healthcare system to preventatively invest in helping women heal properly postpartum than it is to wait until they are in their 40s, 50s, and 60s when gravity + pelvic floor sleepiness has already taken its toll and it’s much harder to fix.
I would take it a step further when it comes to preventative healthcare, and say that all women should have the opportunity for their body to be assessed for potential risk factors for ANY musculoskeletal condition from an early age…(but, that’s another blog topic).
Improving Pelvic Health During Pregnancy
Pregnancy is a sweet spot in women’s’ healthcare journey. It’s a time where women are often extra motivated to create healthy lifestyle habits and change. It can also feel really empowering to care for yourself while pregnant. All expectant mothers should work on improving their pelvic health during pregnancy.
This is exactly why Train4Birth, the deep core exercises + education+ accountability/support program was born. It’s essentially the equivalent of having a PT (virtually) by your side throughout your entire pregnancy for $188 dollars. That’s a tremendous value –when the average cost of incontinence in the US is approximately $900 per person annually.
Plus, when it comes to resource management:
1) It can be easier to afford pelvic health care before you take (usually un-paid) maternity leave.
2) The cost of Train4Birth, which includes the information usually covered in about four in-person PT sessions, which would be about $600, is 1/3 of that cost.
3) It’s VERY hard to find time for self-care with a newborn. With the ability you start Train4Birth starting at any stage of your pregnancy gives you a jump start.
4) Plus, if you are all “tuned up” and the healthiest version of yourself going into labor, you’re less likely to experience instrument assisted birth or complications you have to deal with down the road.
There are a lot of premade pregnancy recovery programs out there, but, because all of our bodies are unique and what helps us truly recover will depend on a deep understanding of your individual movement history, your anatomy, and your specific connective tissue I’m a bit leery of any program that doesn’t also include a listening ear.
Regardless of how you decide to care for your body, mind, and soul, I just want to encourage all women that the pelvic floor and deep core is an essential part of our health. To care for your pelvic floor is to care for both your present day and future self.
Dr. Monika Patel is a mom + DPT + fitness pro + environmentalist + lover of all things peanut butter. I love making people’s Birth-Days extra special and have to reign in my tendency to dream about RV life. I love to hear people’s stories. I don’t love to cook. My car usually has crumbs on the bottom of the floor. And I hope to make even just a tiny dent in improving the world.
Feel free to reach out with questions or thoughts at firstname.lastname@example.org