There’s something women don’t talk about nearly enough and—yes—it has to do with the area “down there.” No matter where you are in your parenting journey, from trying to conceive to celebrating a 2-year-old kid, learning about and discussing your pelvic floor health is important. Read on to learn more!
A pelvic floor specialist is a physical therapist who is trained to address issues with the pelvic floor muscles—the muscles that support the uterus, bladder, and colon. Some problems that arise from weak pelvic floor muscles are:
Urinary and fecal incontinence
Back pain during and after pregnancy
Pelvic organ prolapse
Pain using tampons
Diastasis recti (separation of the rectus abdominum)
It may seem odd to address pelvic floor issues prior to getting pregnant, but it’s something to think about. A pelvic floor specialist can help women rehab after sexual trauma, pelvic surgery, or issues relating to pelvic floor dysfunction such as difficulty controlling urine and bowel movements. A specialist is also trained to help you achieve safe, healthy, and pleasurable intercourse.
While there isn’t a direct correlation between fertility/implantation and conception, starting out your pregnancy with a strong pelvic floor will serve you well as your baby grows—and especially during the postpartum season when pelvic floor issues tend to show up.
Some women like to see a pelvic floor specialist while pregnant to evaluate the strength of their pelvic floor and to learn how to continue to strengthen it throughout pregnancy. If you’re having pain or significant incontinence during pregnancy, we recommend you see a pelvic floor therapist.
While internal work is only recommended in specific cases during pregnancy (it could potentially cause contractions), pelvic floor specialists can help you train your pelvic floor—beyond kegels—and prepare for delivery in other ways.
While a small amount of incontinence is normal and even expected shortly after birth (now you know…!), it should resolve itself within a couple of months. A pelvic floor specialist can also help with diastasis recti (the splitting of the abdominal muscles due to pregnancy). If you’re concerned, speak to your doctor at your first postpartum appointment to determine if you should see a pelvic floor specialist.
Once referred, the pelvic floor specialist will go through your family history and do a thorough exam, including an internal one. (Remember, you can always ask to have a second person in the room to ensure you feel safe and comfortable.) If he or she decides you would benefit from pelvic floor physical therapy, they will walk you through a game plan.
Most commonly, pelvic floor specialists will have their degree in physical therapy or occupational therapy and receive additional certification to treat pelvic floor issues. We recommend looking for therapists who possess a Certificate of Achievement in Pelvic Physical Therapy (CAPP) by the American Physical Therapy Association (APTA) or the Herman and Wallace Pelvic Rehabilitation Institute.
Yes! Registered physiotherapist, orthopaedic and pelvic health floor physiotherapist, Lamiya Zaidi explains: “You’ve still had nine months of baby on the pelvic floor, plus you’ve had a large incision in your abdomen. A big thing a lot of patients aren’t told is to work on your scar, which gets the deep abdominal muscles underneath firing again.”
Yes! In 2018, a study was published that found that pelvic floor physical therapy is an effective treatment for women who experience urinary incontinence and improves their quality of life.
Once you find a pelvic floor specialist, you’ll work out a plan based upon your needs. Typically, patients are seen one day per week for 6-12 weeks.
The cost varies greatly depending upon your health insurance. Some health insurances cover pelvic floor specialists (or a portion of the visit) while others do not. They may require a prescription from your doctor. (Fun fact: pelvic floor specialists are widely used in Europe and covered in full!)