Why should you care about your pelvic floor muscles? Simple: They are the key to optimal sexual, bladder, bowel health and function!
The pelvic floor is finally getting the attention it deserves! You’ve likely been hearing about all the new tools and apps to help you kegel, or cues to “contract your pelvic floor” in Yoga and Pilates, or maybe you’ve even been bombarded with articles on all sorts of treatments for your vulva and vagina. Talking about the vagina, vulva, and pelvic floor muscles is empowering. Conversations are being had about what really can happen after child birth to those pelvic floor muscles, what to do when sex is painful, and how to maximize sexual pleasure itself… and that’s a wonderful thing.
While this newfound awareness is important, it can be tricky navigating what the safe, healthy, and even necessary choices for you and your body are. As a doctor of physical therapy who specializes in pelvic floor muscle health and dysfunction, I am here to help, as all sex education is not created equal.
What Is Your Pelvic Floor & Why Does it Matter?
Let’s discuss. This first part may not be so sexy, but let’s delve into it, because knowledge is empowering!
Your pelvic floor is a sling of muscles that support organs such as your bladder, uterus, bowel, and ovaries. It plays a key role in bladder, bowel, and sexual function. If these muscles are not functioning properly, the most common side effects affect your sex life, your bladder, and your bowels. These side effects are profoundly intimate. They can feel extremely uncomfortable and be embarrassing. They can impact intimacy with your partner and often your sense of self.
The good news is that the power is in your hands. Pelvic Floor physical therapists can rehab these muscles just like you would any other muscle group. Weak muscles can be strengthened and tight muscles can be released and lengthened. (Yes, there is such a thing as having vaginal muscles that are too tight!)
Pelvic Floor-Related Symptoms Are ‘Common,’ Not ‘Normal.’
Where do we start? Let’s dispel the common myths I hear on a daily basis. I am constantly repeating the line “Common, NOT NORMAL.”
Your Grandma, your Mama, your Aunts, your friends may all say “it’s the new normal” after having a baby or “Welcome to being a Mama”. Let’s stop this outdated nonsense right here. Please know that wetting your pants when you laugh, sneeze, cough, or exercise may be common post pregnancy, but not normal!! Same with being unable to control passing gas all the time. These are not symptoms you are destined to live with now that you have joined the Mama tribe. These are typically symptoms of pelvic floor muscle weakness. On the flip side, having painful sex and constipation, are typically signs of pelvic floor muscle tightness. You can also have muscle weakness due to tightness, but we can get into nitty-gritty later. Again, these muscles are just like any other muscles in the body despite what you’ve likely been raised to think. If you had a problem with your shoulder, would your friends say “Welcome to the joys of Motherhood”?! No, they’d say go get some help.
How Can Pelvic Floor PT Support Postpartum Mamas?
So what can you do? If you lived in France or parts of the UK, pelvic floor PT would be a given after giving birth. If you are cleared at the six week checkup, you go to see your PT. You don’t even need a prescription. The emphasis there is on healing and taking care of the Mama, not just baby. In the US, unfortunately, the emphasis is usually just on the baby. We are neglecting our Mamas. Let’s change this. Let’s educate ourselves and be empowered so you are not living with symptoms that you don’t have to. I always say, if your doctor tells you that leaking urine or painful sex is “the new normal” after childbirth, find a smarter one….Pelvic Floor physical therapy has been around for decades and we have the evidence based practice and top tier studies to prove its efficacy. Go talk to a pelvic floor PT and start the journey to feeling better.
PT doesn’t have to wait until you are requiring your own diapers either. You can be proactive and see a pelvic floor PT during pregnancy to discuss pelvic floor muscle care as well as addressing Diastasis Recti aka Mummy Tummy so you are in the optimal shape before delivery. If kegels are right for you, we can teach you how to kegel properly (yes, you may be wasting your time and doing it wrong!) and give you a home regimen so that you can be working on getting better every day not just at PT, just as if you went to PT for Tennis Elbow. Also, not everyone should be doing kegels. This is probably one of the biggest misconceptions I find when talking to my patients. If there is any muscle tightness or other differential diagnosis, kegels may actually make your symptoms worse, so check with your PT first. Let’s make sure you are not creating more pain for yourself! Your body has already been through enough.
You just made a human and as important as that human is, so are you. If you feel “just not the same” or unsatisfied with how sex feels, or even fearful of having sex because of how it may feel even though you want to, your PT can examine you and determine what the right course of treatment is to help you feel good and powerful in your body. Not to mention, help resolve hip, low back, and neck pain. Postural education for breastfeeding and carrying or picking up baby is part of patient education as well as is diet and hydration. For example, limiting hydration due to fear of wetting your pants can actually worsen symptoms. Sounds counterintuitive, but it is not!
Pelvic floor physical therapists are specially trained to assess both internal and external muscles. They’ll guide you in internal and external workouts targeted for your pelvic floor muscles and other muscles which support your pelvic floor. Get the care you need, so you feel better. Ditch the embarrassing and uncomfortable symptoms and enjoy your sexuality and sensuality. Remember, Happy Mama equals Happy Baby.
Dr. Francesca Warner is a physical therapist specializing in women’s and men’s Pelvic Floor health and dysfunction, including pre-natal and post-partum conditions, chronic pelvic pain, Diastasis Recti, urinary frequency/urgency, incontinence, Interstitial Cystitis, prolapse, pain with sex, sexual dysfunction, gastrointestinal dysfunction, and more. She received her doctorate from New York University and has studied with the Herman & Wallace Pelvic Rehabilitation Institute. As an identical twin, she was born on a team. Consequently, she loves building strong bonds with her patients and championing their progress. She treats all pronouns.