Ask the Expert: What Should We Know About Pelvic Health?
Updated: Aug 29, 2019
At Bluegrass Doulas, we are passionate about supporting new mothers as their bodies adjust to pregnancy and childbirth. Pelvic Health is one of those issues that while not often discussed, is of vital importance. We are excited to learn from a local expert what Pelvic Health looks like during maternity and postpartum with the Clinical Director of Dunn Physical Therapy, Melissa McElroy.
Meet Melissa McElroy, DPT, WCS, and Clinical Director of Dunn Physical Therapy.
"I take pride in knowing that I can help improve someone's quality of life on a completely different level. For me, it's about getting people back to living their lives without underlying fear or concern."
Can you explain what Pelvic Health Physical Therapy Is?
Sure! Pelvic Health is a specialty practice of Physical Therapy where we put a lot of focus on the spine, pelvis, hips, core and a specific component of the core that most don’t think of as such, the pelvic floor musculature. I like to say that we treat all the things that people don’t talk about, (such as incontinence -any leakage is incontinence, pelvic pain, sexual dysfunction), as well as any and all prenatal and postpartum concerns/issues (back pain, “sciatica”, round ligament pain, diastasis rectus abdominis, blocked milk ducts, neck pain/headaches, injuries due to ligamentous laxity anywhere in the body). We also work a lot with scar tissue and adhesions from past surgeries and traumas that can contribute to pain and dysfunction.
What are some things women often think are normal after childbirth, that actually are signs they could benefit from physical therapy?
I 100% believe that every woman who has had a baby should be assessed by a PT postpartum. It’s this way in most other countries, but not seen as important in the U.S. for whatever reason. There are a lot of things that our bodies have compensated for during pregnancy, now in the postpartum that can lead to more issues down the road. I can’t tell you how many times a day I hear in the clinic “Why didn’t anyone tell me this sooner” as we’re working with women whose “babies” range in age from just weeks old to decades old. Incontinence any time after 4 weeks postpartum is something that should be addressed. This includes leaking when coughing, laughing, exercising, or when trying to get to the bathroom. Urinary or fecal urgency, frequency of urination, feeling like you’re not emptying your bladder, constipation, pain with intercourse, pressure/heaviness/bulging through the lower abdomen or vaginal region, changes in sensation through your abdomen or perineum, or doming of the abdomen when attempting to exercise or in everyday activity are all signs that things aren’t coming together after baby like we’d like. Back pain is another HUGE and overlooked issue, because we all think “well It’s just from carrying the baby around (insert shoulder shrug)”, and yes, it is, BUT it’s also your body asking for help to function in this new role of motherhood. So many of the issues that we shrug our shoulders at now, may compound and cause more serious issues later in life. PT for new moms is a great start to decrease the likelihood that more serious issues don’t occur later.
What is the first visit for pelvic floor PT like?
Your first session is a lot of finding out “Your Story”. We want to know your history: pregnancies and deliveries, surgical history, bowel and bladder habits, potential sexual concerns (nothing is TMI, trust me), and history of any other injuries. All of this gives us a better indication of how we may be able to help. We will discuss the specifics of your symptoms (if you are having any) and provide any education on these to help you better understand why they may be occurring. We assess abdominal musculature and connective tissue, hip mobility, spinal mobility and pelvic ring mobility. Most of the time, if deemed appropriate, and with consent, an internal pelvic muscle assessment will be performed. This is a very straightforward assessment of pelvic floor muscle stretch, strength, endurance and control that you are walked through before and during. We also look at diaphragm control/breathing patterns to determine if or how that may be contributing to your symptoms. We talk through the findings with you to make sure that it all makes sense, then we develop a plan to help you work toward your goals (laugh without leaking, pain free sex, pick up baby without pain,…). We understand that these are things that most don’t ever really think about, so we do our best to take the time needed to answer any questions, or address any concerns that you may have.
If you could give pregnant or postpartum women some words of advice, what would you say?
For the pregnant woman: Don’t be afraid to move and stay active, but listen to your body and acknowledge that you’re doing a heck of a lot of work, even at rest right now. I would strongly recommend that you make sure you have good activation strategies for your deep core, before baby gets too big, or before baby’s grand entrance into this side, as it will help in later stages of pregnancy and in your recovery.
For the postpartum woman: Give yourself some grace! Your body has gone through tremendous change and it’s done something completely incredible over the last 40-ish weeks, things aren’t going to “go back to how they were” in a matter of a few weeks, NOR SHOULD THEY. Your body has to heal – Give yourself some grace and allow for it to heal as it should. Movement is still good, but there’s a lot of transition that your body has gone through and more that it will continue to go through; Don’t push the exercise intensity.
Dunn Physical Therapy is an outpatient orthopedic physical therapy clinic specializing in women's pelvic health since 2001. You can call either location to schedule a consultation.
10321 Champion Farms Drive Louisville, KY 40241
4042 Dutchmans Lane Louisville, KY 40207