What does a Pelvic Floor Physical Therapist gift her pregnant friends at their baby showers?
By Molly Bachmann PT, DPT, PHRC San Francisco
Working in the medical field places one in a unique position when it comes to relationships with family and friends. Frequently I’ll receive questions about aches and pains, emails asking for advice, etc. Working in the medical field and specializing in disorders of the pelvic floor makes conversations with friends and family quite special. For most, the pelvic floor is unchartered territory in regards to information . . . knowing what is normal and what is abnormal function. I’ve made sure that they’re all in my life are fully educated and now they are some of the best marketing people I know for encouraging people to seek out a Pelvic Floor Physical Therapist. This is especially true for my friends who call me up to tell me that they are pregnant and starting their families.
I am so fortunate to be able to care for friends and family in so many ways. I especially love springing into action for friends who are preparing for birth. So often we think about what the baby needs, but the birthing parent is neglected. Let’s change that. I know you all must be wondering what a Pelvic Floor PT might recommend in regards to products that assist with peripartum changes . . . well you’ve come to the right place. Let’s do a little “unboxing” of my peripartum gift guide:
Pelvic Girdle Pain is quite common during pregnancy. This can mean pain anywhere along the pubic bone, tailbone, low back, sides of the hips, undercarriage, or lower abdominal region. While you should always see a physical therapist to make sure this is right for you and your body, the Serola belt is helpful in giving the pregnant body a little extra support to reduce pain throughout the region. This can especially be helpful if you know you will need to be on your feet all day or performing a more strenuous activity. In our office, we typically have samples that we may use with patients in the clinic to make sure they have the right fit.
On our social media platforms, you’ll frequently see us discuss birth itself and ways we can use positioning the body and other modalities to reduce harm and injury. The peanut ball is an awesome modality that can be used to provide comfort, reduce perineal tearing, reduce cesarean rates and help get people in more therapeutic positions especially if the pregnant person has had an epidural. Check out our recent TikTok video about it!
If you’ve experienced birth, then you know that the first bowel movement afterwards can be rough. Often, safe bowel movements are challenging to achieve even beyond the first one. Squatty Potty is an excellent tool to get your pelvic floor muscle in better alignment to eliminate stool as well as reducing the need to strain which is not recommended at any time throughout the lifespan.
Immediately postpartum and potentially persisting through the next couple of weeks, wiping after urination is quite uncomfortable. The vulvar tissues have experienced quite a bit of trauma and often feel raw and irritated. Instead, using a peri bottle is an effective way to maintain hygiene without irritating already irritated tissue. If you are birthing in a hospital, sometimes this is a part of the kit sent home with you. Regardless, it’s always good to have multiples especially if you live in a home with multiple bathrooms you will be accessing.
Sitz baths are quite soothing to irritated and vulnerable vulvar tissues. In a vaginal birth, the pelvic floor muscles stretch more than 3 times their original length and the pudendal nerve is stretched more than 15% of its strain threshold. You bet this area is going to need some TLC. Sitz baths are a relaxing way to soothe and heal these tissues in the initial postpartum period.
Urinary and fecal leakage are COMMON in the postpartum time. And in some ways, it is expected that in the first 1-2 weeks, birthing people will have difficulty controlling urine, gas, and stool. As your body begins to repair itself, sometimes these things will spontaneously improve. Other times, leaking will persist in which case it is always recommended to work with a pelvic floor physical therapist. Just because it is common to have leakage, does not mean that it is normal. Having comfortable pads that keep the vulva and vaginal canal hygienic is key. Ask your friends what size they prefer and order A LOT so that they don’t have to think about adding one more thing to their shopping to do list.
Aloe + Alcohol free Witchhazel
One of my favorite things to do is to have a ‘padsicle’ making party. Let’s make postpartum preparation fun! Padsicles are sanitary pads with a little bit of aloe and alcohol free witch hazel rewrapped and placed in a freezer. They are so great because they are easily made ahead of time. Padsicles feel really soothing to irritated tissue and help to repair the vulva.
If you are breastfeeding or chest feeding, this can cause some temporary hormonal changes on top of the physical changes the pelvic girdle goes through during birth. The vulva and vaginal opening specifically is sensitive to these changes. This can cause persistent irritation in the vulva and vaginal opening making insertion of tampons, gynecologic exams and penetrative intercourse uncomfortable or even painful. Products like vital v help to soothe and repair the tissue.
Earthmama nipple butter and NippleShield
If your pregnant friend or family member is choosing to breastfeed or chest feed or pump, you’ll likely hear at some point just how much time is spent feeding the child or children. In fact it is well known that the amount of time feeding a child is actually equivalent to that of a full time job . . . literally. That means that breast and chest tissue is also vulnerable to irritation. Nipple butter helps to repair sore tissue. Nipple shields can be used for lots of different reasons and function will vary based on their shape. Take a look in the link above.
A google doc of qualified Pelvic Floor PTs near them
If you’ve worked with PHRC before, you know that each of our providers is working towards improving access and information about pelvic floor PT. One of the many barriers for people to get pelvic floor PT in the postpartum is finding time to research and make an appointment. Take some of the load off your friends and family by helping them find a qualified provider near them. This can be done through the American Physical Therapy Association, Pelvic Rehab, or Pelvic Guru.
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Are you unable to come see us in person in the Bay Area, Southern California or New England? We offer virtual physical therapy appointments too!
Virtual sessions are available with PHRC pelvic floor physical therapists via our video platform, Zoom, or via phone. For more information and to schedule, please visit our digital healthcare page.
In addition to virtual consultation with our physical therapists, we also offer integrative health services with Jandra Mueller, DPT, MS. Jandra is a pelvic floor physical therapist who also has her Master’s degree in Integrative Health and Nutrition. She offers services such as hormone testing via the DUTCH test, comprehensive stool testing for gastrointestinal health concerns, and integrative health coaching and meal planning. For more information about her services and to schedule, please visit our Integrative Health website page.
Melissa Patrick is a certified yoga instructor and meditation teacher and is also available virtually to help, for more information please visit our therapeutic yoga page.
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FAQ
What are pelvic floor muscles?
The pelvic floor muscles are a group of muscles that run from the coccyx to the pubic bone. They are part of the core, helping to support our entire body as well as providing support for the bowel, bladder and uterus. These muscles help us maintain bowel and bladder control and are involved in sexual pleasure and orgasm. The technical name of the pelvic floor muscles is the Levator Ani muscle group. The pudendal nerve, the levator ani nerve, and branches from the S2 – S4 nerve roots innervate the pelvic floor muscles. They are under voluntary and autonomic control, which is a unique feature only they possess compared to other muscle groups.
What is pelvic floor physical therapy?
Pelvic floor physical therapy is a specialized area of physical therapy. Currently, physical therapists need advanced post-graduate education to be able to help people with pelvic floor dysfunction because pelvic floor disorders are not yet being taught in standard physical therapy curricula. The Pelvic Health and Rehabilitation Center provides extensive training for our staff because we recognize the limitations of physical therapy education in this unique area.
What happens at pelvic floor therapy?
During an evaluation for pelvic floor dysfunction the physical therapist will take a detailed history. Following the history the physical therapist will leave the room to allow the patient to change and drape themselves. The physical therapist will return to the room and using gloved hands will perform an external and internal manual assessment of the pelvic floor and girdle muscles. The physical therapist will once again leave the room and allow the patient to dress. Following the manual examination there may also be an examination of strength, motor control, and overall biomechanics and neuromuscular control. The physical therapist will then communicate the findings to the patient and together with their patient they establish an assessment, short term and long term goals and a treatment plan. Typically people with pelvic floor dysfunction are seen one time per week for one hour for varying amounts of time based on the severity and chronicity of the disease. A home exercise program will be established and the physical therapist will help coordinate other providers on the treatment team. Typically patients are seen for 3 months to a year.
What is pudendal neuralgia and how is it treated?
Pudendal Neuralgia is a clinical diagnosis that means pain in the sensory distribution of the pudendal nerve. The pudendal nerve is a mixed nerve that exits the S2 – S4 sacral nerve roots, we have a right and left pudendal nerve and each side has three main trunks: the dorsal branch, the perineal branch, and the inferior rectal branch. The branches supply sensation to the clitoris/penis, labia/scrotum, perineum, anus, the distal ⅓ of the urethra and rectum, and the vulva and vestibule. The nerve branches also control the pelvic floor muscles. The pudendal nerve follows a tortuous path through the pelvic floor and girdle, leaving it vulnerable to compression and tension injuries at various points along its path.
Pudendal Neuralgia occurs when the nerve is unable to slide, glide and move normally and as a result, people experience pain in some or all of the above-mentioned areas. Pelvic floor physical therapy plays a crucial role in identifying the mechanical impairments that are affecting the nerve. The physical therapy treatment plan is designed to restore normal neural function. Patients with pudendal neuralgia require pelvic floor physical therapy and may also benefit from medical management that includes pharmaceuticals and procedures such as pudendal nerve blocks or botox injections.
What is interstitial cystitis and how is it treated?
Interstitial Cystitis is a clinical diagnosis characterized by irritative bladder symptoms such as urinary urgency, frequency, and hesitancy in the absence of infection. Research has shown the majority of patients who meet the clinical definition have pelvic floor dysfunction and myalgia. Therefore, the American Urologic Association recommends pelvic floor physical therapy as first-line treatment for Interstitial Cystitis. Patients will benefit from pelvic floor physical therapy and may also benefit from pharmacologic management or medical procedures such as bladder instillations.
Who is the Pelvic Health and Rehabilitation Team?
The Pelvic Health and Rehabilitation Center was founded by Elizabeth Akincilar and Stephanie Prendergast in 2006, they have been treating people with pelvic floor disorders since 2001. They were trained and mentored by a medical doctor and quickly became experts in treating pelvic floor disorders. They began creating courses and sharing their knowledge around the world. They expanded to 11 locations in the United States and developed a residency style training program for their employees with ongoing weekly mentoring. The physical therapists who work at PHRC have undergone more training than the majority of pelvic floor physical therapists and as a result offer efficient and high quality care.
How many years of experience do we have?
Stephanie and Liz have 24 years of experience and help each and every team member become an expert in the field through their training and mentoring program.
Why PHRC versus anyone else?
PHRC is unique because of the specific focus on pelvic floor disorders and the leadership at our company. We are constantly lecturing, teaching, and staying ahead of the curve with our connections to medical experts and emerging experts. As a result, we are able to efficiently and effectively help our patients restore their pelvic health.
Do we treat men for pelvic floor therapy?
The Pelvic Health and Rehabilitation Center is unique in that the Cofounders have always treated people of all genders and therefore have trained the team members and staff the same way. Many pelvic floor physical therapists focus solely on people with vulvas, this is not the case here.
Do I need pelvic floor therapy forever?
The majority of people with pelvic floor dysfunction will undergo pelvic floor physical therapy for a set amount of time based on their goals. Every 6 -8 weeks goals will be re-established based on the physical improvements and remaining physical impairments. Most patients will achieve their goals in 3 – 6 months. If there are complicating medical or untreated comorbidities some patients will be in therapy longer.