My Experience with Pelvic Floor Therapy
I was over two years post-partum from my second child before I finally said to my OBGYN, "hey, things just aren't going back to normal. I regularly do core exercises and I feel like I'm doing kegels correctly, but… maybe I'm not!" She told me to ask my primary care doctor for a physical therapy referral.
I had heard about pelvic floor physical therapy before, in magazine articles and web searches. But it always sounded like the extreme solution. Like, wasn't I supposed to be able to "return-to-normal" on my own after having a baby? Didn't most women?
The answer is… probably not.
This is one of those grey areas that we tend not to talk about because it makes some folks uncomfortable. Or because -- like me -- there's a misconception that the "extreme" solution isn't what we need. Maybe, like me, women tell themselves that their problem "isn't really that bad" or is "normal."
Now that I've been doing pelvic floor physical therapy, I can tell you -- the problem is that bad, it doesn't have to be normal, and the solution isn't extreme. Actually, the solution should be more widely available (and is, in other countries).
If you can't cough, sneeze, jump, or walk downhill quickly without having an issue… you shouldn't just live with it. Some women I've talked to can't laugh either. And on the gross end of the spectrum, let's not talk about how bad it is when you have a stomach bug….
These problems are really common. The more women I mentioned my therapy to, the more confessed to me that they had similar issues. In fact, the estimate is that 1:4 women have pelvic floor dysfunction. Which means, you probably know several women who have it too.
The (Not-Extreme) Solution
I'm now 10 weeks into physical therapy and it hasn't been at all like what I expected. I had a lot of misconceptions, actually.
I always thought physical therapy was primarily for people with sports or muscle injuries or who were recovering from serious illnesses like strokes. I pictured it a lot like the movies with people struggling to walk and breaking down in tears. But, to date, I have not seen anyone crying in physical therapy in 20 sessions… except myself. And that has been out of frustration… with myself.
Unlike the movies, my therapy office is kind of like a more comfortable carpeted gym filled with exercise equipment, massage tables, and bizarre props that help with a plethora of muscle tensions. There are always several sessions going on at once, and everyone is very cheerful and supportive (which kind of makes me feel worse, when I cry. heh.)
My therapist is similar to a workout trainer, cheering me on, setting my pace, pushing me to try harder, and correcting me when my posture or positioning are wrong. But, most importantly, she is non-judegmental, encouraging, and… this is what she does for a living.
We regularly think to hire professionals to fix things like our roofs or faucets, but we tend not to hire them to fix our bodies. My therapist's job is to improve people's quality of life by helping them regain (actual) normal function of their bodies. I only wish I'd thought to reach out to a professional earlier.
The First Stages of Therapy
My first few sessions focused on relaxing. Literally just relaxing. That was transformative to me.
See, this whole time, I had assumed I wasn't using my muscles correctly or that they weren't strong enough. But it turns out that was only half of the story. The other half is that my body wasn't allowing my muscles to work correctly and get stronger.
I'm not a doctor or a therapist, so I'm not going to get into all the muscle names and structure and so on, but essentially a lot of muscles in my body were super tense from compensating for the muscles that weren't functioning correctly. To strengthen the weak muscles, I first needed to relax the over-worked muscles.
So for several weeks, I did breathing and stretching exercises twice a day at home and twice a week with my therapist. People always talk about breathing and the benefits of things like restorative yoga. And… I am not a relaxer (ask anyone), but this process really pointed out where my tension was. In fact, it even explained my bruxism! (Did you know that pelvic floor and jaw muscles are connected?!)
Once my muscles were more relaxed and we could target strengthening exercises, I had another revelation: my walking stance has been wrong… potentially my whole life.
Everything is Connected; a Judo Therapy Session
I had a Judo Therapy session a few months before I started physical therapy. Don't know what Judo Therapy is? I didn't either! It was a random recommendation from a humidity system installer who claimed Judo Therapy eliminated his limp. When I looked into the posture and alignment correction it could do, I said, "I have to try that."
My Judo Therapy session was the first time I realized that all of the muscles in my body are way more connected than I thought they were. The Judo Therapist would ask me to move my arm, observe my motion, then press on (what I thought was) a non-related muscle in my back or neck… and suddenly my arm would move easier than it had been. I was shocked. The before and after photos of my posture and neck mobility are crazy. He didn't take a photo of my hip alignment, but that had been off too.
The Judo Therapy session was great and I was sent home with homework to fix my sleeping position, sitting position, and walking stance. I did well with the first two pieces: I retrained myself to fall asleep on my back and I no longer cross my legs while I sit… but the walking stance, I wasn't able to really work on that until the pelvic floor therapy. And it suddenly all made sense why once I started physical therapy.
I've had a random, re-occuring pain in my mid-back. It's gotten worse since having kids. It's just below my rib cage. Nothing I've done (stretching, massage, the Judo therapy) has ever made it go away. It has diminished from time to time (especially after a good massage or the Judo Therapy) but it's never been completely gone.
This pain is the main thing I was hoping the Judo Therapist would fix. But it turns out he was just one domino. This pain is related to my walking stance, which is caused by poor posture, which is caused by improper muscle use in my abdomen, back, and legs… The very things I am working on in pelvic floor physical therapy. Because, as I said above, everything is connected.
The Continuing Stages of Therapy
My strengthening exercises do contain core exercises -- so I wasn't wrong to focus on that prior to therapy. But they also contain glutes, adductors, quads, and the pelvic floor muscles themselves. And now that I'm nearing the final stages, they include a lot of movement while exercising pelvic floor muscles (think jumping, stepping, hopping… all while contracting). Sometimes the sequence to get the exercise correct is very frustrating (hence the afforementioned crying).
In one of my more frustrating sessions, when I confessed to my therapist that things were going a lot slower than I wanted them to, she said to me, "Rebecca, if this was going to be easy, you wouldn't have needed physical therapy." She also reminded me that, like anything you learn, you learn at your own pace. So, there is no quick or slow because you shouldn't be comparing yourself to anyone else. See what I mean about the encouragement?!
My exercises, like the stretches, are to be done twice a day at home and twice a week in therapy. This is very tiring and time consuming. However, it's also worth it. I miss the early days of the breathing and relaxing, but I'm also glad to sneeze, jump, and cough without an issue. Even if I feel like it is taking forever to solve my problems 100%.
I really wish I had hired a professional sooner! Hahaha.
In a few weeks, I will "graduate" from therapy, back to normal, with better quality of life, and improved walking stance, to boot. The random pain should be banished, my bruxism will be diminished, and I'll be ready to go back to the Judo Therapist for a progress check-in. Who'd have thought the one admission to my OBGYN would have helped to solve so much?
I also learned, in my repeated life's lessons:
I don't need to suffer through this alone.
I should evaluate my preconceptions to figure out if they are misconceptions.
My experience can help other people.
Hopefully, if you or someone you know is suffering from pelvic floor dysfunction, this story will inspire you -- or them -- to get some help!
