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5 Signs You Need to See a Pelvic Floor Physical Therapist During Pregnancy



Overview


If you experience or struggle with any of the following symptoms during pregnancy, pelvic floor physical therapy can help! a pelvic floor physical therapist has specialized training in treating the pelvic floor muscles and dysfunction associated with the bladder, bowel and sexual organs.




When It's Time to See a Pelvic Floor PT


#1 Urinary Incontinence - You pee your pants when coughing, sneezing, exercising, etc.


Peeing your pants a little bit is a very common (and annoying) tendency that can arise during pregnancy, however you can learn to control it! This happens often due to a lack of coordination, impaired pressure management through the body, excessive muscle tension, or a muscle weakness issue. A pelvic floor physical therapist can evaluate you to determine where the problem lies, and then provide exercises and a specialized treatment plan to aid in optimal bladder control. With this being said, urgency and frequency of urination only increases as the baby grows and places more pressure on your bladder. This is why most women struggle even more to control their bladder during the third trimester, but it is still quite achievable with the help of a specialist! Research has demonstrated that seeing a pelvic floor physical therapist during pregnancy can actually decrease your chances of developing a more serious pelvic floor dysfunction after birth.



#2 Constipation - You constantly strain to go #2 causing pain or hemorrhoids.


The majority of women experience constipation during pregnancy due to the influx of hormones, and more so in the later stages of pregnancy as baby grows and pushes against the organs. Hemorrhoids are also common due to the pressure baby places down on your perineum and pelvic floor region in addition to straining with bowel movements secondary to constipation. A pelvic floor physical therapist can help you manage constipation through education on hydration, instruction on exercises to promote healthy intestinal mobility as well as proper body and pushing mechanics to avoid straining. Understanding how to properly push additionally helps prepare you for the pushing phase of birth and decreases your risk for developing pelvic organ prolapse.


Left = Poor Posture, Right = Safe Posture

#3 Diastasis Recti - You notice conning or doming of your abdominal muscles when getting in/out of bed, exercising, etc.


All women develop stretching or weakening of their core muscles (AKA diastasis recti) at some point during pregnancy. This is simply due to how much the abdominals have to stretch and make room for a growing baby. To maintain strength and prevent making your diastasis worse it is important to understand how to properly engage your core, move and manage pressure appropriately. This can even include simple tasks like getting in and out of bed or placing items in an overhead cupboard. A pelvic floor physical therapist can help you manage your diastasis and prevent it from weakening

further through education on safe body mechanics, proper breathing mechanics and guided instruction on appropriate core strengthening exercises for your stage of pregnancy and capabilities. This can look different person to person depending on your fitness level.



#4 Pain - You have pubic bone pain, low back pain, hip pain, abdominal pain or are experiencing pain during sex.


Various aches and pains commonly accompany the stages of pregnancy as hormones loosen the joints and ligaments to prepare for the birth of your baby. Muscles can then experience increased tension as a result of compensating for hypermobile joints (joints that are too loose). A pelvic floor physical therapist can assess your pain concerns and provide a specialized treatment plan to reduce and manage your pain including manual therapy techniques (massage, stretching, myofascial release, joint mobilization) and a home exercise program to help strengthen and lengthen muscles, ligaments and joints as your body changes.


#5 Uncertainty or Concerns Regarding Exercise - You want to exercise for you and baby’s health, but are not sure what is safe.


So many clients have told me they stopped exercising when they found out they were pregnant, because they didn’t think what they were doing for exercise was safe. This is a fear that several expecting moms face, and unfortunately you may receive conflicting evidence from your OBGYN when it comes to safe exercise during pregnancy. This actually happened to me at my 10 week pregnancy appointment - my nurse told me that I shouldn’t be lifting more than 25 lbs when I had been deadlifting well over 100 lbs earlier that week. This was not a research based recommendation and was definitely erring on the side of caution. Rule of thumb is you should be able to maintain a similar exercise intensity even once you find out you’re pregnant. The American College of Obstetricians and Gynecologists also supports starting an exercise regimen if you had not exercised prior to pregnancy. If you feel stuck, or something doesn’t feel right when exercising, a pelvic floor physical therapist can assess your movement and provide tips and modify movements so that you and baby are safe during exercise. There are so many benefits to exercising during pregnancy for both you and your baby so don’t just give up and stop all together!




Scheduling an Appointment


Any concerns during pregnancy should be discussed with your doctor. He or she may refer you to pelvic floor physical therapy depending on your conversation. In most states you can also directly contact a physical therapy office to set up an evaluation without a referral, but ultimately the therapist will eventually want your doctor in the loop regarding your treatment as well.


Check out how pelvic floor physical therapy helped these two individuals:

“Dr. Hayley was absolutely amazing! I was initially very nervous about going to pelvic floor therapy, but she made the experience wonderful! She made me feel safe, comfortable, and extremely cared for in every appointment. I only wish I would have gone sooner, and would recommend anyone considering pelvic floor therapy to go!”


“Dr. Hayley at Fuel Therapy was helpful, professional, knowledgeable and I would highly recommend her. I had some bladder issues and other discomforts with intercourse after giving birth. I thought those things were normal but after meeting with her, I now know there is a lot to be done about them and healing is possible. She gave me tips and tricks on exercises/therapy to work through and it has made such a huge difference. She made me feel so comfortable the whole time and I’m so thankful I met with her. If you are having any complications after childbirth it would totally be worth meeting with Dr. Hayley and checking on your pelvic floor.”



If you have any questions or concerns about pregnancy, postpartum, pelvic floor dysfunction or pelvic floor physical therapy please don’t hesitate to contact me at my number or email listed below.


P.S. - If you are interested in a private one-on-one consultation and evaluation you can schedule here or email hayley@fuelphysicaltherapy.com



In Health & Happiness,

Dr. Hayley VanBeek, PT, DPT

Athlete & Pelvic Health Specialist

Fuel Physical Therapy & Sports Performance, LLC

(616) 757-0932

hayley@fuelphysicaltherapy.com

IG: @dr.hayleyvanbeek.dpt























References


https://www.acog.org/womens-health/faqs/exercise-during-pregnancy


https://aptapelvichealth.org/2021/07/20/5-reasons-why-you-should-refer-all-pregnant-clients-to-a-pelvic-health-physical-therapist/