Peeing your pants, also know as urinary incontinence or urinary leakage is common. Research is a little all over the place, but anywhere between 1 in 4, to 1 in 2 women over 30 years old, struggle with urinary incontinence.

Urinary leakage can be triggered by: High pressure activities such as coughing, sneezing, or laughing, high impact activities like running, and jumping, or high load activities like squatting, and lifting

Postpartum physical therapy aims to strengthen the pelvic floor muscles, address postural changes that occurred during pregnancy, improve common postpartum symptoms of urinary, bowel, sexual health changes, and pain including lower back pain, pelvic pain.

All pelvic floor physical therapy should take place in a private treatment room with your therapist, although there are some locations where pelvic floor therapy is occurring behind a closed curtain in an open gym. It is important that you get all of the details of the setup of the office prior to booking your initial appointment. Since the pelvic floor is a pretty complicated area of the body, your session should be at least an hour long.

Unfortunately the term “pelvic floor therapist” and “pelvic floor therapy” are not protected terms. Meaning, anyone that is doing any kind of treatment to the pelvic floor can say that they are doing “pelvic floor therapy”.

A pelvic floor therapist SHOULD be a licensed occupational or physical therapy that has advanced training in rehabilitating pelvic floor conditions. OTs and PTs will have a deeper understanding of WHY you might be having your symptoms and will work to rehabilitate your pelvic floor and your body as a whole.

Pelvic floor physical therapy is gaining popularity in the modern day. Many people understand the benefits of physical therapy when it comes to helping to heal postpartum, but unfortunately few understand the benefits of pelvic floor physical therapy while one is pregnant.

Prenatal pelvic floor physical therapy is extremely effective in helping to improve maternal well-being, and improve overall childbirth outcomes.

Through birth preparation, prenatal physical therapy can help patients connect with their body, understand the labor and delivery process and confidently go into childbirth with an ability to connect with their pelvis and pelvic floor.

According to the NIH, a C section is the most common surgery in the United States, with over 1 million Cesarean deliveries occurring every year. (1)

A C section involves disruption to 7 layers of tissue including the skin, subcutaneous tissue, fascia, abdominal muscles, peritoneum, uterus, and amniotic sac. In other words, a C section involves deep trauma to the abdominal wall.

An exercise program that is individualized and catered to core stability is effective at reducing diastasis recti. Physical therapy with a pelvic floor physical therapist who is trained in and understands diastasis healing is an important part of core retraining.

The Emsella Chair is a medical device that has been approved by the FDA as a safe treatment for urinary leakage. Essentially patients sit in the chair and the chair sends electrical impulses to stimulate the pelvic floor muscles to contract. The Emsella advertises that in a 20-ish minute session, it can mimic 10,000+ pelvic floor contractions.

That sounds great, but kegels are not always the answer.

Pelvic floor physical therapy is gaining more popularity in recent years. With the emergence of new pelvic health biomedical technology, social media influence, and push for women’s health advocacy, pelvic floor physical therapy is becoming a household name. But what exactly is pelvic floor physical therapy, and who specifically would benefit from it? Let’s break it all down.

In pelvic floor physical therapy, any condition affecting bowel, bladder, or sexual function can be treated and addressed. This includes constipation and fecal incontinence, urinary urgency, frequency, and leakage, and sexual dysfunction or pain in adults. These symptoms are all forms of pelvic floor dysfunction.

Pelvic floor dysfunction, or symptoms of a problematic pelvic floor typically occur when the pelvic floor muscles are weak, tight, painful, or not working properly.

Treatment for vaginismus will differ person to person, but mental health therapy and pelvic floor physical therapy are crucial components to vaginismus treatment.

Pelvic floor physical therapy plays another crucial role in vaginismus treatment. Pelvic floor physical therapists can help patients relax the pelvic floor muscles through manual treatments, dilator therapy, nervous system relaxation, and pelvic floor relaxation exercises.

The key components to a diastasis recti physical therapy program includes core, shoulder and hip strengthening exercises. Since diastasis recti can affect the abdomen anywhere from the ribs down to the pelvis, it is important that physical therapy for diastasis recti incorporates strengthening and improving function of all the muscle groups that control the core.

Since we are also likely dealing with compensations, your diastasis recti physical therapy treatment should also consist of manual therapy, including soft tissue and joint mobilizations to help relax the tissue that may be compensating for core activation.

Tailbone pain during pregnancy is extremely common. Postural changes, weight gain, pressure and tension on the pelvic floor during to the weight of the growing baby, and increased ligament laxity all contribute to reasons you may have tailbone pain start in pregnancy.

Diastasis recti physical therapy can begin immediately postpartum on fundamental movement and breathing techniques, as well as lifestyle factors that might be playing a role. A diastasis recti physical therapist will design a treatment plan that is customized to your activity level, postpartum healing stage, and your specific functional capacity of your core.

Pain with sex. Painful intercourse. Dyspareunia. Vaginismus. Whatever you call it, when your partner is in pain, having intercourse can be extremely difficult or impossible. Pain with penetrative intercourse is one of the top things that we as pelvic floor physical therapists help our patients overcome.

Typically, patients experiencing pain with intercourse have significant pelvic floor muscle tightness or pelvic floor muscle spasm. When the muscles are tight, they are painful. When something is painful, it leads to more clenching, tension, and spasm. When something is painful, we typically don’t want to keep doing it and therefore when sex is painful, sexual desire plummets. This vicious cycle is seen way too often in the pelvic health world. So what leads to this cycle in the first place?

Your body goes through a lot of changes during pregnancy. Over the course of 9 months, your ribs widened, your diaphragm shortened, your pelvic floor lengthened, your pelvis widened, your posture changed and your ligaments got more stretchy. Postpartum PTs specialize in helping women recover from pregnancy and it important that the postpartum physical therapist your choose is qualified.

Postpartum physical therapy focuses on restoring the joint alignment, posture and muscle coordination so that you can connect with your body post-birth. The goal of postpartum physical therapy is to get you back to the activities you love, safely. Postpartum physical therapists help create routines of postpartum exercises that can progress you towards all the things you want to do postpartum.

Not all physical therapists are diastasis recti specialists however. Diastasis recti therapy is a specific type of physical therapy. Not all physical therapists have the training in how to rehabilitate a postpartum woman’s core and how to structure a safe yet effective rehab program for them.

There are several types of diastasis recti therapies for you to pursue if you are struggling with diastasis recti. Different types of diastasis recti therapies include: at home diastasis programs, training with a personal training, working with a diastasis recti physical therapist, and surgery.