Chat with a Provider: Pelvic Floor Physical Therapy with Bridget O’Brien PT, DPT
So many changes happen throughout a lifetime, especially in the prenatal and postpartum periods (and the lifetime after pregnancy and delivery too). The changes that the body goes through over just several months is hard to comprehend. It’s a toss up which of the changes are most challenging to process; from hormonal to emotional to physical changes, there is so much shifting and a new normal to adapt to. Just because life isn’t even going to be the same as it once was, doesn’t mean that one has to settle with potential complications and new symptoms of that change. In regards to the physical changes that can happen in the pelvic floor and related tissues (hips, core and back), I reached out to a pelvic floor physical therapist to get information to provide to the mamas of the world about what resources are available to help! I personally have not done pelvic floor physical therapy but the more I hear about it the more I am interested. In my perinatal yoga training, I have learned about functional movement and importance of awareness of the body, including the often forgotten pelvic floor, and that it is able to engage and relax, just like other muscles in the body. It’s what holds us up so to speak and lots of important structures where they are supposed to be. It’s so important to take care of yourself so that you can take care of others (I’m sure you hear that a lot but it really is true). Here is the lowdown on pelvic floor physical therapy to make it feel like the accessible and non-intimating process that it is!
Bridget’s Bio:
Hey mamas! I’m Bridget O’Brien, mom to a crazy pup named Sammy and 1-year-old little man named Joshua. My boys (including my husband, Peter) and I live in Columbus, OH but are diehard Buffalo Bills fans. Go Bucks & Go Bills!
My career is rooted in helping women improve their lives by navigating and improving the physical barriers that come our way. I am a Doctor of Physical Therapy with clinical specialties in pelvic health and orthopedics. I chose my career because I have battled with my own pelvic health issues and understand firsthand how intimidating these conditions can be and how important it is to self-advocate. These things CAN get better!
This information should not take the place of your healthcare provider’s recommendations. Please always contact your healthcare provider with any concerns, questions or need for further elaboration or clarification.
Pelvic Floor Physical Therapy (PT) has become more well known over the past few years. However, just because the words are out there doesn’t necessarily mean all us people of the world know what it involves. Can you describe what pelvic floor physical therapy is and who it is for?
Pelvic floor physical therapy was described to me once as “orthopedics in a cave”. PT’s are movement specialists, so we look at how all of your joints, nerves and muscles move together to improve your daily function. Pelvic floor physical therapy is looking at all of the tissues that make up your pelvis assessing how to make their function better. These structure happen to be inside of you and in the same region as your organs; hence, “the cave”. We teach you how to connect with your muscles and improve what they do in order to get you back to the things that make you, you. Pelvic floor PT is for anyone who has a pelvis, but especially for those who have gone through any type of child bearing or birthing process.
How would a person know if she/he would benefit from pelvic floor PT?
I LOVE this question! If you have a pelvis, you can benefit from PT. In the American culture, there is a large gap of knowledge surrounding healthy bowel and bladder habits and what can be done when issues arise. If you are someone who is:
A. Having ANY difficulty controlling bowel or bladder functions, meaning having a hard time going or not being able to hold it or leaking (yes, even after childbirth!!)
B. Have a history of or currently have any type of pelvic, hip, abdominal or low back pain (including pain with sex, tampons, Obstetrician (OB) exams, etc)
C. Have a history of falling on your tailbone or have tailbone pain of any kind
D. Pregnant and having pain. OR pregnant and wanting to know more about how to properly push or position yourself for labor and delivery
E. Postpartum (at any point). It is never too late and the postpartum journey is forever, not just the immediate recovery of the first few months.
You can and likely will benefit from pelvic floor PT!
In the perinatal period (before and after having a baby), is pelvic floor PT recommended during pregnancy as well or just in the postpartum period?
Yes to all of this! We are here to educate and support through all phases of pregnancy. Unless there is a medical reason that you cannot participate (best to check with your OB to be sure), pelvic floor PT is recommended. In 2018, the ACOG published an opinion piece strongly recommending pelvic floor PT for musculoskeletal and neuromuscular conditions during and after pregnancy.
How does one get started? Is a prescription typically needed?
In most states, you will need to ask your OB for a prescription. If you believe you are a good candidate for pelvic floor PT and your OB does not bring it up to you, ask for a referral!! Self-advocating is very important in our field—do not let a provider tell you that pain or leakage is “normal” under any circumstance. [Advocating for yourself and speaking up can be difficult and feel so intimidating at times, especially during rushed appointments. It’s okay to interrupt and tell your providers what is going on and ask questions for your benefit!]
What is the initial assessment like? Is it painful or scary (especially with immediate postpartum people in mind)?
The first visit to a pelvic floor PT should be whatever you are comfortable with. Many times, it is about an hour in length and is a lot of patient education and taking a full history (including lots of questions about your habits, difficulties, and what your personal goals are). We will NOT perform an internal assessment unless you consent! There are many other “fish to fry” initially so to speak. We identify the cause of your concerns to the best of our ability, set up the plan for your treatment and send you home with some things to get started (and lots to think about). If you have any concerns prior to your appointment, call the clinic and ask to speak to one of the therapists!
Do you have any recommendations for safe and easy at home exercises, even before an assessment?
1. Drink more water!! The minimum amount required for proper pelvic health is half your body weight in ounces per day
2. Self assess: Where do you hold your stress? Unclench your jaw, breathe into your belly and let those glutes (butt muscles) go. Pelvic floor leakage has more to do with coordination than it does strength.
Are there any activities or exercises you recommend avoiding if a person has pelvic floor dysfunction? This is a very specific, but common question for us to receive and it is a topic we go over at every initial evaluation. The answer to this question is based on your specific symptoms and evaluation, so if you have questions about safe exercises, go see a pelvic floor PT!
What else do you want the world to know about the pelvic floor and/or physical therapy services?Just because something is common does NOT make it normal. 1 in 4 women is living with some type of pelvic floor dysfunction and over half never seek help. We are here to help!! Many of us have been in your shoes and we want you to get back to whatever your goal is. Whether it be sneezing in pink leggings or running 26.2 miles, the pelvic floor PTs of the world have your back 🙂
What questions do you have for Bridget??
Let’s talk soon,
Al
Featured Cover Photo by Otto Norin on Unsplash