Stop Crossing Your Legs When You Sneeze: The Case for Pelvic Floor Therapy

Upon finding out that I was pregnant with my daughter, I vowed to keep up with my exercise regimen. Labor was going to be a piece of cake this time. Come to think of it, I was also going to have fewer pieces of cake. Turns out that working out did help with my morning sickness. The kind that was not just in the morning and not just in the first trimester. Groan. But, better than that it made labor much easier. Minus the moment where I cried and said, I can’t have two babies, right as they told me to start pushing. My husband, in all his wisdom, informed me that it was a little too late for that. Fast forward five weeks, that cherubic not so tiny 8 lb 12 oz baby that my stronger mom-bod pushed out (with the help of some Pitocin) wasn’t healing quite right. I called my OB in a postpartum haze only to hear the words pelvic floor physical therapy mentioned. Panic.

But why panic?

In a world where every other Super Bowl commercial is about erectile dysfunction drugs, why was I so uncomfortable with the thought of healing a part of my body that had just been through birth? I’ve made, before and since, plenty of jokes about crossing your legs when you sneeze postpartum or how trampolines are for the young and childless unless you bring a change of clothes, but sweet ladies, this does not have to be the case. With the right treatment and compliance all sneezes and Will Ferrell movies are safe even if you are freshly postpartum.

Now, I’ll Be Honest

This treatment was recommended to me roughly a year ago now, and I did exactly what I know better than to do as a nurse. I was non-compliant. I’m not sure how much more I can stress this point, but this process can make you feel incredibly vulnerable. I think that is why women so often turn it into memes and lighthearted jokes. Because the emotional weight of discussing not feeling comfortable with the changes in your body can be so heavy, many women remain silent. Even to their doctors. I also will say that if something does not feel right and you share that with your doctor and they blow you off. Well, honey, they aren’t the only shop in town. Fight for your body. The same goes for intimacy issues after baby, which I will refer more to in a later post. FINDING A PHYSICAL THERAPIST THAT YOU FEEL COMFORTABLE WITH WILL MAKE OR BREAK YOUR EXPERIENCE.

I am far from an expert here.

I am never above seeking out an expert source for an issue that is not in my wheelhouse of expertise which these days is somewhat limited to Paw Patrol puppies locomotives of choice and diaper rash creams, maybe a little snarky humor. Lauren Peterson, PT, DPT and her husband Sean Peterson own a new franchise of FYZICAL Therapy & Balance Centers here in Oklahoma City. Lauren, currently pregnant with her third baby, was gracious enough to sit down with me and talk about the ins and outs of pelvic floor therapy from a practitioner perspective.

Meeting with her was like having coffee with a friend, but in a doctor’s office type environment. She filled me in on where to seek out the most up to date information regarding postpartum health. If you are in the Oklahoma City metro and needing pelvic floor PT, I would certainly not hesitate to make an appointment with Lauren.

I know what a Kegel is. Can’t I just do those?

This was totally me. I was completely beyond a shadow of a doubt convinced I knew what a Kegel was. I did not. Not only did I not know what they were, but I was not very good at them once I did figure it out. A Kegel is when you can stop the flow of urine midstream. It is not when you can hold your breath, squeeze your butt, cross your legs (a favorite of the pee-sneeze crowd), or tighten your abs. They are actually quite difficult when one has a weakened pelvic floor as many women do. Per recommendations of the American Physical Therapy Association, women should be able to do 10 kegels that are held for 10 seconds and then 10 quick flicks to have what is considered a “strong pelvic floor”. I know you just tried to do it. It’s hard, huh? Don’t feel bad if you can’t do it now. Just means you (and I) have some things to work on, but better to have a small place to start, right?

But isn’t it well, weird?

If you’ve just had a baby, literally everyone on shift saw you spread eagle during that process. Not to draw attention to that fact, but it’s the truth. Your health is important. This is about so much more than being able to get on a trampoline without fear of the future. Can you run with your kids? Can you have a pain free intimate relationship with your partner postpartum? Do you feel as close to the old you as possible only with a heart full of more love for a sweet baby? If you are looking for help in any of these areas pelvic floor therapy may be the answer.

What should I expect when I go?

• Expect questions on your history and current problems whether they be urine leaking, pain with intimacy or as a result of tearing from birth, pelvic organ prolapse, or any other number of condition
• Expect information on how healthy muscle groups should work and what goals you should have
• Expect an external and internal exam similar to an OBGYN appointment
• Expect for the PT to have you Kegel or something similar during the exam so he/she can assess the strength/issues that will be treated
• Expect privacy and professionalism during the exam
• Expect a conversation about goal setting and exercises to practice at home for follow up appointments

Think of the appointment like you would any other women’s health appointment. You have a problem and you are going to a skilled and highly professional provider to help you fix that problem. It is completely normal to have some anxieties or reservations so I highly recommend seeking out a therapist you feel comfortable with and changing to a new provider if you do not. Additionally, if you have any past history of assault/trauma this may be particularly difficult for you. I encourage you to speak with your therapist about your unique circumstances.

How to find a provider

Most often, referrals are made through OBGYNs, but if your physician is not proving very helpful or knowledgable you can always seek treatment independently. Most pelvic floor therapists accept commercial insurance or offer private pay options.

My typical style of writing is fairly satirical. I believe in interjecting humor to make the heavy things in life a little bit lighter. But, I believe in women standing up for themselves. Issues like this one have hidden in the shadows for too long. Women suffer in silence. In pain. In embarrassment, thinking there is nothing that can be done for them. Pelvic floor physical therapy can help women make tremendous strides toward improving a marriage, self confidence, and over all quality of life for women. If you are nervous, take the leap. You’ll never regret taking care of yourself.

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