Guest Spot: Do You Have A Physical Therapist On Your Team?
Would you ever sign up for a marathon without running a single mile to prepare? Would you expect Serena Williams to return to the court after a major injury without a period of rest followed by intense rehab with her trainer? Of course not! But somehow the norm for pregnancy and postpartum is for women to experience a 25+ pound weight change in less than a year, deliver a baby via abdominal surgery or the vagina, and mysteriously “bounce back” to normal activity, appearance, and function without any guidance, likely while caring for one or more very adorable, yet extremely needy human beings.
Wow!! Talk about putting unrealistic and unfair expectations on moms! I know I’m preaching to the choir here, but it’s about time that society recognizes the fact that child-rearing is hard work and calling in reinforcements is acceptable and often necessary. Thank you doulas, lactation consultants, counselors, chiropractors and more for all that you do! I would like to propose that a women’s health physical therapist could ALSO play a vital role in your pregnancy prep and postpartum team.
Women’s health physical therapists specialize in the changes that occur within your body’s alignment and muscles during and after pregnancy. Their additional training in pelvic health means they have learned how to assess the pelvic floor’s function from an external as well as an internal perspective.
Some common things that you might set-up an appointment with a physical therapist for during pregnancy or in the postpartum period are the following:
● Safe exercises to do while pregnant
● Optimal birthing position to decrease mom’s risk of injury during delivery
● Ways to prepare the pelvic floor for labor and delivery like breathing and relaxation
● Exercise, positioning and pain relief techniques for mamas on bedrest
● How to prep your home for a newborn if you have a disability
● Treatment of urinary and fecal incontinence before or after childbirth
● Painful intercourse surrounding pregnancy
● Management of diastasis recti recovery due to pregnancy
● Nerve injuries incurred during delivery that make walking and climbing stairs difficult
● Pain and loss of function due to pubic symphysis diastasis or separation
● Pain related to a tailbone injury
● Pain and discomfort attributed to breastfeeding
● Pelvic organ prolapse
● Healing well after a cesarean section delivery
● Advice to return to exercise safely
The miraculous process of creating and growing life changes a woman’s body forever, but it’s heartbreaking when mamas feel broken after childbirth. Physical therapists #1 priority is to equip moms with tools and strategies to maintain strength and function so that you can lift and chase, run and jump, enjoy intimacy, and participate in that barre class, 5k, nature hike, etc that makes you healthy and happy inside and out!
It is a common misconception that women “pee when they sneeze” BECAUSE they have had a baby. It’s “normal for sex to hurt” BECAUSE they have had a baby. “Vaginal heaviness” occurs BECAUSE they have had a baby. While it’s true that these things commonly happen BECAUSE we’ve had babies, they are NOT normal or indefinite after having babies. Contrary to the advice given in Cosmo magazine, it will require more than just lots and lots of kegels to solve these problems. Becoming connected with the movements of your pelvic floor,acquiring strength throughout your body, and learning how to confidently move in pain free ways are important skills to learn after pregnancy.
Have I convinced you yet that physical therapy during pregnancy and postpartum recovery is important? Hopefully you’re wondering how you can access physical therapy now or in the future. Physical therapy for mamas could be done during your birth hospitalization, at an outpatient clinic, or even in your own home with home visits or virtual therapy sessions! And while there are lots of therapists just waiting for mamas to walk through their doors, it isn’t standard for physical therapists to be included in prenatal or postpartum care in the United States. Good news though, they are accessible and sometimes even covered by insurance when you seek them out.
When looking for a qualified physical therapist, look for therapists with special training that will be indicated by words like “APTA” or “Herman and Wallace” trained or “CAPP” certified in their bio section. It’s important that your therapist is pelvic floor trained, if they plan to do an internal assessment of your pelvic floor during your appointment.
You’ll know you’ve found an excellent therapist when you can answer YES to the following 3 questions:
My physical therapist asked me what my goals are.
My physical therapist gave me homework to do at home between sessions.
I notice progress after each session.
Knowledge is power, and I hope that this information empowers you to feel comfortable talking to your providers about physical therapy or seeking it out independently. Click the link https://mamasandmisses.com/pt-flow-chart/ and download this flowchart to help you decide if physical therapy would be helpful for you right now! Mamas do incredible things. You deserve to have the resources you need to live your best life.
If you’re ever looking for free information from the perspective of a mama and physical therapist, I put out videos weekly on my YouTube channel Mamas and Misses. Telehealth or in-home appointments are a great option that allow you to get individualized care without leaving your home or stressing about scheduling outings. You can learn more about scheduling an appointment with me on my website https://mamasandmisses.com/book/
Investing in your health is one of the best investments you can make. Becoming a STRONG mama allows you to grow a STRONG family!
Dr. Nicole Bringer, DPT
APTA trained in Pelvic Health and Obstetrics
Owner of Mamas & Misses LLC