Listen up, ladies! It's time to talk about all of the things your mom, your girlfriends, your OBs, your PCPs...you catch my drift...haven't told you about the pelvic floor.
This region of the body seems to remain taboo and masked in confusion and mystery. However, it's important that women understand their bodies—in its prenatal, post-natal, and years-past-post-natal forms.
To help boost your body IQ, we sought the advice of an expert. Dr. Sara Black, a pelvic therapist with Zia Physio, is here to offer some simple schooling surrounding the pelvic floor and, more specifically, pelvic health.
It's likely you've heard the phrase pelvic floor and most certainly Kegels, or actively engaging the pelvic floor. According to Dr. Black, for most women, their knowledge base stops there. In this article, she'll challenge you to strive for a healthy and functional pelvic floor—because it’s essential to your wellbeing.
Dr. Sara Black's Top 5 Things You (Probably) Didn’t Know About Your Pelvic Floor
The pelvic floor is made up of muscles. And there’s therapy for that. As a specially trained pelvic health physical therapist, I work in the pelvic area, specifically with the pelvic floor and other associated muscles. All skeletal muscles can contract and relax as well as shorten and lengthen. They can feel supple and healthy or taut and ropy. What’s more, they can have pain-inducing tender points and knots. The pelvic floor is no exception.
When appropriate, a pelvic therapist will access these muscles through the vagina and/or anus using proper draping and sanitary measures, gloves, and lubrication. Muscle length, tone, and function are assessed as well as external muscles throughout the core complex. I look at the body as a whole; the pelvic floor is just one small piece to the complex puzzle; it works synchronously with neighboring muscles. When framed in this manner, it tends to take the mystery away from this intricate region of the body.
Around 1 in 3 women will experience pelvic floor dysfunction in their lifetime. Common symptoms of pelvic floor dysfunction include pelvic/vaginal/perineal pain, urinary leakage, constipation, painful sex, pelvic organ prolapse, urinary urgency and frequency, separation of abdominal muscles, and tailbone/hip/back pain, just to name a few. Pelvic health physical therapy can mitigate and reduce symptoms as well as prevent worsening of symptoms as you age.
Pelvic health physical therapy isn’t just for postpartum women. In fact, I highly encourage women who are considering becoming pregnant or who are already pregnant to meet with a pelvic health physical therapist. In order to classify something as dysfunctional or abnormal, we have to know more about our normal. In other words, we need to know more about our bodies prior to pregnancy. How much are your abs separated? What does your vulva look like? How strong and coordinated are your pelvic floor muscles? Let’s get that baseline information and dampen these unrealistic expectations, all while improving postpartum self-image.
Prenatal pelvic health physical therapy can specifically address aches and pains; assist in coordinating pelvic floor muscles to reduce perineal tearing, tailbone injury, pelvic organ prolapse, postpartum leakage, etc.; and review labor pain management strategies and optimal labor positions to ensure a healthy postpartum period.
Kegels are not for everyone. The advice to Kegel is very dated; yet, it’s still a recommendation offered to a lot of women. I’m here to tell you, at least anecdotally, that most women need to practice the Reverse Kegel instead. Kegeling your brains out at a stop light, or even in bed with your Elvie, may be ineffective and/or actively exacerbate the issue. Generally, Kegel exercises should only form a small part of a grander scheme to ensure pelvic health.
Childbirth isn't the main culprit. I generally don't blame pelvic floor dysfunction on childbirth. In fact, I treat women, men, and children of all ages, from 9 to 95. Hey, we all have pelvic floors! When it comes to pregnancy, more often than not, women who end up with pelvic-floor problems had underlying core concerns that were exacerbated by labor and delivery. That's why it's important to get a prenatal evaluation. I see women in their 70s, 80s, and 90s with lingering concerns. The faster you address your concerns, the better!
I strongly encourage you to strive for a healthy and functional pelvic floor, and consider meeting with a pelvic health physical therapist to assist you in your journey. Whether you’re a newlywed thinking about starting a family, a busy mom of four, or even a grandmother looking to travel the world, achieving and maintaining a healthy pelvic floor will help you do the things you want and need to do.