Rehab for the vagina???
Yup. It's just like it sounds. Rehabilitation for your vagina and its surrounding region.
Okay. Perhaps it's a little more involved than I'm letting on. Often times pelvic physical therapy (PT) requires internal work (anal and or vaginal).
But it's not broken. I just had a baby.
For sure. We didn't break an ankle playing volleyball or develop shin splints from sprint training. We did, however, carry a baby for several months and deliver her either out of a hole too small hardly making any sense or by having someone cut through several layers of abdominal tissue.
Our body needs help recovering.
Best case scenario, our nether region needs a little TLC and R&R. On the other end of the spectrum, our rectum forgot how to function and shit comes out with no abandon, we don't feel like our hips can support the weight of our bodies, and injured flesh (vaginal or abdominal) isn't healing or is forming a mountain of scar tissue.
In the same way that we'd go to a PT for an aching joint or a sports injury, pelvic PT helps physically rehabilitate childbirth injuries, including and not limited to tearing, pelvic misalignment, incontinence, and bowel, bladder and sexual dysfunction.
Even if you don't think you had a childbirth "injury," during pregnancy our bodies change quite a bit. The ribs expand and rise to accommodate the growing baby, our heart grows larger to better handle the 25-40% increase in blood volume, internal organs get pushed to the front, back and sides, we carry around a lot of extra poundage, and the hormone relaxin loosens up our joints by loosening the ligaments, in preparation for childbirth.
Our bodies endure a lot and it takes time for us to feel and function normally again. Often, it doesn't just happen on its own. Yes, our bodies have the incredible ability to heal itself, but we tend to get in the way by doing too much too soon. Worse we ignoring glaring issues, mistakenly accepting them as part of our "new normal" after giving birth.
Pelvic PT isn't just for mamas who've had vaginal deliveries. Pelvic PT can help with internal and external tissue scarring from c-sections as well as restoring pelvic alignment and core strength. C-section mamas who labored can also experience incontinence and pelvic dysfunction. Pregnancy in itself is physically very demanding on our pelvises.
Here are some common conditions that pelvic PT can help:
- Scar tissue adhesion
- Painful surgical scars
- Pelvic or perineal pressure
- Diastasis recti (abdominal separation)
- Pelvic floor weakness
- Pelvic organ Prolapse
- Incontinence (urinary and bowel)
- Painful sex
- Pelvic pain
Often, if you're having several of the issues above your doctor may refer you to a urogynecologist, suggest reconstructive surgery, or ask you to play the wait and see game. All of which my doctors suggested to me.
Mama, we have options between let me surgically insert a sling around your urethra and let's wait and see.
How many sessions will I need? What exactly do they do?
It REALLY depends. No two mamas are the same.
The severity of our symptoms and amount of time we've put up with them account for how long and how many sessions we may need. Some might experience fast relief after just one treatment while others might need a handful of sessions before noticing improvements.
What the therapist does during treatments also depends. I have scar tissue buildup on the skin and pelvic floor muscles from a third degree tear, so my therapist has been working on mobilizing those tissues through a technique called myofascial release (MFR). I also have very tight abdominal muscles (tight DOES NOT mean strong ladies) and some hip alignment issues. These are pre-pregnancy problems that have come back to haunt my pelvic function and health. We work on those issues too, because all the parts are connected.
I'm about five sessions in and I'll write posts about my treatments so you can get a sense of what goes on at my pelvic PT sessions. So far no two sessions have been the same, but there are seven things that have consistently happened each time with the two therapists I see.
- We have a quick rap session. I'm asked, "Where are you at today?" "How are you feeling today (physically, emotionally, other)?" "What's going on with your body, health, spirit this week?" "Anything note worthy?"
- The therapist checks my alignment and mobility (clothes on).
- She does external work on non-private parts (clothes on).
- After ~40 minutes of hands-on "conventional" PT work, the therapist asks if we can do internal work. It's always a genuine question. She explains what she thinks we should work on if I say "yes."
- She leaves the room and my bottoms are off. I cover up with a linen blanket.
- With all PT work on private parts, the therapist tells me exactly what she's doing, when and where, and what sensations I might experience. It's a constant dialogue with her explaining and asking questions and me describing my experience. It feels very safe.
- All sessions have been an hour with the therapist working with me almost the entire time.
I've definitely noticed improvements, though I have a lot to work on since I've had years of pelvic pain from endometriosis and gynecological surgeries before pregnancy. What keeps me going back is that I trust the help I'm getting and I'm committed to exhausting less dramatic interventions (read: surgery) for my birth injuries. Doing pelvic PT allows me to be an active participant in my own healing, which is empowering after months of feeling disappointment in my body.
Ready to find a pelvic PT? Here are some tips and considerations for your search.
Would you ever consider pelvic PT? What are some additional things you'd like to know?