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Getting Back After Baby

I love working with clients post-partum! 6 weeks or 6 months or 6 years, there is always so much to teach, so much progress to be made, and so many women who look at you with eyes welling up in gratitude for the words you’ve just said, “This can get better.”  To expect that after delivery women should accept things like urinary incontinence, pain with intercourse or pelvic exams, and saggy weak abdominals as if there is no hope for these ever returning to any kind of normal, is disheartening.  There are so many providers who will see you at your 6 week check up and if you even dare complain of urine leakage or pain with sex, look you sternly in the face and say “give it time” or “you did just deliver a baby”.   As if we should just sit back, shut up and live with it!  Well, girls, I am here to tell you, beg you, please don’t just live with it!  You don’t have to.  I am going to share some insights into those problems and how physical therapy can heal your labor and delivery battle wounds.

Let’s begin with the trauma of giving birth.  Give yourself some serious points here, as this process is truly amazing, but at the same time horrifying for those poor tissues and muscles within the pelvis.  Their ability to stretch is on level with some super-human abilities, if only the recovery were as easy.  We can compare delivery to a whip-lash injury in a car accident. Those pelvic muscles are stretched to their max in a short amount of time, often with tearing of the fascia and connective tissue and/or nerve tissue aggravation. Or we have the reverse, where a woman is asked to push for 2-3 hours, which is darn near the time it takes to run a marathon!  We expect that people after whiplash or after running a marathon will have full recovery and return to their normal activities, so why not after baby?  Well, for years women were just accustomed to the problems that bearing children left them. Thank heaven for modern progress and for pelvic PT’s everywhere!   We are working hard to get the information out, educate people and providers so that  we can live happy healthy lives, laugh with our friends without leaking, and enjoy sex with our spouses!

What exactly do Pelvic Physical Therapists do to help you?  We start with a very thorough musculoskeletal evaluation. We can rule out lumbar spine, sacroiliac joint, pubic symphysis joint, hip joint and the abdominal wall as a source of the problem.  We will examine your abdominal, pelvic floor and spinal musculature to determine weakness, poor coordination, muscle imbalance, and dysfunction. These joints, connective tissues and muscles must all work together, in a coordinated manner, or symptoms such as urinary incontinence, urinary retention,  constipation, coccydynia (tailbone pain), pain with sex, or vaginal or pelvic pain with other activities  will appear.  The trouble with “just giving it time” is, it won’t generally work itself out on it’s own. You will heed the advice of the media or other fitness guru who will work your abs, gluteals, hamstrings, quads until they are so sore you cant get out of a chair, but you wont see the pelvic symptoms resolve. This is because strengthening these big, global muscle groups will only mask or worsen your problem. You have to get to the source of the problem and PT’s, namely pelvic PT’s, are the only specialists who truly know how to examine the many muscles that make up the pelvic girdle, while also examining the spine, SI joint and  hips and put it all together to develop an individualized program to help you reach your goals.  Physicians don’t do it, trainers, yoga instructors or pilates instructors can’t do it.   Pelvic Physical Therapists will take the time to find the source of your problem, devise a treatment plan that will work for you and spend countless hours educating you so that you can continue to maintain a healthy pelvis after you are no longer seeing us.

So girls, please hear what I am saying!  I love to treat this, I have seen it time and time again, even years after the last baby.  You can stop hurting and enjoy sex again. You can sneeze, cough, and laugh hysterically and not leak. You can return to activities and exercise you love and see your abdominal wall get stronger.  I can help you do it!  Our clinic was founded for this purpose!  Foundational Concepts  focuses primarily on pelvic dysfunction, and we want to help you feel better. So, stop reading all the self help exercise stuff, put Dr. Oz on pause and come in to see us and see what we can do to help! It is worth your time, money and effort. Believe me you will thank me for it!

–Sarah Dominguez, PT, MSPT, CLT


This blog is here for your help. It is the opinion of a Licensed Physical Therapist. If you experience the symptoms addressed you should seek the help of a medical professional who can diagnose and develop a treatment plan that is individualized for you.  If you enjoyed this blog, check out our website at for more blog entries and to learn more about our specialty PT practice, Foundational Concepts.  Follow us on Twitter @SarahpelvicPT or @Jenn_pelvic_PT and like us on Facebook at Foundational Concepts for updates.

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