The other day I heard the common statement that makes me pause: “I knew I was peeing my pants, having pain with intercourse, and some weakness after my first child was delivered, but I wanted to wait until I completed my family to work on those issues.” This mom now has three children under the age of six, lingering back and hip pain, and is embarrassed because she leaks urine. She told me sex is “not fun” because she is having some “normal” pain with intercourse. Let us just ignore the fact that she thought her back and hip pain were permanent markers of age and motherhood so she did not even think they could be addressed with PT (they can). Things could have been much better for this mom if she had gotten PT right after her first delivery. Her outcomes would have likely been better too.
Let me break down why:
-When we put off postpartum PT until after our family is complete, we assume that pelvic floor issues are not additive, when in fact they are. Participating in therapy right after each pregnancy helps you recover to your optimal level of pelvic floor and core health and strength. The ligaments that get stressed and elongated during the growth of your uterus and belly during pregnancy get the muscular support retraining they need to get you through that next pregnancy, and the next one.
-The trauma of childbirth and the muscle length changes of pregnancy make it hard for our muscles to feel what they are supposed to do. Imagine a sprained ankle that does not move like the other one even after the pain is gone because the ligaments and muscles are loose and the muscles are not firing as they should. Running on a weakened ankle is hard on the whole body and sets us up for more injury. This is no different than a new mom lifting toddlers all day long and running after children without the benefit of retraining her muscles to handle the job. She is at higher risk of pain and injury doing her basic daily activities.
-Getting the core and pelvic floor muscles back to ideal function is rarely automatic over time. Movement compensation patterns arise because of pain or weakness and become entrenched. The longer you wait to address them, the stronger the patterns become over the years. These compensation patterns are often the cause of mystery aches and pains that creep up.
If we have muscle imbalances, an online or basic strengthening program can give limited benefits. A PT-led personalized approach will tease out and address your specific needs, saving time, frustration, and money in the long run.
Moms who wait and stack up many issues before starting PT also take longer to rehabilitate. They need more time and training to change those faulty movement patterns they have established over time.
The alternate scenario:
When you have postpartum PT you can enjoy a pain-free sex life with your partner and lift your growing children with ease and grace. You get to be a happy mom, and it is worth every penny and every bit of time spent, both for you and your family. I have heard this from numerous moms who were disbelievers but went ahead and made that first appointment.
Good news for all:
It is OK if you waited for years to address these issues. Any time after a baby is still effective and will help you to meet your goals of enjoying daily activities, hobbies, and your family without pain and difficulty. The time to start is always NOW.
So moms, please put yourself first and consider pelvic floor therapy after your first (or your most recent) pregnancy. You will be happier, more fit, more confident, and more comfortable so you can enjoy that growing family!
–Marla Jacquinot, PT