I am 11 months postpartum and I finally got in to see a pelvic floor physical therapist.
I am strong. I am a former division 1 athlete. I bike and swim and walk and lift. I do strength training and HIIT and spin classes. I have focused on gentle postpartum core strength and healing diastasis recti. I work out 6 days a week, on average – not crazy, but at least a 30 minute walk and 25 minutes of something else. I am in shape and I feel great.
But for the past few months, I’ve felt a twinge of pain in my groin, some ligament perhaps? I’ve found it more difficult to do plank moves, leg lifts, burpees. I’ve felt like my hips can’t support and stabilize my weight, particularly if I’m trying to lift one leg or arm off the floor and remain stable with three points of contact.
For months, I’ve been wondering if it’s a core issue – am I just not strong enough yet? Are my hip flexors tight? Do I need to strengthen my quads? In my mind I fell back to the “pelvic floor” issue because I’m postpartum and it feels like a postpartum issue and postpartum issues are all about the pelvic floor, right?
So I reached out to my OB/GYN and they referred me to this pelvic floor physical therapist. I had to wait about a month and a half just to get in. (Is there only one that takes my insurance? Really?)
I had hesitated to request an appointment in the first place because I was worried that whatever they would tell me would be things I could find online by Googling, or by following physical therapists and athletic trainers on Instagram. I’ve already found a lot of postpartum workouts and tips on social media that I really love. But I my curiosity and frustration with myself got the better of me. I figured at the very least, they’d tell me to do some stretching or some simple exercises and having the “doctor’s order” to do it would make me actually follow through.
For the most part, I was right. But I did learn a few eye-opening tidbits. The first of which was that my groin issue is not actually an issue with my pelvic floor. It is likely that my tight adductor muscles and hip flexors are causing weak ligaments and the weakness is causing the pain and instability. So she sent me home with some stretching homework, as I expected.
But she also noticed that my pelvic bones were not lined up correctly. They are literally uneven, probably due to being super stretched out and loose when giving birth and they just didn’t go back correctly. And the crazy part was that she could pull on my leg in certain ways and get it lined up again. Or at least better than it was. Mind blown.
Lastly, I answered in the negative for all of her questions to diagnose any kind of real pelvic floor issue – incontinence, leaking when jumping or sneezing, pain, etc. – but she figured out that I might still have some pelvic floor issues going on and sent me home to practice kegels too.
Any other person in my situation might have just shrugged off that fact that burpees and plank jacks are no longer an option. Oh well, they’d say, there are lots of other workouts and exercises to do. Someone with no pelvic pain and no leakage might count their lucky stars and get ready for baby #2.
But the physical therapist told me that just because there isn’t any pain doesn’t mean there aren’t any issues. And also that subsequent pregnancies can make things worse and reveal a whole lot more damage than there would have been if it had been fixed earlier.
This is so important. Our bodies go through so much physical trauma during pregnancy, and there’s a lot more to recovery than people realize. When other people go through surgeries or procedures, or have medical issues that require hospitalization, physical therapy or some form of recovery program is prescribed. You actually wouldn’t expect someone who broke their ankle to get the cast off and then just be walking around like normal. There would be weeks of recovery time, healing, therapy, rebuilding muscles, strengthening tendons and ligaments, ensuring that everything was working correctly once again.
But when women give birth, it feels like any sort of recovery treatment is optional. If you’ve heard of pelvic floor physical therapy, which you may not have because most doctors I know don’t even bring it up, then you’ve only heard about it because maybe you know someone who had major painful problems. Or maybe you’ve heard about it, but since it wasn’t prescribed, it’s not really required. Or your insurance doesn’t cover it so you don’t want to pay out of pocket for it.
Why wouldn’t insurances cover this? Why is it like this? Why wouldn’t our health care system care about the recovery and rehabilitation of women who have just brought life into the world? Why isn’t it acceptable for us to recognize that our bodies don’t just bounce back. My bones literally shifted out of place. How would I have known that? How would I have fixed that? How would I have ensured that future pregnancies don’t completely disable me because I hadn’t fully recovered from this one?
Recovery and rehabilitation shouldn’t be optional. It shouldn’t be just for those who can afford it or for those who can fit it in to their schedule. It should be mandatory to make sure that women are taken care of after giving birth.
If you’re reading this and you’re a postpartum mom who has never seen a pelvic floor physical therapist, I encourage you to find the time and find the money, if you have to. Make the request to get a referral and prioritize your health. We deserve it.