How Can I Fix My Mommy Tummy?

After childbirth do you feel the nagging sense of self-consciousness as you wonder how that abdominal pooch looks to yourself and your significant other? Do you silently pray that they can’t see the layer of squish that won’t leave your mid-section, no matter how many miles you run or crunches you complete or pounds you lose?

Having a “mommy tummy” is a major hint that you have diastasis recti. Diastasis recti is the separation of the rectus abdominis muscles during and after pregnancy. This could mean a visible bulge or “pooch” that protrudes just above or below the belly button. It may also have a softness or jelly-like feeling around your belly button.

You may also notice symptoms such as low back pain, pelvic pain, and signs of pelvic floor dysfunction, such as urinary incontinence/ urge/ frequency, prolapse, and even pain with intercourse. However, these symptoms can also occur in the absence of diastasis recti.

The best way to know for sure if you have diastasis recti is to consult with a prenatal and postnatal health-care provider, such as a Pelvic Floor Physical Therapist. A highly trained Pelvic Floor Physical Therapist can diagnose diastasis recti, determine how severe the abdominal separation is, and help you re-train the muscles to repair it.

While diastasis recti can also occur in men and children due to abnormal abdominal pressures, women are primarily affected because pregnancy weight gain is one of the main causes. It used to be thought of by how much a woman weighed before pregnancy, how much weight she gained during pregnancy and how large her baby was that increased her risk for diastasis recti; however, research actually suggests that 100% of women have at least some degree of abdominal separation by the third trimester. Seeing a Pelvic Floor Physical Therapist early in your pregnancy can be beneficial in that the PT can show you ways to prevent worsening diastasis.

Do you have Diastasis Recti? If so, the goal of Magic City Physical Therapy is educate you on how to prevent the worsening and also how to help it heal. Healing diastasis recti requires a change in your habits and also gaining body awareness. The best part is that whether your baby was born a few months ago or 20 years ago, a Pelvic Floor Physical Therapist can help you close a diastasis and strengthen your core with proper care.

Fixing this problem often takes persistent hard work over a period of time. A Pelvic Floor PT can help you retrain the deep core muscles to close the separation. However, you can start doing simple things on your own to assist in the healing: use a squatty potty when pooping to decrease straining, practice good posture when sitting and standing, and exhale with exertional movements.

If you are pregnant or plan to become pregnant, think PREVENTION by consulting with a Pelvic Floor Physical Therapist. Seeing a Pelvic Floor PT can help you prevent worsening Diastasis, bladder problems, constipation, and aches and pains. In addition to prevention, Pelvic Floor Physical Therapy can help prepare you for birth!

If you are postpartum, whether it’s a few months or many years, contact us to help decrease your Postpartum symptoms!

Pelvic floor Dysfunction in Women with Breast Cancer

Recent studies show that breast cancer patients are experiencing pelvic floor dysfunction including urinary incontinence, fecal incontinence, and sexual dysfunction during and after receiving treatment. Up to 58 percent of survivors report difficulty with bladder control or urinary incontinence. 1 Painful sex is never normal and 52 percent of women up to six months post-breast cancer treatment report sexual dysfunction and 19-26 percent continue to report sexual dysfunction five to 10 years after their diagnosis. 2

Constipation is a common problem post-cancer treatment patients face. Constipation can be related to medications, decrease in activity, abnormal toilet posturing, pelvic floor muscle dysfunction, and diet. Normal bowel habits can vary from person to person. The frequency of having a bowel movement can be between three times per week to three times a day. Abnormal bowel symptoms include straining, hard stools, loose stools, not completely emptying, or fecal leakage. Constipation can be associated or cause other problems like urinary incontinence, fecal incontinence, pelvic organ prolapse or pelvic pain.

Pelvic floor symptoms in women with breast cancer may be related to hormonal changes after chemotherapy or endocrine therapy use. Breast cancer treatment can cause weakness, thinning, and dryness in the pelvic floor muscle tissue that can cause pain, tightness, weakness, and/or leakage. Fatigue and decreased activity along with changes in hormone levels can cause further atrophy (muscle loss) in the pelvic floor muscles, worsening symptoms. Urinary incontinence can also be caused by improper
bowel and bladder habits, abnormal pressure management, and diet. A pelvic floor physical therapist can help with these symptoms, teach proper bowel and bladder habits, and help coordinate the muscles of the core and pelvic floor.

Scar tissue from breast cancer surgeries can not only contribute to shoulder pain and dysfunction, but can also cause fascial restrictions in the trunk. Fascial restrictions in the trunk can contribute to abnormal posture and breathing strategies, which can greatly affect the pelvic floor.

Participants in a 2022 study reported there needs to be more awareness about Pelvic Floor dysfunction in women undergoing treatment for breast cancer. 3 They would have liked to receive information about pelvic floor dysfunction prior to starting cancer treatment, to be screened for pelvic floor dysfunction during cancer treatment, and be offered therapies for their pelvic floor dysfunction after primary cancer treatment. Therefore, a greater focus on managing pelvic floor symptoms by clinicians may be warranted in women with breast cancer to help decrease Breast Cancer patients and survivors from being frustrated
and dejected.

Patients experiencing leakage, constipation, pressure, or pain are encouraged to mention it to your health care team as pelvic floor therapy can cure or significantly improve incontinence issues and sexual dysfunction. It is an important component of survivorship and thriving and should not be ignored. Incontinence, urgency, and pelvic/genital pain can be addressed and your pelvic health is important for your quality of life.

Pelvic floor therapy can include treatments such as hands-on techniques to decrease muscle tension and pain, deep breathing and relaxation techniques, and conscious control of pelvic floor musculature. Control and coordination of pelvic floor muscles does NOT mean performing kegels at home. Those with pelvic pain and leakage are discouraged to perform kegels on their own, as this exercise can contribute to worsening of symptoms. Significant education is provided by Pelvic Floor PTs on vulvar care, lubrication, sexual positioning, proper diet, and proper toileting mechanics. Exercises are individualized
for each patient and progressed as tolerated. Exercise prescription should include functional training, mimicking activities that patients perform on a daily basis.

If you are having any of these problems, talk with any of your doctors. Ask for a referral to pelvic floor physical therapy to help address any of these issues! A pelvic floor physical therapist is a licensed physical therapist who has gone through specialized training to be able to evaluate, assess, and treat the pelvic floor and its associated problems.

Jennifer Self Spencer, PT, DPT, CLT, OCS, has advanced training in the treatment of Pelvic Floor as well as Lymphedema and Cancer Rehab. She has over 14 years’ experience as a PT. She sees clients in the Birmingham, Alabama, region as well as virtually.

Magic City Physical Therapy
3075 John Hawkins Parkway, suite J
Hoover, AL 35244
(205) 202-0874
www.magiccitypt.com
@magiccitypt (Facebook and Instagram)

  1. Donovan KA, Boyington AR, Ismail-Khan R, Wyman JF. Urinary Symptoms in Breast Cancer: A
    Systematic Review. Cancer. 2012 Feb 1; 118(3): 582–593.
  2. Seav SM, Dominick SA, Stepahyuk B, Gorman JR, Chingos DT, Ehren JL, Krychman ML, Su HL.
    Management of sexual dysfunction in breast cancer survivors: a systematic review. Women’s Midlife
    Health 2015 1:9.
  3. Colombage UN, Lin KY, Soh SE, Brennen R, Frawley HC. Experiences of pelvic floor dysfunction
    and treatment in women with breast cancer: a qualitative study. Support Care Cancer. 2022
    Oct;30(10):8139-8149. doi: 10.1007/s00520-022-07273-2. Epub 2022 Jul 5. PMID: 35788772; PMCID:
    PMC9255500.

Can Pelvic Floor Therapy Help My Irritable Bowel Disease?

What is the difference between Irritable Bowel Disease and Irritable Bowel Syndrome? IBS is a chronic syndrome made up of a group of symptoms. IBD, on the other hand, refers to inflammation or chronic swelling of the intestines and includes 2 conditions: Crohn’s disease and Ulcerative Colitis. It is called inflammatory bowel disease because it is categorized by chronic inflammation of the GI tract, which include all the organs that are involved in digestion from the mouth all the way to the anus. Inflammatory bowel disease affects 1.3% of US adults.

Crohn’s disease can affect any part of the GI tract, but it primarily affects the small intestine. The tissue is damaged in patches in areas next to healthy tissue. Inflammation can affect multiple layers of the walls of the GI tract. Ulcerative colitis occurs primarily in the large intestine and rectum. The tissue is damaged to a greater extent than just patches, and inflammation is present in the innermost lining of the colon.

Symptoms of IBD can include fecal incontinence, constipation, urinary incontinence, fatigue, and pelvic pain. Seeking treatment from a pelvic floor physical therapist can help you manage and overcome many of these symptoms.

Below are several ways that pelvic floor physical therapy can help you with irritable bowel syndrome.

  1. Develop good bowel habits: Your posture and your breathing greatly affect your bowels. In general, assuming a position where the knees are bent higher than the hips can open up the pelvis and reduce the amount of straining. Using a toilet step stool or a Squatty Potty is a way to bring the knees higher than the pelvis. Deep breathing to help to lengthen the pelvic floor muscles also assists in easier stool evacuation. A pelvic floor physical therapist can discuss this further and adjust the ideal position for you based on your body.
  2. Abdominal Massage: Sometimes the bowels need some external help to move. Try laying on your back, start on the right side of your stomach at your front pelvic bone, rub in a circular motion lightly up the right side until you reach your rib bone, move across the top to the left side, and work your way down to the left hip bone and back toward the belly button. Rub in slow, circular motions for about 5 minutes total, repeating the pattern as needed.. A pelvic floor physical therapist can perform this type of massage and show you different techniques to get the digestive system moving.
  3. Reduce pelvic pain: A large portion of people with IBD also have pelvic pain. A physical therapist will do a thorough assessment of the muscles in and around the pelvis. When pain is present there is often muscle tension. PT can show you different techniques to reduce muscle tension.
  4. Improve pelvic floor coordination and support : Pelvic floor muscles may be tight and/or weak, leading to symptoms such as urinary and fecal incontinence. A Pelvic Floor Physical Therapist will assess your pelvic floor muscle coordination and prescribe exercises to assist with overall muscle function.

If you are dealing with Inflammatory Bowel Disease, see a pelvic floor physical therapist. We will do a full evaluation reviewing your bowel habits, assess your pelvic floor, posture, and overall movement, and start you on your healing journey! Your program will be individualized to fit what works best for you, in an effort to reduce the effects that Irritable Bowel Disease has on your everyday life.

Do you need help managing symptoms of Irritable Bowel Disease? Contact us!

We offer 60 minute one on one sessions.