Safe Return to Exercise after

The structural and hormonal changes that happen during pregnancy don’t just disappear as soon as your baby is delivered, and overdoing it after pregnancy can result in urine or bowel leakage, pelvic discomfort, joint pain and even injury. You may have had a vaginal delivery and you might be recovering from stitches; or you might have delivered via cesarean birth, which involves an incision through the abdomen which cuts through many layers of tissue and muscle. Seeing a pelvic floor physical therapist prior to returning to activity can help address your symptoms and provide guidance on returning to exercise safely while your body is still in recovery. All women heal differently following childbirth, so seeing a Pelvic Floor PT for an assessment of your current state of healing and function can give you great insight on your road to recovery.

The six-week mark is typically when you’ll have your postpartum checkup with your healthcare provider. Any questions about your body, how it’s healing or how you are feeling should be addressed at that visit. The postpartum checkup is also critical for identifying any post-birth conditions like diastasis recti (abdominal muscle separation, a condition that affects 60% of people six weeks after birth and 30% at one year after birth) or incontinence (which can affect one-third of first-time moms and be an indicator of pelvic prolapse), both of which can be treated by a pelvic floor physical therapist conservatively.

Early postpartum 0-3 week exercises will include: Deep breathing with gentle abdominal wall tightening, ankle pumps and foot/ankle circles while you are sitting or lying down, and walking.

3-8 weeks postnatal: it is recommended you wait until your six-week postnatal check before starting a group exercise program or going back to the gym. Exercises can progressively include: walking, pelvic floor and core exercises (but not just kegels!), and progressive body weight exercises.

8-12 weeks postnatal exercises will include: Gym program (maintain posture, light weights, no breath holding), pelvic floor exercises. Visit a pelvic floor physical therapist for a postnatal abdominal muscle check and pelvic floor muscle

testing before returning to high-impact exercise, running, sport or abdominal exercise programs.

As you start exercising, start small and progress slowly. Monitor for any abnormal symptoms. Some “red flags,” to look out for: bleeding during/after exercise, pelvic/vaginal heaviness or pressure, incontinence (either urinary or bowel), low back pain, pelvic pain, doming or gap in the abdominal wall. These red flags mean you would greatly benefit from a Pelvic Floor PT consultation!

Sit ups, curl ups, planks, hovers and mountain climbers are not recommended exercises for postnatal moms, as they can place pressure on the lower abdominal wall and the recovering pelvic floor. A pelvic floor and postnatal abdominal check is recommended before undertaking these intense core exercises.

Are you a postpartum mom wondering where and how to begin exercise following childbirth? Contact us!

What is Visceral Mobilization?

Did you know that almost every organ in your body is covered or supported by fascia? Fascia is a unique connective tissue made mostly of collagen that helps to connect everything in the body and provides support and lubrication to all of your organs, muscles, blood vessels, and nerves. Think of fascia like a giant network of internet fibers connecting everything in the body. If tension patterns form within the vast fascial network deep in the body, it will cause a cascade of issues that can appear far from the origin of the tightness or tension.

Did you also know that almost every organ in your body is always moving? Each organ has its own rhythm that helps it work most efficiently, but if the fascia on or around that organ is too tight or sticky, then the organ can’t move the way it’s supposed to, which can affect its function. This is where visceral mobilization can be very helpful. “Visceral” means internal organs and “mobilization” refers to the act of making something movable. Using very specific manual therapy techniques, specially trained physical therapists are able to release the fascia around the organs and encourage their normal movements patterns in order to improve their function.

Visceral mobilization also helps improve blood flow and lymphatic flow to the region, which helps remove waste products from the area and aids the overall function of the organs and surrounding soft tissue. Visceral manipulation helps to gain space around the organ and within an organ that may be compressed, restricted or adhered to another structure. Visceral manipulation has been proven to help prevent and release adhesions and also improve lumbopelvic pain, infertility, surgical pain (including c-sections and hysterectomies), scar pain, and bowel activity. After an abdominal surgery, scar tissue can form around the organs, compromising their mobility and ability to function most effectively. Through visceral mobilization, the physical therapist can gently introduce movement and ease tension on the internal organs. Other issues that can be helped with Visceral Manipulation include gastroesophageal reflux (GERD), constipation, bladder problems such as interstitial cystitis, diastasis recti, chronic sensitivities, breathing problems, and endometriosis.

At Magic City Physical Therapy in Hoover, AL, we use visceral mobilization to help with many different conditions, including pelvic floor dysfunction and orthopedic problems such as pelvic pain, constipation, bladder dysfunction, low back pain, and post-operative healing. We use this technique in combination with other techniques to get your whole body moving better. By utilizing different manual therapy and exercise techniques, we are able to help improve your overall function.

If traditional exercise and self-treatment has been ineffective for you, please contact us at Magic City Physical Therapy to see if visceral mobilization can help with your problem!

How to Fall Asleep Fast by a Pelvic Floor PT

How to Get a Good Night’s Sleep by a Pelvic Floor Physical Therapist

Many people have trouble falling asleep at night, or they may wake up in the middle of the night and have trouble going back to sleep. You may be asking, “Why is a Pelvic Floor Physical Therapist writing a blog on sleep?” Besides wanting to feel rested and focused the next day, there are tremendous health benefits to a good night’s sleep. Sleep is important for improved immune function and may even have pain-relieving (analgesic) effects. This is important for people suffering from chronic pain, especially since an estimated 66% of people with chronic pain experience poor or unrefreshing sleep (according to the Sleep Foundation).

A multi-level study by Tang et al in 2012 examined the sleep patterns and pain presentation of 119 men and women (74% of them being women) with both chronic pain and sleep problems. Their results showed that pre-sleep pain was not a reliable predictor of subsequent sleep. Rather, pre-sleep cognitive arousal showed consistent impact on the quality of sleep. In addition, sleep quality consistently predicted pain in the first half of the day (but not so much in the second).

A review by Kundermann and colleagues in 2004 found that pain disturbs sleep by increasing arousal and triggering the neurobiological consequences of stress leading to more disturbed sleep. They also suggested that a higher quality of sleep could lead to better pain regulation and that better pain regulation could lead to more restorative sleep.

Waking in the middle of the night

Many factors can increase the frequency and duration of night-time waking especially those that promote greater levels of hyperarousal or alertness, including mental health issues such as anxiety and depression. Poor diets containing high amounts of stimulants such as caffeine, alcohol, or cigarettes are also common reasons for increased alertness and overall waking more. Other courses of sleep disturbance include sleep-disordered breathing issues (snoring and sleep apnea) and restless leg syndrome. Another reason for waking up in the night is feeling uncomfortable on your mattress or pillow. If yours has seen better days, you may need to upgrade your sleeping quarters to best fit your body type and sleep position.

Breath work to help you fall asleep

There is great evidence behind 4-7-8 breathing to aid in falling asleep. This involves breathing deep into your abdomen and not so much your chest; this means you are trying to get your

diaphragm muscle to lower deep into your belly. The inhale breath through your nose should be 4 seconds long, the inhalation hold should be 7 seconds, and the exhale should be out through pursed lips and last 8 seconds. This 4-7-8 breathing helps to stimulate the Vagus Nerve, which is responsible for relaxation and also digestion. Focussing your attention on something in the moment such as the movement of your breath can be helpful in helping you fall back asleep more quickly. Each time your mind wanders and you start to worry about something, practice gently returning back to focus on the breath and the present moment.

Segmental Relaxation

Another technique to promote relaxation is to segmentally try to relax each body part from your head to your toes. Many people do not realize that tension often starts in the muscles of the scalp, so start with relaxing your eyebrows, followed by the muscles of the mouth, jaw and cheeks (an easy way to do this is to rest your tongue on the roof of your mouth). Then think decreasing tension in your neck and shoulders and letting your shoulders drop. Are you clenching your abdominal muscles or glutes? Relax those as well. Continue to practice your 4-7-8 deep breathing as you think of each body part from your head to your toes relaxing.

So, what can you do today to sleep better and help improve your pain? Develop good sleep habits!

Develop a sleep ritual such as maintaining a 30 minute relaxation period before bedtime and do something like read!

Make sure the bedroom is restful and comfortable. Environmental factors such as the room being too warm, too noisy, or too bright can make sleep more difficult.

Avoid heavy exercise within 2 hours of bedtime. Rather, try to stay active during the earlier parts of the day.

Try not to avoid eating a heavy dinner late at night.

Avoid sleep-fragmenting substances such as caffeine, nicotine and alcohol during the latter part of the day.

Go to bed only if you feel sleepy.

Sleep only in your bedroom.

Maintain stable bed times and rising times. Arise at the same time each morning regardless of the amount of sleep obtained that night.

Avoid daytime napping. If you do nap during the day, limit it to 30 minutes and do not nap, if possible, after 2pm.

Use a sound machine with soothing sounds to assist in lulling you to sleep.

Supplements such as Magnesium Glycinate and Ashwahhanda can assist in physical and mental relaxation and promote better sleep.

Pelvic Floor Physical Therapy can help with improving your diaphragmatic breathing and pelvic floor relaxation. We are also here to decrease any chronic pelvic pain you may have, to ultimately help your sleep and day-to-day function!

Kundermann B, Krieg JC, Schreiber W, Lautenbacher S. The effect of sleep deprivation on pain. Pain Res Manag. 2004 Spring 9(1):25-32

Tang NK, Goodchild CE, Sanborn AN, Howard J et. al. Deciphering the temporal link between pain and sleep in a heterogenous chronic pain patient sample: a multilevel daily process study. Sleep. 2012 May 1:35(5):675-87A

Chronic Pelvic Pain

Chronic Pelvic pain is one of the most common diagnoses we see here at Magic City Physical Therapy. We wanted to highlight this diagnosis today and give you more information about how pelvic floor therapy can help.

Pelvic pain is more common in females than males. More than ½ of women who have chronic pelvic pain cut down their daily activities and 90% of women who report chronic pelvic pain also report pain with intercourse. Chronic pelvic pain impacts not only the physical health well-being but it progresses to impact their emotional health and negatively affects relationships.

What is the difference between acute and chronic pain? Acute pain happens when the body is hurt, and we get an immediate response, there is typically an obvious and immediate cause for the pain in an acute situation. Chronic pain is very different. Sometimes there is not a specific original cause or the original pain has persisted for a significant period of time. In the medical world, chronic pain is diagnosed after pain has been lasting for more than 6 months. Other changes that may signal development of chronic pain can be changes in ability to sleep, changes in appetite and bowel function with increase in constipation being a sign. Emotionally there may be more depression and anxiety or an overall feeling of dread. It may feel like you are changing your role as a caregiver, wife or employee and that it’s affecting how you’re able to do your job or take care of your family.

Chronic pelvic pain is a big umbrella term that can describe pain occurring anywhere from the belly button, down to the upper thighs. People may have pain all across this area, or it may be specific just to the vagina or the vulvar area. It may eventually spread out into the buttocks or back around to the tail bones. How your body perceives the pain can also change overtime.

Chronic pain can lead to behavioral changes regarding how you cope with the pain. It may change how much you are able to do, like take care of your kids or participate in your favorite hobbies. It can be a big emotional and psychological toll.

We unfortunately often hear from our patients way too often when they are dealing with chronic symptoms, they have been written off by many medical providers saying “Oh, you know, everything looks fine. It’s all in your head. You just need to relax. You just need to calm down.” But, they are not really getting answers to why they’re feeling what they’re feeling.

At Magic City Physical Therapy, we are here to listen and validate that chronic pain is not at all in your head. We work with women and men dealing with chronic pelvic pain on a day to day basis. Often, pelvic floor physical therapy is an integral part in helping you to start to feel like you can return to activity like you used to and live a more pain-free life. We don’t want people just living with chronic pain and think there’s nothing that can be done to help!

If you feel like you may be experiencing chronic pelvic pain, give us a call to schedule a discovery 5 minute phone call with one of our PTs to start your healing journey.

Men Have Pelvic Floors, Too!

Most times when we talk about pelvic health we hear it in reference to women, men have pelvic floors, too. Just like women, men can get pelvic floor dysfunction. Pelvic floor dysfunction can affect men of all ages!

Due to differences in anatomy and childbirth, women are often more susceptible to pelvic floor disorders, but men often suffer from many of the same issues like urinary incontinence, constipation, pain, and sexual dysfunction.

Let’s talk a little about male anatomy. Males lack a vagina, but they have a prostate (a large gland that makes secretions for sperm) that sits underneath the bladder. In males, the urethral canal, where urine leaves the body, is much longer than in females.

Even though there are differences, males still have a pelvic floor comprised of many of the same muscles and ligaments as women. The male pelvic floor also supports their pelvic organs and controls urination, bowels, sexual function, and spinal health.

When the pelvic floor muscles aren’t working properly, we can start to see the same issues as women. The pelvic floor muscles might be weak, tight, or may have a coordination problem.

SO WHAT PROBLEMS CAN THE PELVIC FLOOR MUSCLE CAUSE?

Incontinence
Men can suffer from incontinence which is ANY INVOLUNTARY leakage of urine. Even if it is just a few drops of leakage, this counts as incontinence! Several conditions can contribute to this including an enlarged prostate (BPH), prostate cancer, weak pelvic floor muscles, and overly tight pelvic floor muscles.

1 in 7 men is diagnosed with prostate cancer making it the second most common type of cancer in males. Sometimes prostate cancer requires a radical prostatectomy surgery, , where the prostate is removed. After this surgery, up to 87% of men have incontinence 6 months later.

Removing the prostate decreases the physical support of the bladder. The bladder normally sits on top of the prostate, and removing the prostate can let the bladder fall slightly, contributing to bladder leakage.

Research has shown that pelvic floor muscle training BEFORE prostate removal surgery can help to improve symptoms like urine control and erectile dysfunction.

If the prostate is larger than normal as in BPD, this can cause extra pressure on the bladder and urethra, making you have to go more frequently and also experience increased urinary urge.

Sexual Dysfunction
The pelvic floor muscles help with arousal, pleasure, and orgasm during sex. If they aren’t working properly, this can lead this can lead to erectile dysfunction, leaking urine with orgasm, premature ejaculation, and anorgasmia (lack of orgasm). Pelvic floor muscle training (and not just doing kegels!) can help with these problems.

Pelvic Pain
Just like women, men can suffer from chronic pelvic pain, often called “chronic prostatitis.” Often accompanied by pelvic pain in men and women are urination problems, sexual dysfunction, and depression. After seeing a healthcare provider to rule out an infection, seek help from a Pelvic Floor Physical Therapist! Pelvic pain can be caused by your pelvic floor muscles! Muscles in and around the pelvic floor can become tight and painful just like any other muscle in your body, leading to pain. But the good news is, these muscles can be treated and retrained like the rest of our muscles.

Diastasis Recti
You may have heard of a diastasis recti in pregnant women, but they can occur in men, especially as they age. A diastais recti is a separation or widening of the linea alba between the rectus abdominis muscles of the abdomen. Basically, the tissue between your “six pack” muscles becomes stretched or separated. This can cause bulging of the abdomen, especially with activities that stress that area, such as with lifting and sitting up. Diastasis recti in men can cause low back pain and decreased efficiency of the pelvic floor muscles, which can lead to bladder, bowel, and sexual dysfunction.

What Can a Pelvic Floor Therapist Do for Male Pelvic Health?
The good news is that pelvic floor physical therapy can help to address all of these issues! An expert pelvic floor physical therapist will develop and coordinate a treatment plan especially for you. We will talk with you and discuss your concerns privately. The therapist will ask questions about your medical history, bladder and bowel function, and sexual function to better understand your condition and to develop a treatment plan that is customized to you. After the examination, the pelvic floor therapist may give you
exercises, diet modifications, and other tips to help manage and improve your symptoms.

Men, are you ready to take control of your pelvic floor issues?
Ask your healthcare provider for a referral to a Pelvic Floor Physical Therapist who specializes in seeing men. Give us a call today! We treat men in the Birmingham, AL area and are also able to treat clients virtually!

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.

How Can I Protect my C-section Scar After Giving Birth?

It’s important for all new parents to conserve energy and protect their own bodies while adjusting to the care of a new baby, especially those who have had a cesarean section. Abdominal straining, which can occur with heavy and improper lifting, can contribute to wound separation, hernias, prolapse, and diastasis.

Lifting Restrictions
As a cesarean section is an abdominal surgery, your doctor will likely advise you to not lift anything over 8-10 lbs, depending on the doctor as well as the details regarding your cesarean and your personal health. Lifting restrictions typically last anywhere from 6-8 weeks. This may prevent you from lifting household items heavier than a gallon of milk, which means no carrying baskets of laundry or heavy bags of groceries.

This will also mean that you won’t be able to lift and carry an older sibling during this time. If possible, encourage the older sibling to climb onto your lap, into bed, into the car, etc. Also, try to get help around the house and with chores such as grocery shopping, lifting heavy loads of laundry, and other activities that require moderate to heavy lifting.

Position your body so that you are lifting your baby straight on, not from the side or at an angle. Get close to the crib, changing table, etc. so you avoid unnecessary strain when lifting and putting baby down. The same goes with lifting the baby carrier: keep the carrier close to your body and do not place the carrier in the car from the side or at an angle. Placing one foot in the vehicle can assist in preventing leaning too far over and straining your back.

One of the most important things I teach ALL of my patients, is to exhale with exertion, or blow as you go. What does this mean? Exhale as you are lifting the baby, car seat, etc. Exhaling will allow your pelvic floor and abdominal muscles to fire appropriately to protect your spine and prevent hernias, diastasis, prolapse, and c-section incision strain.

Here are a few easy tips/ tricks you can do prior to giving birth:

  1. Set up baskets or stations for baby care with needed supplies that support and protect the body by eliminating unneeded bending, lifting, twisting, and stair negotiation.
  2. Bending over the changing table can cause a sore back and neck. Set up a station that allows you to change and dress your baby at hip height to avoid having to lean over. Have all the supplies you need at hand in a place where you do not need to bend and struggle to reach or find things.
  3. Having a “nursing station” with comfortable furniture and all of your needed supplies will allow you to nurse or feed your baby while you rest comfortably. Many find rocking chairs or recliners with footstools to work well as furniture. Use a small pillow to support your low back and another pillow to support the baby and to keep them off the c-section scar. Have a basket or shelf next to the chair with all supplies you may need including diapers, wipes, changing pads, towels, blankets, a bottle of water, an extra change of baby clothes, and anything else you may need: tissues, a book, magazines, a phone charger, etc. This will reduce your need to get up and down, and allow the baby to nurse while you rest.

Do you need further help managing your pregnancy and postpartum symptoms? Pelvic Floor Physical Therapy can help! Contact us to schedule a one-on-one session!

How Should I Sit on the Toilet?

Did you know there is a proper way to sit on the toilet? We find the vast majority of our patients who have difficulty emptying their bowels or bladders are not sitting correctly on the toilet! We tend to find that people sit upright and tall, hunch over, or even do the unthinkable, hover. Try these tips below to ensure you can effectively empty while sitting on the toilet.

  1. Do not Hover! Make sure you are sitting completely on the toilet seat. This will allow the pelvic floor muscles that control your bowel and bladder function to fully relax. If these muscles are not fully relaxed, that can lead to incomplete emptying of the bladder and bowels.
  2. Elevate your knees higher than your hips.The optimal position to empty the bowels and bladder is in a seated squat position. I recommend a product called the Squatty Potty to help achieve this position. A squatty potty is designed to sit at the base of your toilet and has placement marks for your feet. If you don’t have a squatty potty, you can use a step stool or even stacked up books; however, a squatty potty can be easily tucked under the toilet so it is not a trip hazard after using.
  3. Separate your knees out wide. Make sure you pull down your clothes all the way to your feet to prevent your knees from not being able to separate. This allows the pelvic bones and muscles to be open and relaxed.
  4. Keeping your back straight, hinge at the hips and lean forward with hands or forearms on knees. Think about this position like the guy reading the Sunday paper. Hinging forward at the hips with feet and knees elevated will allow you to assume a modified “squat” position, allowing the pelvic floor muscles to be open and relaxed, something that is needed for complete bladder and bowel elimination.

Why does this position matter?
Getting into this position allows the bowels to line up more straight and assists in decreasing the “kink” that is present towards the end of your rectum. This “Kink” is a tightened Pelvic Floor muscle called the Puborectalis that is tight when you are not in a squat position. Leaning forward also applies more pressure onto the bladder to assist with complete bladder emptying.

Try using a step stool the next time you go to the bathroom! If you are still having issues with bowel movements or complete bladder emptying, a Pelvic Floor Physical Therapist can help! Contact us! We offer 60 minute one on one sessions.