If your postpartum follow up visit was like mine, your c-section incision was most likely visually assessed and, as long as there were no issues with healing, you were sent on your way to gradually return to daily activities.  Thankfully, I was a PT and knew the importance of scar massage!

  If you’ve had a c-section you already know it’s a major abdominal surgery, however, women are not typically given the best guidance on how to help themselves heal.  I often see women for treatment who have had issues related to c-section going on way too long!  

Some of the potential side effects of c-section include:

• Abdominal/pelvic/low back pain
• Painful Intercourse
• Diastasis Recti (separation of the abdominal muscles)
• Secondary Infertility
• Digestive issues or bloating
• Bowel obstruction

  Now, I’m not against c-section (obviously, I’ve had 3!) but women should be informed on what to look out for in their healing and definitely referred to pelvic physical therapy.  Scar tissue can remodel for up to 2 years so the earlier it is addressed the better but positive changes can still occur even if it’s been many years since a c-section.  And occasional scar massage should be continued over the lifetime to maintain good mobility of the tissue and prevent excessive scar tissue restriction.

  During treatment, I work directly on the scar and surrounding tissue as well as incorporate visceral mobilization (see video below) to ensure the pelvic and abdominal organs are not too restricted.

Want to know more about how you can help your body after c-section (even if it’s been years)?  

Check out the upcoming class I’m hosting!

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  There is a significant correlation between low back pain and pelvic floor dysfunction, so much so, that one study even reported that 95% of women with low back pain had some form of pelvic floor dysfunction!¹ And many other studies have shown similar connections between the two. Pelvic floor dysfunction can present as pain, pelvic heaviness/pressure, bowel or bladder issues. If you have low back pain you are much more likely to develop pelvic floor dysfunction, such as bladder leakage, and if you have bladder leakage, you are much more likely to develop low back pain.

  The common factor between low back pain and pelvic floor dysfunction is that we often find issues with muscle control surrounding the trunk and pelvis. When treating low back pain it is important to know if pelvic floor dysfunction is present because including pelvic floor interventions in treatment for low back pain has been shown to be more effective in reducing pain and having longer term relief. This may be the missing piece for some who suffer from chronic low back pain!

  Pelvic floor interventions focus on increasing awareness and coordination of the pelvic floor muscles. And no, it’s not just about doing Kegels. Kegels are merely an introduction to the pelvic floor muscles and do not result in proper coordination with functional movements. Pelvic floor treatment does not necessarily mean internal treatment either. The important thing is that we are addressing low back pain and pelvic floor dysfunction more comprehensively to ensure better resolution of symptoms and improved quality of life.

Struggling with low back pain and/or bladder leaks? 

 Click below to schedule a FREE consultation

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1. “Association between lumbopelvic pain and pelvic floor dysfunction in women: A cross sectional study.” Musculoskelet Sci Pract. 2018 Apr;34:47-53.

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It might be due to diastasis recti (abdominal muscle separation).
Now no one’s stomach is flat all the time and someone can be at an ideal weight and still have a stomach that pooches more. 
    Although diastasis recti is often referred to as a separation of the rectus abdominis muscles, when treating it we need to consider the factors that caused it. It’s not purely an abdominal strength issue!  The connective tissue between the muscles is overstretched by increased intra-abdominal pressure, leading to an area of weakness.  We need to address how the body regulates intra-abdominal pressure in order to improve this condition.  Alignment of the pelvis, ribs, and spine are also factors in regulating this pressure.  When the ribs are thrust forward or the pelvis is excessively tilted forward or backward it impacts core strength and the ability to regulate the intra-abdominal pressure. 
    So, treating diastasis recti involves addressing all these issues to improve how the body functions and reduce areas of weakness.  The gap between the muscles may close a lot, a little, or not much.  But, it’s what is happening beneath the surface that’s more important.  And a flatter belly can still be achieved when the core muscle system is working together

Diastasis recti can result in:

• doming or bulging of the abdomen
• pelvic floor issues such as pelvic organ prolapse or bladder leakage
• low back, pelvic, or hip pain
• feeling of weakness of the abdomen

Wondering if you might have diastasis recti and want to know what to do about it?  Click here to schedule a FREE diastasis recti screening

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Approximately 15% to 25% of women have iron deficiency during pregnancy.

  Being a vegetarian, that information would’ve been very helpful to know as I am more at risk of developing iron deficiency.
  And that’s not the only nutrient that pregnant women are more at risk of becoming deficient in: Vitamins A, C, D, E, K1, and B6, folate, choline, potassium, calcium, magnesium, and zinc are also common.

Whoa, that’s a problem!   Especially since many pregnant women are not counseled on pre/postnatal nutrition.  Taking a prenatal vitamin may not be enough.  Fast forward to postpartum when our bodies have been depleted of nutrients and it’s trying to heal.
  Thinking back to my own experiences I realize how this depletion contributed to progressively worse hair loss after each pregnancy and drenching night sweats after my last pregnancy.  We often think of things as a normal part of postpartum, or are told that from providers, when in reality are body is telling us something is off.
  I see these imbalances contributing to my client’s concerns as we work through issues with pain, bowel or bladder issues, and weakness.  Because it is well known that systems of the body are very connected.  When we treat an issue we have to consider all possible factors involved to resolve the actual cause of the problem, not just the symptoms.
  I see a lot of ways we can improve postpartum healing and long term health for women, if we just give them the proper education and guidance.  I strive to do my part to provide this information from my position as a pelvic health expert so that future generations will have better postpartum healing and prevention of pelvic health issues.
  Whether you’re planning to become pregnant, currently pregnant, or postpartum I urge you to consult with your provider or nutrition expert to determine what your specific needs are.  And if you’re currently experiencing bowel or bladder issues or pain or concerned about issues such as diastasis recti or postpartum return to exercise click below to schedule a free phone consultation.

  It’s not too late for the healing to begin!

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  Pelvic organ prolapse has often been defined as a condition related to weakness of the pelvic floor and described as a “falling down of the pelvic organs.”  This has created a sense of fear for many women; feeling that their bladder, uterus, or rectum might just fall out😬 Now there are times when there is damage to muscle or ligament that can definitely decrease the support structure for the organs, however, in many cases the cause may be tension.

  New research points at a tensegrity model to explain why pelvic organs may shift out of place.  In a tensegrity model, everything is suspended by a network of tension.  The myofascial system of the body can be described this way.  If one area is pulled it can affect another area.  Using this model, the pelvic organs may be pulled down or to the side but are not falling down.
  I’ve seen this with many women in my practice!  Their strength is good but they still have prolapse.  It’s been amazing to see how prolapse symptoms improve when we address the actual cause: tension not weakness.
  Many women don’t realize they even have an issue with pelvic organ prolapse.  Common symptoms of pelvic organ prolapse include:

• Bladder or bowel leakage
• Difficulty starting a stream of urine
• Difficulty emptying the bladder completely
• Constipation
• Low back pain
• Pain with sex
• A feeling of pressure or heaviness in the pelvis 

  Wondering if tension could be the reason for your pelvic floor issues? 

Contact April@pelvicbalance.com

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You’ve prepared for the past 9 months. Looking forward to the arrival of that little bundle of joy. You may have taken prenatal exercise classes, changed your diet to get better nutrition, tried to decrease stress more, all to ensure that you stay well so baby stays well.

So, why does that all end once baby is born? Doesn’t mom’s wellness matter anymore? Of course it does! Mom just went through a lot and may have had some unexpected things happen too. Birth results in many physical and emotional changes and challenges that often last beyond the birth experience. Not only is mom dealing with bodily changes but also mood changes. And then there is the added stress of taking care of this new little human and maybe feeling like you have no clue what you’re doing. It’s definitely a lot to take in. But what does mom’s postpartum care look like? A check up with your physician after 6 weeks? (that is most likely brief to say the least) So, many women are left to fend for themselves as far as negotiating the healing process. Give it time, don’t do too much…

Now let’s talk about the new and improved postpartum healing process! Caring for mom; not just baby! Baby has all those appointments to make sure he/she is healthy so, why not mom? What mom doesn’t want to feel cared for and guided in her healing process? Imagine feeling confident in your new postpartum body, feeling heard, feeling like you’re more than just a mom!

Most have probably heard about postpartum depression but maybe not about the physical side effects of birth. These can include bladder and bowel issues, pain with sex, abdominal pain, hip pain, low back or tailbone pain, abdominal weakness, and overall decreased body confidence. And these things can often pop up much later after birth. But guess what? These issues can be prevented! If mom receives the care she deserves after birth her pelvic health can be improved for a lifetime!

So, how can mom ensure she is taking care of herself too?

• Enlist support while you’re still pregnant. Find someone who will be able to check in to make sure you’re getting adequate nutrition, emotional/mental support, and sleep (this may be someone other than your significant other)
• Amp up nutrients prior to birth, as pregnancy and birth can create deficiencies in iron, Vitamin B12, Vitamin D, zinc, magnesium, and copper (consult your physician prior to taking any new vitamins or supplements)
• Schedule a postpartum visit with a pelvic physical therapist at 6 weeks postpartum or sooner if concerns regarding pain or bowel/bladder issues (scheduling the postpartum visit prior to birth may ensure you don’t get too busy and forget)
• Put filled water bottles in the usual baby feeding places around your home to make sure you’re staying hydrated

Ready to embark on your postpartum healing journey?

Find out what you can do today to get started to ensure you get the care you deserve for proper healing and to feel confident in your postpartum body!

Schedule your FREE phone consultation

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  Symptoms of pelvic floor tightness and weakness can be similar so it can be hard to tell.  And pelvic floor muscles that are tighter can also be weak.  Here are some common symptoms to help determine what might be going on down there.
Symptoms of pelvic floor muscle weakness:

• bladder leakage with coughing, sneezing, laughing, exercise
• having to urinate more than 8 times per day and/or waking at night to urinate
• difficulty stopping a stream of urine
• dribbling after urination
• sudden urinary urgency and having to rush to the toilet
• loss of control of the bladder or bowels
• constipation
• heaviness in the pelvis or a “falling out feeling”
• pain with sex
• difficulty holding back gas

Symptoms of pelvic floor tension:

• constipation
• difficulty emptying the bladder completely
• straining or pushing to empty the bladder
• having to urinate more than 8 times per day and/or waking at night to urinate
• sudden urinary urgency and having to rush to the toilet
• bladder leakage
• painful urination or UTI like symptoms
• frequent UTIs
• difficulty starting a stream of urine and/or slow flow
• pelvic pain
• pain with sex
• low back/coccyx/hip/abdominal pain

Treatment for pelvic floor tightness and pelvic floor weakness is often very different so it’s important to know what the cause of the symptoms is.  In pelvic physical therapy we determine the cause for long term resolution of these issues.  We use a full body approach, as there can be many different factors involved depending on the individual. 

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How can you prevent tearing during vaginal birth?
Although there’s no guarantee, there are things you can do to reduce your risk of perineal tearing, especially 3rd and 4th degree tears, during vaginal birth.  Click on the video above to see one tip that can help reduce your risk of tearing.  Want to reduce your risk even more?  Contact April@pelvicbalance.com for a free consultation.

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1. Make a plan with your support person to ensure self care

It’s easy to put your own care on the back burner when you have a new baby.  I’ve been guilty of this        myself.  However, you’re not only doing a disservice to yourself but also your family.  Just like the saying “you can’t pour from an empty cup.”  Rather than wait until after your baby is born and things are already a little chaotic, talk with your spouse or family to come up with a plan to make sure you’re not forgotten.  And, I’m not just talking about making sure you have time to take a shower, because that should be a given.  I’m referring to activities that will help with your emotional, mental, and physical healing.  This could be exercising, reading, painting, whatever you enjoy doing that will help facilitate your healing process.  And I speak for myself, and probably other women, when I say we often won’t ask for help or say how overwhelmed we are which is why we need to tell our support person to make sure they help us make sure we are also taking care of ourselves.

     2. Make sure you get adequate hydration and nutrition

This can go along with the idea discussed in tip 1.  Sometimes we are the last ones to eat or find that we’ve hardly had any water all day.  I tell women to keep a water bottle where they often sit to breastfeed so that they stay hydrated.  And although I can’t give detailed advice on nutrition, I can say it’s so important to your healing to make sure you are eating nutritious meals.  This can help you avoid constipation and improve the healing of your muscles and connective tissues.  Talk to a nutrition professional to come up with a plan that works for you.

    3.  Watch your posture

Yes, this is often the last thing on our mind as we carry the baby, diaper bags, and car seats, but it can make all the difference.  I see many women with back pain that is often aggravated by the positions or movements of our body.  Think about how much time new moms spend breastfeeding.  If you’re in bad position, that can really start to take it’s toll.  To reduce onset of pain or muscle tightness make sure to bring baby up to breast versus breast to baby with the support of extra pillows as needed.  I love the breastfeeding pillows but found that I often needed a pillow under them to avoid leaning myself forward.  With the popularity of wraps, it’s easier to find something supportive to carry or feed baby in to take some of the stress off of your own body.  Also, be sure to watch how you bend or lift and keep your spine straight, which is especially important when there is more abdominal and pelvic floor weakness after birth.

    4.  Start your Kegels early

Regardless of whether you have a vaginal or cesarean birth, your pelvic floor muscles have been tested while  carrying a growing baby for 10 months.  Then add the trauma to the pelvic floor region that happens during vaginal birth and you really need to make sure you give this area extra care.  Typically, it’s okay to start doing Kegels right away but check with your physician to make sure.  The benefit of doing Kegels is that it helps strengthen the muscles that are the foundation of the core.  So not only does it help support the pelvic organs but it helps support the pelvis and spine and provide you with increased core strength.  One problem is that over 50% of women do them incorrectly, which leads me to the last tip…

    5.  See a pelvic physical therapist!

Pelvic physical therapists can ensure you are doing Kegels correctly and come up with a plan that is appropriate for you.  I’ve seen so many women over the years who wished they knew about pelvic PT sooner.  Why?  Because many of them had been dealing with issues such as bladder leakage, pelvic pain, or diastasis recti for a long time (some even 20 years or more!).  Pregnancy and childbirth puts women at more risk to develop pelvic, abdominal, and low back issues so why not try to prevent them?  Women often wait, hoping the problem will just go away.  Or some will try different exercises, giving up quickly when they don’t see results.  Pelvic physical therapists are the experts in this area!  We can help!  Sometimes only a few sessions are needed.  Think the 6 week postpartum visit is sufficient?  I’m afraid not.  Physicians are often just assessing for major issues such as infection or pelvic organ size and position, not pelvic floor muscle function.  And the issues discussed above can develop later on rather than immediately after birth.  I promise you will learn so much from pelvic physical therapy that will benefit you for a lifetime!

Now that you’ve learned these very helpful tips, don’t keep it a secret!  Please share with the other women in your life!

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