The League of Extraordinary SuperMoms: When a PT needs PT

At week 20 of my pregnancy, I was still going out for runs. One day, I was about 2k into my run when I felt pressure in my bladder and an uncontrollable, unstoppable urge to pee. Emphasis on unstoppable.

Uh oh.

I was mortified, but I chalked it up as a one off. Then on my next run, I coughed to clear my throat and felt some leaking. Once was unfortunate, but twice? I was at the halfway point of my pregnancy and knew that this was unacceptable. I was not going to leak my way into motherhood!

It is a strength to know what you don’t know. This is how I approach my role as a physiotherapist - I understand what my knowledge and skill set allow me to do, but I am always acutely aware of what is not in my wheel house. Having that level of humility will serve you and your patients well. In this case, I knew immediately that I needed help dealing with my incontinence before it became a larger problem. I have treated postpartum women through the lens of improving mobility, strengthening their abdominals and other muscles that had weakened during pregnancy, and scar management if necessary. Incontinence though is something that I knew I needed expert advice on, so I reached out to a pelvic floor physiotherapist.

What is pelvic physiotherapy?

Pelvic floor physiotherapy is the assessment and treatment of conditions that involve the pelvis, such as incontinence, painful intercourse, and prolapse. The muscles of the pelvic floor are located within the pelvis and often need to be assessed via an internal examination. Some people are squeamish about that, but any physiotherapist trained in internal examinations are rostered with the College of Physiotherapists of Ontario and, as all PTs, are held to a standard of professionalism and care.

This field has taken off over the past few years, and I am thrilled about it. As cliché as it sounds, it is empowering to be able to talk about your body openly without feeling ashamed or shy about it. At the end of the day, we are talking about muscles here, and like any muscle of the body, they can be tight and/or weak, and therefore can also be rehabbed. This can be critical, especially for women who are pregnant or postpartum.

But I’m a physiotherapist. Can’t I just rehab myself?

As I mentioned at the top, I know what I don’t know. I can build a strengthening program for my core, but to ensure I am engaging my pelvic floor correctly, I need some feedback from an expert. I found immense benefit to seeing a pelvic floor physiotherapist prenatally to build some pelvic strength to stop the leaking. Closer to my due date, we went over some stretching in the event of a vaginal birth, but I had an emergency C-section, so we had major abdominal surgery to deal with instead! And you know what, even with a C-section, I still need pelvic PT to work on releasing pelvic floor tension and rebuild strength and control. It really is for all mamas no matter the delivery method! I am grateful for my pelvic PT Nadia who has been an awesome therapist and teammate in my pre- and post-natal recovery.

Why am I filing this post under “The League of Extraordinary SuperMoms”? You might pee your pants, have back pain, or develop a hernia, but at the end of the day, you are doing something extraordinary - growing a human. Pregnancy can be messy, but know you can find help and support.

I have treated women who are over a year postpartum and are still dealing with hip or back pain. Pain in general is not normal, so don’t put it off! If you have questions about general strengthening both prenatally or postpartum, getting back into shape, or finally dealing with that nagging pain since giving birth, drop me a line at sayaka.physio@gmail.com and we can talk about how to get you strong!