Legacy Physical Therapy 2961 Dougherty Ferry Road Saint Louis, MO 63122
Call: 636-225-3649 Fax: 888-494-7074 Email: info@legacytherapystl.com

Health Information

Postpartum Core Strengthening

Postpartum Core Rehab

There is one question that we get asked by neary EVERY postpartum mom…

Which exercises are best for me to strengthen my core and abdominal muscles after I had a baby?

The simple answer is it depends. I know that this is not the answer you want to hear, but it really does depend. There is no one size fits all exercise that is going to get your abdominals back after having a baby. It depends on many factors:

  • what you were doing pre-pregnancy
  • What you were doing during your pregnancy
  • how your abdominal muscles are working currently
  • how everything coordinates together

I’m not going be giving you specific exercises, but instead I’m want to give you some things that you should be watching out for when you are exercising to make sure that things are working correctly. I, as a physical therapist, hate hearing people say that they should never do something. Our human body is amazing and there are definitely things and ways that we can modify so that people can be doing the things that they want be doing.  

Here are my tips for the things that you should be watching out for so that you know that you’re potentially protecting and properly engaging through the abdominal muscles.

  • If you are trying to decide if an exercise is appropriate for strengthening your postpartum core is you want to make sure first that you can breathe while you doing it. You should not have to hold your breath to complete and exercise. There are certain exercises when we doing very high level lifting, heavy lifting when breath holding can be a good strategy that needs to happen. However, for the vast majority of us especially when we’re just getting back to exercise, if you cannot properly engage your core muscles and breathe while performing the exercise  then it’s probably not appropriate. And that goes for whether the exercise is specific to strengthening your core muscles or not.
  • The other thing to think about if you are trying to make sure if a core exercise is appropriate is can you maintain a deep abdominal activation. At the start of a core strengthening exercise you should be able to gently draw in your abdominal muscles on an exhale and maintain this muscle activation throughout the exercise.   If during the exercise, your feel your abdominal muscles push forward/bulge out or maybe if your laying down, you feel your back arch off the ground then that’s the sign that your not using the abdominal muscles the right way anymore.

 

So, if you can’t keep breathing or maintain a deep abdominal muscle activation while doing the core exercise, then it’s not probably not an appropriate exercise for you yet. That doesn’t mean never, it just mean right now.

What can you do if you are in a situation where there is an exercise that you want to be doing but you’ve notice now that you’re doing it holding your breath and you’re belly pushes out every time you do it? This is the time to partner with a pelvic health physical therapist to evaluate what is going on in your abdominal wall that you may be not recruiting correctly. They can show you how to perform the activities correctly so that you can get back to doing the exercise that you want you be doing.

It’s my goal as a physical therapist to try and get you as active as you want to be, doing what you want to be doing, and working with you to achieve the goals that you want to achieve. Sometimes, we all just need a little help along the ways.

Postpartum Core Reactivation

Postpartum Core Reactivation

Today, I want to talk to you about 3 simple easy exercises that you can do to for postpartum core reactivation in those early days after delivering your baby.

Many women are concerned about how their core muscles will return after they deliver their baby.  There are things that you can be doing early on in the postpartum recovery time help the abdominal muscles get back to working the way they were designed.  The beauty of these exercises is that they are very simple to do.

The core muscle involve the diaphragm on the top, the abdominals on the front and the pelvic floor at the bottom. We are going to be looking at how we can easily activate these muscles to work together to create some nice support for that postpartum belly as it’s healing.

None of the exercises that I am talking about should be painful.  If you are experiencing any pain when doing, please stop and consult your healthcare provider. Because these exercises are gentle, you can start them in your first week postpartum. Just make sure to perform the exercises in a comfortable range that’s not causing pain.

 

Exercise 1: Deep Breathing

Deep breathing is a wonderful way to get all of your deep core muscles coordinating together again. Sit or lay in a relaxed position of comfort. Start by taking nice big slow breath in and out. When you inhale, big and slow, you’re letting your abdominals expand and your belly fill up with air. A visual that works well for many people is to imagine your rib cage opening up like an umbrella as you inhale. Then as you exhale the umbrella closes. Try to slowly inhale for 5 seconds then exhale for 5 seconds and do 10 repetitions.

The beauty of deep breathing is that we get movement of the diaphragm, abdominals and the pelvic floor all together. So as we inhale, the diaphragm comes down, the abdominals expand out and the pelvic floor comes down a little bit to accept the load from that increased air pressure. Then, as we exhale, the pelvic floor rebounds back up, the abdominals come back in, the diaphragm goes back up.

 

Exercise 2: Transverse Abdominal Activation

The transverse abdominals are the deepest layer of abdominal muscles. Think of them forming a corset around your midsection. These muscles get very stretched out with pregnancy and can use some assistance to work correctly after delivery.

Again, sit or lay in a comfortable position. Gently inhale and then as you exhale, try to gently draw your belly away from your pants. You shouldn’t be holding your breath to do this. You are also not trying to squeeze your belly in as tight as you possibly can. Try to hold the contraction for 5 seconds and then relax for a few seconds. Do 10 repetitions at a time several times a day.

 

Exercise 3: Pelvic Floor Muscle Activation

The third exercise is for the pelvic floor muscles. These muscles are intimately located around the urethra, vagina, and anus. There are a couple of different ways that you can think of doing a pelvic floor muscle contraction. Try to pucker the anus like holding back gas or you can think about trying to pull the vagina up and in. You can do this in any position, but you may find it easier to feel the contraction in laying down or sitting at first. Just like with the transverse abdominal muscles try to hold the contraction for 5 seconds and do 10 repetitions.

Especially if you delivered vaginally, you may have a hard time feeling the pelvic floor muscles contract. After all, they are recovering from a big stretch with the delivery. Early activation is very helpful though. Gentle contract and relax of the pelvic floor muscles will help improve blood floor to the area and help the swelling go down. Both of which will help the healing process.

So, there you have it, three exercises that you can do in the early postpartum days to help reactivate your core muscles. Reactivation of the core muscles is important for you to be able care for your baby and return to healthy active lifestyle. If you have difficulty performing any of these exercises, it may benefit you to partner with a women’s health physical therapist.

What is Pelvic Physical Therapy?

What is Pelvic Physical Therapy

Pelvic physical therapy is something that is unfamiliar to many people.  I would say for about every 10 new patients that come to see us here Legacy Physical Therapy, about 7 or 8 of them start out their evaluation by saying that they have never heard of Pelvic Physical Therapy and they are not sure how we can help them.

We are passionate about helping women & men of all ages enjoy active, healthy lifestyles, by restoring confidence and dignity in pelvic, bladder, bowel, and sexual function, without relying on medications or surgery. We provide conservative treatment options for many conditions that people may be unaware that they even can do anything about.

Conditions Pelvic Physical Therapy Can Help

  • Bladder Issues:
    • Leakage, Urgency, Frequency, Painful Urination, Urinary Retention
  • Bowel Issues:
    • Constipation, Fecal Leakage
  • Pain Conditions:
    • Back Pain, Pelvic Pain, Tailbone Pain, Sacroiliac Joint Pain, Vaginal Pain, Rectal Pain, Vulvar Pain, Abdominal Pain, Penile Pain, Painful Sex
  • Pelvic Prolapse Issue:
    • Cystocele, Rectocele, Uterine Prolapse, Vaginal Vault Prolapse
  • Pregnancy/Postpartum Related Issues:
    • Low Back Pain, Sciatica, Diastasis Recti, Clogged Milk Duct, Episiotomy or C-section Scar Tissue Adhesions

Many people are surprised to learn that all of the above conditions can be helped by pelvic physical therapy. One of the things that we commonly see happen is that a patient will be referred to us by their urologist for bladder issues. Then once we get talking with them, we find out that they also have some back pain or hip pain issues that despite treatment aren’t going away. We teach the patient how all everything can be related.

Aren’t You Just Going to Teach Me to Kegel?

One of the things that we get asked all the time is, “I’m already doing Kegel exercises.  It doesn’t help, why would coming to pelvic physical therapy help?” For those of you who don’t know a Kegel exercise is simply a contraction of the pelvic floor muscles like you are trying to hold back gas or pee.  Muscle function is not simply about contraction. We need to make sure that we have a variety of different movements with the muscles. Muscles need to be able to contract, relax, stretch, and coordinate with other muscles.  

As pelvic physical therapists, our job is to figure out how your pelvic floor muscles are working and coordinating with other muscles. We really take the whole body approach to looking at how things are coordinating together. It is never simply just about Kegel exercises. Those may be a part of your treatment plan, but it may not be. For some people, the problem is that they are doing pelvic floor muscle contractions or Kegel exercises incorrectly and that is actually causing more of the problem. For other people their pelvic floor muscles may be too tense or tight and trying to squeeze them more isn’t going to improve their symptoms. Instead, we need to actually teach them to relax and let go.

Pelvic PT Can Help Before or After Surgery

Another thing we hear commonly when we talk with patients on the phone is that I’m planning them to having the surgery so why would I need to see pelvic physical therapy. Our simple answer to that is if you’re planning on having shoulder surgery, neck surgery, back surgery, or knee surgery; 9 times out of 10, you’re going see a physical therapist either before or after the surgery to help make sure that you rehabilitate the muscles and that everything is working well together. Similarly, working with the pelvic physical therapist after you’ve had surgery for a bladder sling, prolapse repair, hysterectomy, or giving birth can promote return to optimal muscle function allowing you to have better, longer lasting surgical outcomes.

Pelvic PT Helps During Pregnancy & Postpartum

Females who have given birth are at a greater risk for pelvic dysfunction. Here at Legacy Physical Therapy, we feel strongly that every women should see a pelvic physical therapist for at least for 1 visit postpartum to identify any musculoskeletal issues that may be preventing her from improving her core and pelvic function postpartum. This should happened before she starts out with any type of exercise regimen, especially a high level one, to make sure that the pelvic and abdominal muscles are functioning the way that they should be. The therapist will also review movement patterns to make so she doesn’t develop any bad habits that will potentially lead to problems down the road such as bladder leakage or pelvic prolapse.

Pelvic physical therapists also work with women during their pregnancy. We help make sure that the pregnancy progresses as comfortably as possible and that you are able to be as active as you want to be. Pregnancy is a time that can be very stressful on the abdominals and pelvic floor because of the changes in your body. Working with the pelvic physical therapist to help you maximize pelvic and abdominal support and control can really make a big difference for a comfortable pregnancy.

You May Need Need to Advocate for Yourself

So now that you have learn a little more about what pelvic physical therapy is, you may be wondering why you haven’t heard of it before or why your doctor has not told you about it despite you mentioning some of the symptoms. Unfortunately, many doctors are unaware that pelvic physical therapy is an option out there to help their patients.  Even the ones who do refer to pelvic physical therapy already may not be aware of all of the different thing that we can be doing to help patients. Because of this, you may have to be an advocate for yourself if you feel like you need to see a pelvic physical therapist. Don’t be afraid to ask your doctor for a referral to pelvic physical therapy.

If you feel like you’re dealing with any of these issues that we’ve been talking about, you may have to be the one to advocate for pelvic PT. You as a consumer, have the right to go wherever you want to go for your treatment. You do not have to necessary to go only to a place that is in your doctor’s office. You can seek healthcare from a pelvic physical therapist with whom you feel comfortable.

So, that is the brief introduction to pelvic physical therapy. If anything you have read about seems like something you are dealing with, give us a call at 636-225-3649. We are happy to chat with you about what  you are experiencing to see if pelvic physical therapy would be a good option for you.

5 Simple Desk Stretches

Many people have desk jobs and spend much of their day sitting. We recommend getting up from your desk and walking around at least once an hour, but sometimes time just gets away from us. Our office manager Rosie is here to show you 5 simple, quick, stretches that you can do at your desk during your work day.

Our first stretch is for your neck and you are going to pull on the side of the head gently. Tipping it over to one side to elongate through the side neck. Hold on that side for about 20-30 seconds, and then switch over to the other side and do the same thing to the other side for a comfortable stretch and pull. It shouldn’t be painful. Again, hold the stretch floor, 20-30 seconds each side.

Our next stretch is to help relax your shoulders a little bit. Let’s do a shoulder roll. We start roll on the shoulders forward and then backwards behind you as comfortably as possible in a really relaxed state. Do  5 to 10 shoulder rolls each direction to create that movement.

Our 3rd stretch is a torso twist.  You are going to use your office chair to help you twist and then look behind you as far as you comfortably can. Let your trunk twist with you. Hold over there for about 20-30 seconds and then untwist and go to the other side and hold for 20-30 seconds.

Our 4th stretches for our hip muscles. We are going to cross one ankle over the other knee, and then lean forward into that stretch. You should feel a stretch or pull in the buttocks area. Again, hold for 20-30 seconds and then uncross and switch to the other leg up to do that same stretch on the other side. Lean it into a comfortable range so that you feel that stretch in the buttocks.

Our final stretch is a seated hamstring stretch. You are going to  dig that heel into the ground with a straight leg and lean forward into it until it stretches down the back of the leg. Hold for 20-30 seconds and then come out of it and switch and put the other leg out, lean forward and hold for 20-30 seconds.

Hope you enjoyed our  simple 5 stretch routine that you can do it you desk during your work day.

10 Signs Pelvic Floor Dysfunction is Affecting Your Workout

10 Signs Pelvic Floor Dysfunction is Affecting your WorkoutSo this time a year a lot of times people resolution is to get healthy and workout more which is awesome. We see a lots of exercise routines and new workouts started but unfortunately sometimes that can bring to light a problem that people don’t know that they have … pelvic floor dysfunction.

 

Today I want to talk to you about 10 signs that pelvic floor dysfunction may be affecting your workout.

  1. You have Bladder Leakage when you run, jump do burpees, jumping jacks, jump rope, Push ups, Squats any physical activities. Leakage with Physical activity is not normal, “It is not a badge of honor to leak while you exercise” it is a sign of pelvic floor dysfunction and there’s something that you can do about it.

  2. Low back, pelvic, hip or a Abdominal pain with or soon after your workouts, “Pain should not be a part of your workouts.” Yes should be pushing yourself hard but there’s a difference between muscles burn and pain. And if you’re dealing with pain any of these areas it may be a sign that your core muscles are not functioning well together and you need to make a change.

  3. If you need to pee, pre and post workout then this is a sign that your bladder and pelvic floor muscles may not be function optimally, if you’re doing a 40 to 60 minute workout you should be able to make it without having to urinate before or after class.

  4. You are experiencing pelvic heaviness, pressure or falling out feeling during or shortly after workouts, This can be a sign that you are experiencing pelvic floor dysfunction and/or pelvic organ prolapse and it’s a definite sign you need to modify activities in order to performed at a level that your core and pelvic support muscles can function at appropriately.

  5. Your belly bulges out or pushes out especially when you’re performing abdominal exercises. You should be able to maintain a gentle belly pull in during the exercises. If you feel that your abdominal wall is pushing out or your back arching off the floor then “you are not using right support muscles to perform the exercise and you’re actually not going to get the same benefit out of it” This also is putting more pressure down through your pelvic floor area. It can be a sign of dysfunction.
  6. You need to pee mid workout. Again going back to number 3, you should not need  to pee before after or during workout and if it’s only 40 minutes to an hour long. So if you need to stop your workout to make sure that you don’t pee your pants then it’s a sign  that you probably have some bladder or pelvic floor issues that need to be taken care of.
  7. You hold your breath to complete an exercise. Whether you doing crunches, plank, squats, lunges, bridges or any type of exercise, “If you find that you have to hold your breath to complete those exercises that is using a pressure system to create stability vs thoroughly engaging your core support muscles well”.

  8. You feel that your form fails you or you get exhausted easily from your exercises. Again it’s can be a sign that your core support muscles are not working the way that they should be and your body’s trying to compensate with other areas but it’s not able to do so.
  9. “You skip part of your workout because you know you will have bladder leakage if you do it”, So if you are avoiding the double unders,  jump lunges, jump ropes,  jumping jacks or squats because you will know you will leak when you do them, then that is a sign that you have pelvic floor dysfunction. There is something you can do about it so that you can get back to doing your entire workout.

  10. You have gas leakage while performing your exercises. So if you cannot hold the fart in while your are exercising then this is the sign that your pelvic floor muscles are not performing optimally.

 

So we just went through 10 signs that pelvic floor dysfunction may be affecting your workout. How many of these applied to you? If they do, Don’t worry. There something that you can do!  Partnering with the pelvic physical therapist is one of the  best options that you can do to make sure that your pelvic floor and core muscles are performing optimally to get you back to your exercise routine. We want to help you reach those new year resolutions and goal that you would like to achieve. So if you answered yes to anyone of these 10 signs then we’d love the opportunity to work with you. You can give us a call @ 636-225-36-49 and we can get you setup for a free discovery session to find out if pelvic physical therapy is right for you.

10 Tips for Healthy Bladder

10 Tips for Bladder HealthToday I want to clear up of some common misconceptions about bladder health that we hear all the time. Do you know how to keep your bladder healthy and happy? Check out below to learn 10 simple tips for a healthy bladder.  

  • Do not push to pee. We are not designed to strain or push to empty our bladder. Women especially tend to be what I called “Power peers.” They go as quick as they can because they hurry to get in/get out out and get back to their day.However forcing or pushing to urinate puts more strain on our pelvic floor and bladder. We are designed “just to sit and relax and let the urine come out”. Take a moment sit down and let the flow happen vs trying to strain or push.
  • “To keep your bladder happy, you need to drink more water”. Most people, especially if they are dealing with bladder leakage, urgency or frequency will limit their fluid to reduce the amount of times that they have to go to the bathroom or that they leak. Unfortunately when we limit fluid it actually irritates the bladder. Concentrated urine is more irritating to the bladder, so we need to take in plenty water throughout the day to stay hydrated and keep the bladder happy. You can tell that you are drinking the right amount of fluids by looking at the color of your pee. Your pee it should be a pale yellow color. If it’s a dark yellow or even towards a brown side that is definitely a sign that you are not drinking enough water.

  • Sit down on the toilet. Many women hover over the toilet because they are worried about germs. However, “we are designed to sit down and relax to urinate.” If you are worried about germs on public toilets, then use toilet seat covers or line the seat with toilet paper, because we need to sit to empty fully.

  • Limit or avoid caffeine. Now this can be a sad one for lots of people. Don’t get me wrong I like my cup of coffee in the morning but “caffeine is a bladder irritant” and can cause increased urgency and frequency. If you’re dealing with urinary urgency and frequency the first thing I would recommend is to cut out caffeine. If you absolutely cannot cut it out then for every cup of coffee that you drink, you should also have a cup or 2 of water to try to dilute the bladder irritant.

  • Be gentle when you wipe. Our tissue down in there is delicate. Wipe front to back and potentially just dab to be even more gentle.

  • “Don’t ignore the urge to go”.  Our bladder communicates with our brain to tell it when our our bladder. This usually occurs every 2 to 4 hours. “Listen to your bladder”. When you feel that need to urinate and it’s been close to or over the 2 hour mark then go. If you are going more frequently than every 2 hours then you may be dealing with urinary urgency and frequency.

  • Squeeze before you sneeze. When we have warning that a sneeze, a laugh or a cough is coming we want to pre-contract our pelvic floor to brace and prevent bladder leakage. To contract your pelvic floor,  try to pucker around the anus or draw the vagina up and in. If you’re having through doing this or not sure that you are doing it right, then this is a great opportunity to connect a pelvic physical therapist to figure out how your pelvic floor muscles are working.  We need the pelvic floor muscles to be on and ready to accept that extra pressure that is going to happen when we cough, laugh, or sneeze.

  • When you finish peeing, rock side to side and back and forth on the toilet to funnel fluid down in the bladder to make sure that you are emptying completely. Rock ‘n’ roll on the toilet instead of trying push or strain to get that last a little bit of urine out.

  • “Don’t Rush”. Sit down, “Relax and let your body do it’s thing”. Rushing can prevent completely empty your bladder fully. While sitting on the toilet take 5- 10 deep breaths to help everything empty out fully. If you have trouble slowing down try setting a timer on your phone for 1 minute to get you to sit for a little longer.

  • Partner with a pelvic physical therapist. A pelvic physical therapist can help you evaluate your bladder habits and assess your pelvic floor muscle function. They can help you identify potential bladder problems and come up with a plan to address issues.

After reading these 10 tips for healthy bladder, how many are you practicing? Could your bladder use some healthier habits? We are here to help. Feel free to call us at 636-225-3649 to talk with one of Legacy Physical Therapy’s pelvic physical therapists to get your questions answered.

 

Set Habits Instead of Goals

2018 Resolutions

It is three days into January, have you made your New Years Resolutions for 2018?

If not, that is okay because I want to share with you something a little different today.

I want to put a little twist on the New Year’s Resolution. For years I set [loose] goals and never really achieved them, resulting in me feeling horrible and like I had failed. I’d write them here and there, on scraps of paper, put them somewhere in the house or office, and forget about them. I would find those goals later in the year and realize I didn’t even come close to achieving them.

What’s worse, because my goals never became a plan — I was certain the problem was me, which led to me feeling EVEN worse. So, eventually I grew exhausted feeling this way, I wanted to do something about it….. I really wanted to figure out a way to make these goals of mine become a reality. So I started small, not with a goal or a resolution, but with simple habits.

Set Small Habits To Get Big Results

I began a daily gratitude journal where every day I write down at least one thing I am grateful for to help me stay focused on the positive in life.

I blocked out time in my day to work on the things that mattered to me most, AND to make sure I got to spend quality time with my family.

I started carrying a water bottle with me every day, in order to make sure that I am getting in enough water in on a daily basis and to help me curb cravings.

And soon enough, these small habits became a part of my daily life without thinking twice!

SO, here is my challenge to you…….Start a small habit or two this year. Can be something as simple as drinking 5 glasses of water a day, eating fruits instead of sweets, cutting out soda or stop eating fast food— A SIMPLE habit/goal that is easily obtainable. Stay clear of making drastic changes quickly, as that will lead to frustration and cause you to want to quit. Instead, begin by adding small habits into your day until you do it without thinking. Once you are successful, the feeling of accomplishment and the feeling of improved health with build momentum for the next small habit.

The Power Of Daily Habits

Once I learned the power of daily habits, I could begin setting goals again. And you know what? It’s been FUN to start obtaining goals.

It’s possible to achieve things in life you’ve always wanted by setting big goals to get there – the trick is understanding that they don’t happen overnight, or within a couple of weeks. Goals require daily practice with small daily habits along the way to get there.

So, what habits are you going to set yourself for 2018?

10 Tips for Healthy Bladder

November is National Bladder Health Awareness Month. Earlier in the month we shared Ashley’s story about bladder leakage and her return to #LifeWithoutLeaks.  Today, we are sharing our top 10 tips for healthy bladder.

10 Tips for Healthy Bladder

10 Tips for Healthy Bladder

  1. Don’t strain or push to empty your bladder. Forcing urine out will put strain and stress on your pelvic floor and bladder.
  2. Drink more water. Limiting fluids actually irritates the bladder rather than helps it. Drink plenty of fluids (primarily water) throughout the day to stay hydrated and keep your bladder happy.
  3. Avoid the JIC or “just in case” pee. Going to the bathroom “just in case” can train your brain and bladder to think you need to urinate more frequently than you actually have to.
  4. Sit down on the toilet. Sitting all the way down on the toilet allows your pelvic floor muscles to fully relax improving your ability to empty your bladder.
  5. Limit or avoid caffeine. Caffeine can irritate your bladder causing increased urinary frequency or urgency.
  6. Dab, dab, dab. Our tissue “down there” is very delicate. Wiping front to back might make you feel clean and dry, but it’s abrasive and can be irritating to the tissue. Instead dab front to back.
  7. Don’t ignore your urge. Your bladder and brain communicate when the bladder is full and it’s time to urinate every 2-4 hours. Listen to your bladder (and brain). When you feel that sense to urinate (and it’s been at least 2 hours), then go!
  8. Squeeze before you sneeze. Don’t get caught off guard! Squeezing the pelvic floor muscles before you cough, laugh, or sneeze can minimize or eliminate leaks and dribbles.
  9. Rock and tilt on the toilet. Rocking your pelvis front, back, and side to side can help empty the bladder to get any last dribbles out.
  10. Don’t rush. Sit down, relax, and let your body do it’s thing. Rushing the process can prevent you from completely emptying your bladder.

We hope this helps you improve your bladder health! Here at Legacy Physical Therapy, helping people achieve and maintain healthy bladders is our specialty. If you are experiencing urinary leakage, frequent urination, and/or urinary urgency, feel free to give our office a call at 636-225-3649 to find out how we can help you.

Bladder Leakage with Exercise, Can You Relate?

Female Exercise Class

Bladder leakage with exercise is NOT normal.

I had the opportunity to help a patient awhile back. Let’s call her Ashley. When I met Ashley, she told me her story, an all too common tale for many women. Here’s her story…

Ashley is a 31 year old mother of two kiddos under the age of 3. Her youngest was born 6 months prior to the time she came in to see me.

In the past, she exercised a few days per week varying her activity from walks around her neighborhood, to boot camp and strengthening classes at the gym, to the occasional run.

At 6 weeks postpartum, when she was cleared to return to exercise from her OB/GYN, she returned to regular walks pushing a double stroller. Her body felt pretty good overall.

At around 8 weeks postpartum, she returned to the gym for her first boot camp class. She realized quickly how little strength she had in her body, especially her abdomen. What startled her most was that she could not seem to do any jumping exercises without a trickle of urine coming out.

Ashley fully admitted she figured the leakage was a fluke- maybe she hadn’t emptied her bladder fully, or she drank too much water before class… but it wasn’t a fluke.

Ashley explained to me that her urinary leakage continued to happen every time she would jump during boot camp— jump squats, jumping jacks, even with mountain climbers. Then she noticed leaking urine when she would cough or sneeze. Her problem seemed to be getting worse, not better.

She was frustrated.

She couldn’t exercise like she wanted to, nor could she let out a cough or sneeze without fear she would pee herself. She eventually stopped going to boot camp classes and started wearing a pantyliner “just in case.”

Then one day, scrolling through social media, she read a post on how physical therapy could help with bladder issues. She figured it wouldn’t hurt to try. That’s when she called me at 6 months postpartum.

She told me her goal was to be free of leakage again— to not leak urine when she jumped, coughed, or sneezed. She wanted to return to bootcamp classes 2 times per week and potentially run a 5k in the future. She did not want to wear a pad every day. She did not want to feel limited by her bladder problems.

Ashley met with me for weekly appointments to start, then phased down to appointments every few weeks as she saw improvement in her urinary leakage. We worked together on focused strategies and exercises to target her specific problem areas.

By the end of our time together, she wasn’t leaking any longer with a cough or sneeze. Ashley had returned to boot camp classes without fear of bladder problems.

Ashley told me at her final visit, “I am so grateful that I found pelvic physical therapy. No woman should have to live in fear of her bladder. And I’m thankful I no longer have to.”

If you have a story similar to Ashley, we want you to know that you are not alone. 1 in 3 women will experience bladder leakage some time in their lifetime. You DO NOT need to live with it. Pelvic Physical Therapy can help. If you are experiencing bladder leakage with exercise, contact us at 636-225-3649 to set up a free discovery session to see if Pelvic Physical Therapy is right for you.

Let’s Talk about Sex- Painful Sex That Is

Painful Sex

Sex feels usually feels great, but what if it doesn’t?  Painful sex is more common than you think—nearly 3 out of 4 women have pain during intercourse at some time during their lives. For some women, the pain is only a temporary problem; for others, it is a long-term problem. Pain during intercourse is known as Dyspareunia. It can make women avoid, reduce the frequency, or outright stop having sex.  Women of all ages can experience dyspareunia.

Have you ever struggled with painful sex? You are not alone. Many women suffer in silence when sex starts to get painful. Others may be brave enough to bring it up with doctors, only to be given unhelpful advice such as “drink some wine,”  “just relax,” “you had a baby recently this is normal,”  or “just use more lubrication.” Each of these statements are real quotes from patients of ours here at Legacy Physical Therapy. We want to spread the word that there is hope and help!

Earlier this fall owner, Brooke Kalisiak had the pleasure of joining Angela Skurtu M.Ed, LMFT (AASECT) Certified Sex Therapist on her podcast About SexDuring this episode we discussed some of the common causes of painful sex, potential treatment options, and how pelvic physical therapy can help.

To listen to the episode you can go to:
http://www.aboutsexpodcast.com/e/pain-during-sex-and-how-pelvic-floor-physical-therapists-can-help-special-guest-dr-brooke-kalisiak/

Or you can watch the LiveStream Video below. Brooke Kalisiak brought along her pelvic anatomy model to the taping. Watching the video you will get to have a visual of some of the anatomy she is discussing.

If you or someone you know is dealing with painful sex, please know, first and foremost that you are not alone, and second that there is help. If you would like to learn more about potential treatment options for painful intercourse, you can reach us at 636-225-3649 to talk with one of our experienced pelvic physical therapists.