How Do You Know if You Need Pelvic Floor Physical Therapy

Let’s clear up the mystery of knowing if you need pelvic floor physical therapy!

Quite often here is limited understanding of what the pelvic floor muscles do and whether these muscles might be a problem.   The pelvic floor muscles are located inside the bones of your pelvis and sit like a hammock inside you.  On top of this hammock you have all of your organs:  bladder, bowel, uterus/prostate.  These organs are supported by the muscles.  The muscles and the organs communicate with each other and work together as partners, so if you have problems in one area (such as your bladder control) you will have problem in the other area (the pelvic floor muscles).  Pelvic floor dysfunction presents itself as pain, bladder, bowel or intimacy problems.

This is a checklist of some common symptoms you may be experiencing that can indicate you have pelvic floor muscle dysfunction.

If you have any of these then you know you need pelvic floor physical therapy:

*Pelvic Pain:  Any pain from the abdomen/spine through the pelvis/groin.  This includes mid and lower back pain, SI joint pain, pubic bone pain, groin pain, tailbone pain, abdominal pain.

*Lower Back Pain: This pain gets its own bullet point because research has shown us that people with persistent lower back pain typically also have underlying pelvic floor muscle dysfunction.

*All bladder and bowel issues can also have an underlying problem with pelvic floor muscle dysfunction.  This could be fecal smearing, unexpected loss of gas, urinary incontinence, urinary urgency, painful urination, poor urinary stream, getting up at night to pee.

*Intimacy related struggles:  pain with penetration, pain with erection, pain after intimacy, poor intimacy response, inability to orgasm.

*Pelvic organ prolapse, pelvic heaviness, vaginal and pelvic pressure

*Pelvic muscle weakness, whether you can perceive it or not, is usually happening.  The muscles are commonly stiff, tight, have trigger points and operate slowly and deficiently.  Hence, the laundry list of symptoms here!  Kegels are often not the solution to the problem and, in fact, can make things worse.  So, seek expert care from a pelvic PT if you have any of these symptoms.

If you are interested to learn more about these muscles, here is a link to an article that briefly covers pelvic floor muscle anatomy.

If you know you need pelvic floor physical therapy, what should you do?  Call us and we can help!

Well, we are here to help you!  We provide wholistic and comprehensive care to get you results!  Our compassionate, patient-centered treatment will identify underlying issues that are contributing to your problem and will treat each of these things.  This is key to your success!  By providing numerous assessment and treatment methods we can get your symptoms to improve.  We have a lot of techniques to help you improve such as:

  • Myofascial release
  • Trigger point release
  • Joint mobilization
  • Movement pattern restoration
  • Muscle firing and recruitment re-education
  • Strength and conditioning
  • Trigger point dry needling
  • Self-care education and modification of habits/behaviors that contribute to your symptoms
  • Instruction in optimizing nutritional healing to promote relief of symptoms
  • Postural correction and alignment

If you are pregnant or postpartum the pelvic floor muscles and the rest of your body change dramatically during this experience.  Unfortunately in our region of West Michigan pelvic floor physical therapy is not routinely suggested to a pregnant/postpartum person, even though we know that it helps improve how you feel!

At Purple Mountain Physical Therapy we provide a  comprehensive pelvic health physical therapy treatment program special for pregnant and postpartum women!  If you would like to read more about what we do, here is an article we wrote that details one of our postpartum patient’s experiences with us!

Purple Mountain Physical Therapy located in Grand Rapids, Michigan is a specialty pelvic health clinic that serves women and men who have any pelvic condition.  If you are still wondering “how do I know if I need pelvic floor PT?” then give us a call!  We offer a free phone consult to discuss your condition.  Call 616-516-4334 to schedule your free consult.  No problem is too simple or too difficult for us!  We commonly help people who have failed to get results from other interventions.  The men who come to us often have experienced years of pain and/or bladder & intimacy issues that have proven very frustrating, anxiety producing and depressing.  The women who come to us may also have pelvic pain or could be pregnant, struggling with postpartum recovery, have longstanding pelvic floor dysfunction that shows up as urinary incontinence, constipation, pelvic pressure, painful intimacy, “mommy tummy” or weakness in their back.  If any of these resonate with you, give us a call to schedule your free phone consult:  616-516-4334.

How Do You Feel About Your Postpartum Recovery? Would Pelvic PT help you?

Being Pregnant and Postpartum can be an Overwhelming Experience and Definitely Changes Our Body! Pelvic Floor PT is a Key Component of Your Postpartum Recovery.

Each of us will experience our unique emotional reactions to the changes in our body!  You don’t have to know all the answers.  Expert help from a pelvic floor PT will take your postpartum recovery to the next level!

How do these changes in your postpartum body make you feel?  What do you think about your body now?  If you are struggling with disappointment in your pregnant or postpartum body, I can help you get back to feeling more like yourself when you join me to complete a postpartum PT recovery program.  Pregnancy and the postpartum period carry a risk of low back pain, pelvic girdle pain (such as SI joint pain, pubic bone pain, coccyx pain), painful sex, pelvic floor dysfunction, diastasis recti abdominus and urinary incontinence.  This is quite a long list, actually, of unfortunate things that you be experiencing as a result of being pregnant.  The good news is that working with me you will get a comprehensive evalution and treatment program to ensure you get your  body back into top form.  Pregnancy changes our posture, breathing, abdominal wall, pelvic floor, bladder, bowels and sex life.  I can help you recover all of these things!

What should your postpartum recovery program look like and include?  Pelvic floor PT help you get your body back and return to an active life!

  • Check you for a diastasis recti abdominus and develop a program of recovery from this
  • Evaluate and treat every muscle of your pelvic floor to determine how each one is working and to get each one to come back to function.
  • Teach you how to recover optimal breathing function, which was disrupted when you were pregnant and the baby moved your diaphragm.  Recovering breathing is crucial to recovering your pelvic floor function.
  • Take you through a progressive exercise program to restore your pelvic floor strength, coordination, function and speed.
  • Address your posture, especially increased midback hunch, tight shoulders, forward head and tilted pelvis.  Pregnancy changes your fascia and postural alignment and we look at this and help you correct it.
  • Optimize your pelvic organ suppport, a very important part of addressing pelvic organ prolapse
  • Strengthen your back and abdominals so you can confidently lift your baby and everything else you need to lift.
  • Get you back to higher level activities including jumping, skipping and running.

Research confirms that exercise and hands-on care for pregnant women can help their low back pain

Exercise (any exercise on land or in water), may reduce pregnancy‐related low‐back pain and any exercise improves functional disability and reduces sick leave more than usual prenatal care. Evidence from single studies suggests that acupuncture or craniosacral therapy improves pregnancy‐related pelvic pain, and osteomanipulative therapy or a multi‐modal intervention (manual therapy, exercise and education) may also be of benefit.,Authors’%20conclusions,more%20than%20usual%20prenatal%20care.

Pregnancies and a live baby were hard to come by in my experience.

I was one of the healthiest people I knew.  I was fit and active.  I was a physical therapist and knew how to help women through their pregnancy.  I had a regular cycle and zero clue that becoming a mother would take years of tears, pregnancy losses, hopelessness and digging in.  I had to discover wholistic ways to facilitate fertility, I had to work on stress/mind/body/spirit.  I had to call on my faith to get us through this.  I did just about everything under the sun to facilitate becoming a mother.  If you have experienced infertility you know what I’m talking about.  Yep, I did everything.  Everything.

My postpartum experience wasn’t so peachy, either.  I had to do extensive pelvic floor PT, abdominal wall recovery and rebuilding my strength and conditioning.

In my first 30 days postpartum I had emergency surgeries and spent ten hellish days in the hospital.  My family was amazing and scared to death for me.  It is not an exaggeration to say it looked like I wasn’t going to make it.  The will got drawn up in the hospital bed and the priest came.  It was a serious and dangerous and God-awful experience.  I had two kids under two years old who were not allowed at the hospital.  My family and friends were amazing and provided around the clock care for our kids, with my husband shuttling between the hospital and the two locations where our kids were staying.  My family wanted to touch base with me or my husband each hour to see how I was doing, because it seemed to change rapidly and would go downhill fast.  We were desperate to get me stable, but the roller coaster had begun and it was decidedly out of control.  And, remember, I was one of the healthiest people I knew!  I was an athlete, super healthy eater, had come to pregnancy after completing years of wholistic healing.  And. Still. It. All. Went. Wrong.  Until it went right!  Yay!  Eventually I stabilized and got to go home, exhausted and uncertain if I would be able to take care of our two kids.  And my body was a wreck.  My pelvic floor was a disaster (so many surgeries and my labor and delivery had done a number on me), my abdominal wall had a huge diastasis recti abdominus, all of my body muscles had atrophied.  I remember looking at my calves when I was in the hospital and shedding a tear at how atrophied they became.  It happened so quickly, over a matter of two weeks.  My OBGyne  said “well, you’ve lost all of your pregnancy weight and then some.”  And I remember replying “It is all atrophy.  I will weight lift and get it back.”  And I did.  It took a long time & a lot of discipline to recover my abdominal wall and pelvic floor and to get strong again.  But I did it, with the help of pelvic PT and my clinical background in how to take a woman through a safe and progressive postpartum recovery program.

Now you know a bit about how I got to be the person I am today.   I have been through an epic pregnancy and postpartum recovery and found a path forward that is authentically grateful, happy, strong and whole!  And I offer this wisdom and understanding to my patients.  I know  my patient’s pregnancy and postpartum experiences feel like a huge challenge to them.  May feel overwhelming.  May feel hopeless, like you are stuck with urinary incontinence or a “mommy pooch.”  I am proof positive that this is not the case.

Working with individuals who are experiencing pregnancy or are postpartum is a calling for me!  I love it!

I offer these women an insight, grace, clinical expertise, understanding and joyfulness for their pregnancy.  I had to complete intensive postpartum PT recovery.  Because of the nature of my labor and delivery and postpartum complications I had serious work to do to recover my pelvic floor, abdominal wall, strength, conditioning and function.  I did the hard work.  And, I know the commitment it takes to reach your goals.  It doesn’t happen overnight and it takes real insight and expertise to provide postpartum pelvic health physical therapy to a woman.  It is an honor to work with women who are pregnant and postpartum.

I have advanced training in providing pregnant and postpartum women pelvic floor PT and designing a postpartum recovery fitness program.

And my training dates back to the 1990s!  So, I’ve been studying and treating pregnancy and postpartum recovery for more than 2 decades!  Many pregnant women come to me experiencing miserable pelvic pain.  It might be their SI joint hurts, or their pubic bones are grinding everytime they move their leg, or they cannot roll in bed without back pain.  Or it might be that they are experiencing urinary incontinence or pelvic floor muscle spasms or a diastasis recti.  I can help all of these conditions!  How lucky am I?  It is truly an honor to help women during their pregnancy and postpartum periods.

I offer compassionate, patient-focused wholistic treatment for people who are suffering from pelvic conditions!  Are you interested in addressing your postpartum recovery?  Call Today for Information on our Program.

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Postpartum Pelvic Floor PT in Grand Rapids

Postpartum Pelvic Floor PT in Grand Rapids

What does Postpartum Pelvic Floor PT Treat?

If you are postpartum and wondering what postpartum pelvic floor PT in Grand Rapids would do for you, read on!  We thought it might help you to hear of one woman’s recovery story with us.   If, after reading this, you feel postpartum pelvic floor PT could help you, Contact Us

Here’s a story of one woman we helped.  Her problems:  pelvic and perineal pain, pelvic floor dysfunction with bladder and bowel control problems,  postpartum recovery following severe pelvic trauma with labor and delivery and pelvic reconstructive surgery.

Like all new moms, this woman was impressive!  She worked full time, was in love with her baby, struggled with sleep deprivation and wanted to get back to being athletic.  When we met, she was 6 months postpartum with problems of bladder/bowel control and pelvic instability, pelvic pain, pelvic floor weakness and diastasis recti abdominus (split abdominals).  She experienced inner thigh and pubic pain with walking, exercising, moving in and out of positions when picking up her baby and when driving and moving her foot from gas to the brake.   This pain was her dominant concern, but she also wasn’t happy to have embarrassing and unexpected loss of gas, problems with bladder control, a weak abdomen and a diastasis recti abdominus (split abdominals) as well as knee pains.  Before I met her, when her baby was 4 months old, she had pelvic surgery to correct a serious injury from her labor and delivery.  She had been referred to me by her urogynecologist surgeon, but had tried two other pelvic floor PTs prior to her surgery and before finding me.  Neither of the prior pelvic health PTs could help her pain and she had been told that she needed to get in shape, but she found herself unable to exercise because of pain.

Her Goals:

  1. Get pregnant again and be healthier before the pregnancy, down the line.
  2. Get the adductor (inner thigh & pubic bone) pain to go away. “It prevents me from doing every other exercise.”
  3. Regain the strength of the pelvic floor and muscle control.

We got to work right away with a comprehensive postpartum pelvic floor physical therapy evaluation.  This included a detailed assessment of her:

  • Load transfer ability:  This was impaired, she could not shift weight from one leg to another and keep her pelvis and low back in stable.
  • Strength: Poor all around, she was deconditioned, had weakness in her glutes, pelvic floor and abdominals and low back.
  • Abdominal wall integrity: Disrupted by a diastasis recti abdominus that caused ineffective and abnormal load transfer through her legs, pelvis and core)
  • Pelvic floor integrity & coordination: Integrity of the multiple layers of the pelvic floor was intact, but coordination was impaired and deficient, poor timing and firing of the muscles noted)
  • Postoperative healing: She was doing well, but the vaginal tissues were fragile and needed to be treated delicately and carefully.

Her Plan of Care Included Hands-On Treatments and Graded, Specific and Careful Exercises to Promote Stability, Strength and Coordination

We worked together at each visit, with a very careful and coordinated plan to progressively help facilitate her recovery.  I provided a good amount of hands-on manual therapy to her abdomen, low back hips and thighs and internally to her pelvic floor.  Together we worked to optimize her muscles and her fascia, to improve her pelvic stability, to advance her strength and conditioning and to restore her pelvic floor, breath and core muscle coordination, timing and strength.  If you may benefit from postpartum pelvic floor PT in Grand Rapids, we can offer the same expertise to you!

At Her 5th postpartum pelvic floor physical therapy appointment, she was feeling better!  Less pain!  Less Worry!  Hope and optimism were born!

She arrived with a smile and noticeably less stressed.  She reported this was because she was feeling better and seeing that we were making progress.  Her postpartum pelvic floor physical therapy program was different than the other two physical therapists had recommended and it was detailed, systematic and progressive.  She was feeling improvements and this gave her confidence that she was getting the help she needed.  By this fifth appointment she reported “every now and again I get twinges of pain in my inner thighs or my abs, but it goes away.  It doesn’t happen often.  My walking is pretty good.  Standing on one leg still hurts a little; I have to sit down to put on shoes and pants.  It is unstable and some pain in the proximal adductor.”  This difficulty with standing on one leg is something that women with pelvic instability can experience.  We perform a comprehensive evaluation to determine what are the driving factors with balance, pelvic stability, muscular control and motor coordination.  Then, once we know what is causing this pain and problem, we devise a program to systematically address all of the contributions to it.  In her case, we provided a postpartum pelvic physical therapy program customized to her post-operative precautions and designed to optimize both her post-operative and her postpartum healing.  The results of pelvic floor physical therapy are born from the wisdom and experience of a good pelvic health physical therapist to design an effective and comprehensive treatment program.

Not all pelvic health physical therapy is the same!

For this woman we were challenged to develop a pelvic health recovery program that gave a “Goldilocks” effect.  You remember the childhood 3 Little Pigs tale, with Goldilocks finding the “just right” bed and porridge?  We needed to evaluate and treat her with the “just right” methods of physical therapy.  Enough to stimulate pelvic recovery, coordination and strength while also reducing pain and instability.  Too fast, too aggressive or the wrong exercises and treatments and she was at risk for a huge flare up and possibly adverse healing.  Too little or the wrong exercises and treatments and she was at risk for physical therapy not helping her, having no response and thinking “this doesn’t work and I’m never going to get better.”  If you might benefit from postpartum pelvic PT in Grand Rapids, we are here to help you.  Contact Us

We’ve Seen This Before & We Can Help You!

I had seen this condition before, many, many times over the years.  By working with so many other women and having advanced training in pregnancy and post-partum pelvic floor physical therapy, I knew how to best help her.  She and I worked together in partnership to step-by-step get her to achieve her goals.  One advantage she had in coming to see me was my experience with helping women with these types of complicated cases.  I am an avid reader of clinical research and participant in professional societies and ongoing clinical education, because of this I can offer my patients clinical expertise.  For example, in this woman’s case she had a diastasis recti abdominus, which is split abdominal muscles.  In the last ten years there has been a lot of research, debate and clarifications on how to best treat this condition.  Having kept up with all of this, I was able to offer her the most current and effective methods to resolve her diastasis recti abdominus.  There are many published articles about DRA, here is one that surveyed pelvic health physical therapists to learn what their current practices were to treat this condition.

At 6 Months After Starting Pelvic Floor Physical Therapy She Was Roller Blading!

To help someone recovering after pregnancy and surgery requires expertise.   At 6 months after starting physical therapy, she returned with happiness reporting “I’m feeling ok!  I feel fine doing my core exercises (this is an improvement!).   I went roller blading and felt good.  I feel some soreness in my inguinal region, not like it was before, it is mildly sore, same as my abs.  My knees and back have felt better.  I’m doing all of the exercises you gave me and some extra squats throughout the day and my knees are fine.”  You can see this is a huge advancement in her activity tolerance.  Rollerblading?  That was absolutely out of the question when I first saw her, she would have had pelvic pain, possibly knee and low back pain also, possibly loss of gas or urine.  And, here she was able to roller blade without anything more than some soreness that was normal post-workout soreness!   Her success with roller blading was a huge win and a reflection that all of our pelvic floor physical therapy had correctly addressed her myriad problem.

Free Discovery Visit if you wonder if postpartum pelvic floor physical therapy might help you!

This story gives you a glimpse into one woman’s experience of postpartum pelvic floor physical therapy.  This woman had an unfortunate and complicated case and was able to get back to an active life and achieve her goals.  Many women we help are fortunate to have fewer problems.  But, most postpartum women do experience some challenges to their recovery. Even when they are feeling fine they don’t know exactly which exercises they should be doing.  Or, they may experience some urinary leakage from time to time and don’t know how to get that to go away.  If you wonder if postpartum pelvic floor PT in Grand Rapids could help you, we offer a free Discovery Visit.  This would be an opportunity for us to meet so I can answer your questions and get a sense of what is going on with you.  I could then tell you how and what I may be able to offer to help you reach your goals.  If you are interested in this, call 616-516-4334 and mention this articel and the Discovery Visit and we can find a good time to meet!  Contact Us



Dr. Maureen O’Keefe, DPT