Strengthening my Pelvic Floor Postpartum with Physical Therapy

Strengthening my Pelvic Floor Postpartum with Physical Therapy

Sharing my journey with pelvic floor therapy postpartum and how I regained my pelvic floor...

Sharing my journey with pelvic floor therapy postpartum and how I regained my pelvic floor strength to cure my incontinence.

Strengthening my Pelvic Floor Postpartum with Physical Therapy

Many may say that this blog post is TMI or gross, because I’m talking about peeing myself. And to that I say, “consider yourself lucky!” I wish I didn’t struggle with incontinence, but I do, and it’s a major condition that negatively affected my daily life routine. And frankly, I thought that that was normal and that there was nothing you could do about it, that my body was just changed or “ruined” after childbirth. And I was absolutely misinformed.

And that is why I’m oversharing about peeing my pants, because I’m here to say that it’s not normal, it’s a condition, and it can totally be treated, improved, and even cured. If this blog post helps one woman strengthen their pelvic floor, I’ll be elated.

How my incontinence began (and got worse)

To back up, I’d like to preface that I’ve always had issues peeing my pants. I always joked about my weak bladder and it has always been part of my life – I’ve never been able to “hold it” for very long. I’ve peed my pants laughing with friends, and I’ve certainly peed jumping on trampolines. I haven’t done jumping jacks in a decade, because there’s always leakage. Sneezing or heavy coughing and I have to change my underwear. When running, I’d have to stop in bathrooms along my route to pee, even during just a 30 minute run.

Then, I had children. When I became pregnant with Luca, I thought I just had typical pregnancy bladder issues (because the baby is essentially pushing down on your bladder for 9 months.) I had to give up running entirely and any time I left the house, I had to wear a pad, in fear of completely wetting myself. It was inhibiting my life and it was something I had to think of all the time. Even planning trips to do errands, I had to think about bathroom breaks. I planned my outfits around the time of day, because I knew at some point, I’d probably have a wet spot. Even if I went to the bathroom, I’d leak minutes later, it was like my bladder was always full and I couldn’t empty it.

After having Luca, the problem just continued to worsen. Someone mentioned Pelvic Floor Therapy, I kind of shrugged it off, and I told myself I’d look into it once I was done having children.

My First Attempt at Pelvic Floor Therapy

After Roma was born, my incontinence was so bad, I couldn’t even hold my toddler and walk around the apartment without completely wetting myself – and that’s after I went to the bathroom! Around 8 weeks postpartum, I went to see a highly recommend Pelvic Floor Therapist in my area (in Hoboken, NJ) named The Pelvic PT, Dr. Judith Meer.

Roma was still a newborn and my mom was staying with us, so I brought her to the appointment so I could nurse Roma (we were still trying to get our nursing flow.) Roma was crying hysterically in the room next to where I was having my appointment, so I immediately tensed up, couldn’t focus on what was happening. I went home and didn’t go back… until 14 months later.

Pelvic Floor Therapy, Finally!

My incontinence issues only got worse. I was buying so many pads to wear during workouts and just every day to deal with the leakage, that I would be so afraid to walk out the door without a pad – it was like a security blanket. I never got dressed for the day without a pad. And that was no way to live. I couldn’t run around with my toddlers, I couldn’t go on car trips longer than 15 minutes without peeing myself. I wasn’t living a full life and couldn’t be the active mom I wanted to be!

That’s when I called back the same pelvic floor therapist. I loved her demeanor, the way she made you feel comfortable despite a very uncomfortable situation, how she explained every single thing that was happening to you and why it was happening, and the way she spoke to you and empathized with you. She was a toddler mom, too!

We had our initial appointment, which is a full pelvic floor exam. Now, I am going to butcher all of the technical terms, but essentially, she does an external and internal exam of your pelvic floor, which takes about 45 minutes. Yes, her fingers are internally examining your vagina for about 30 minutes during this exam. She pushes lightly certain places, asks you to tighten your pelvic floor muscles, and feels around while you perform little breathing exercises and muscular movements to basically figure out what’s happening in there. And I have to say, I had no idea how complex our vaginas and pelvic floors were!

After the exam, she concluded that my pelvic floor was very weak and instead of my pelvic floor tightening and staying tightened, it would “flicker,” as in, it would tighten for a moment but I couldn’t keep that tightness for more than a second. This meant that I didn’t have the strength to support my bladder, which sits above your pelvic floor. Whenever my bladder was slightly full, my pelvic floor was so weak, it couldn’t keep the pee in.

Now, there were so many other things coming into play and reasons why I had such a pelvic floor. Pregnancy and childbirth definitely weaken a woman’s pelvic floor (and I had a weak one to begin with!) For me, we figured out that I wasn’t breathing correctly. I couldn’t believe that that was how simple the answer was: breath.

In layman’s terms, when you breath into your belly through your mouth and exhale through your nose, your pelvic floor rises and falls and that helps keep it engaged and strengthened. For me, I was holding my breath a lot and when I was breathing, it was rarely through my stomach – always in my chest, which is a high stress breath. Essentially, I was never activating or engaging my pelvic floor, so it was super weak.

She sent me home with some breathing exercises as homework and from them on there, we made an appointment weekly. I have to say, although I believed her, I didn’t have much faith that breathing would cure my incontinence. I was expecting all those fancy exercises you see on pelvic floor Instagrams. But I promised myself I’d see it through.

In case you want to search some of the exercises that I did, aside from big belly breaths:

  • Glute bridge with adductor squeeze
  • Abdominal stretch with Cobra Pose variations
  • Chid’s pose breathing
  • Prone quad & hip flexor stretch
  • Deep squat with pelvic floor drop
  • Supine marching

Strengthening my Pelvic Floor Postpartum with Physical Therapy

How Pelvic Floor Therapy Strengthened my Pelvic Floor and Is Curing my Incontinence

The first week, she instructed me to practice deep inhalations and exhalations, rising up my belly on every breath and releasing. There were some exercises where I’d breath in and on my long exhale, I’d do a kegel, but that kegel wasn’t an average kegel, it was an engagement of my deep core as well – something she showed me how to recognize after an internal exam in her office. Every day, I had about 5-10 minutes of breathing exercises that I’d do on the couch at night while watching TV with Lu.

And to be honest, within 3 days, I was having less and less sense of urgency to pee. I started to notice that I felt more confidence in my body’s abilities that certain moments that normally would result in wetting myself, I was barely leaking. For example, when I’d get up off the couch at night after watching TV to go to the bathroom, I’d usually have to cup myself and apply pressure so I wouldn’t pee on the walk over to the bathroom! This ended after a week of pelvic floor therapy.

During each weekly 45 minute appointment, she’d do an internal therapy session, so if you’re shy, be prepared. I could barely feel what she was doing in there but she was releasing tense muscles to help engage and activate my pelvic floor. She’d explain what she was doing the whole time and after the therapy, she’d ask me to do my breathing exercises and engage my pelvic floor and each week, it would get a tiny bit stronger.

After about a month, she gave me new exercises to do to help loosen all of my muscles in my back and neck, because everything is connected through breath and to fully operate your pelvic floor, you truly need to breath through your body. I thought it was crazy and the exercises seemed silly (squatting and just breathing for a few minutes, for example) but they really, truly worked.

Continuing to Strengthen and Moving Forward

Three months later, I’d say my sense of urgency has dwindled from a 9 to a 4 and my leakage issues have gone from a 9 to a 3. I’m almost there, and I’ve noticed that when I stop doing my nightly exercises consistently (like if I skip a whole week), I have leakage issues. The holidays and the New Year have set me back a bit, but I’m excited to get back into it.

I won’t have to do these exercises so much forever, but like with any strength program, you have to put in the work to get the results and then maintaining is much easier, once your muscles are built.

My biggest goal with pelvic floor therapy was to be able to run around the house with my kids without peeing my pants, and I’ve accomplished that. My other goal was to be able to run again without leakage. And I’m almost there. There are some moments when I have leakage and now, I can usually distinguish them – like drinking too much water or coffee before going on my run or not doing my exercises and having a bit of weakness. But generally, I’m able to run without leakage 7/10 times right now, which is so exciting to me.

Honestly, I never thought I’d get to a place where I could control my bladder. I thought it was my bladder, but it was my pelvic floor. Now, when I’m in a situation where my bladder is super full and I can’t make it to the bathroom, I know certain exercises I can do to wake up my pelvic floor and have it do its job to get me to the bathroom. There are little techniques I’ve learned (like certain breathing when you’re having a sense of urgency) that have helped tremendously, too.

I’m in such a better place and it has made me feel like a better mom, a sexier wife, and just a complete human.

If you have any specific questions, I’d love to help as much as I can by sharing my own journey, but know that I’m not a doctor and I can’t give any medical advice. My biggest recommendation is to see a pelvic floor therapist to get a full exam to find out what your unique situation is, because it may not be similar to mine at all!

Thank you for listening to my TMI blog post, which isn’t TMI at all – it’s completely essential to talk about these things so women know they’re not alone and that they don’t have to live this way!

I hope this helps other women in a similar situation. Please let me know if you have any questions about my journey!

with love, Ali

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  • Thank you for sharing Ali! I am a physical therapist and it's great to hear you spreading the importance of this lesser-known specialty of PT.
    • Love having you as part of our community!
  • While not as severe as you were, I know exactly what you mean! I do not even feel myself leaking pee, the doctor said that nerves were damaged during the last birth (21 YEARS ago) and when I contract the muscles things do not tighten correctly. He started talking surgery, but honestly I've had enough surgeries and was in no mood to schedule yet another. Your post has given me hope that I can improve things, and not feel like I smell like a wet diaper anytime I need to go to the restroom. I know you must understand that feeling. Just UGH. Since I live on the other side of the country from you, I'll see if such a therapist exists here. Any one that has this problem will totally appreciate your honesty. Thank you!
    • We're so happy you shared your story with us, Angela!
  • Thank you for you honesty! This is great info! Many of us deal with this issue and you're absolutely right, it needs to be talked about.
    • Thank you for sharing with us, Andrea! So happy to have you here!
  • I love this so much. So many people go through this and don’t talk about it or think it has to be their new normal. The more we all discuss it, the sooner everyone can feel better! Great job sharing!
    • Yes! We love that you're here with us, Kris!
  • Thank you so much for sharing your journey Ali! It is definitely not talked about enough and at first I felt very alone with my pelvic floor issues. I have also had success with pelvic floor therapy and encourage others to look into this. I did not have an incontinence issue, but pain walking and definitely running. My issues have improved and it is comforting to hear your story and progress!
    • So happy you're comfortable sharing you're story with us here, Melissa! We love having you as part of our community!
  • As a pelvic floor therapist it was great to see this! Too often I hear women (and men!)say they had no idea pelvic floor therapy existed and they deal, silently, with pelvic floor issues for far too long. That has started to change some as more people share their experiences and women know it's an option. Thank you for sharing your experience- I hope one day it's not considered taboo to talk about one's pelvic floor issues.
    • Kristina! It means so much to hear from you. Thank you so much for sharing and for your support.
  • Thank you so much for sharing this. I just discovered yesterday that I have prolapse and need pelvic floor therapy. I remembered you had mentioned something about having this therapy in one of your stories. Today I searched your blog, hoping I could find more information, and I was happy I did! It encourages me that my issue can hopefully be corrected without surgery. If you hadn't shared your experience, I wouldn't have even known pelvic floor therapy was available.
    • Ann! We are SO glad you found this resource & it was helpful for your healing journey. Definitely lean into therapy as much as you are able. It is amazing how well our bodies can heal when we give them the support they are craving. You'll do amazing! Keep us updated on your journey. We are here for you!