Empowering Moms: Pelvic Floor Therapy for Pregnancy, Birth Prep, and Postpartum Well-Being | The North Shore Moms



I’m thrilled to share this guest post with you today, from Dr. Allison Riley a Marblehead mom of 2 and Orthopedic Clinical Specialist. Dr. Riley is the founder of Stride Physical Therapy, located at 530 Loring Avenue, in Salem. Stride PT focuses on providing orthopedic and pelvic physical therapy.

Empowering Moms: Pelvic Floor Therapy for Pregnancy, Birth Prep, and Postpartum Well-Being
by Dr. Allison Riley

Pregnancy and childbirth are miraculous experiences, but they also bring significant changes to a woman’s body. As an expectant or new mother, you’re likely navigating a rollercoaster of emotions and physical adjustments. One powerful tool that can enhance your pregnancy, delivery, and postpartum experience is pelvic floor therapy. In this guest post, we’ll explore the benefits of pelvic floor therapy during pregnancy, how it can help prepare you for childbirth, and why it’s essential for postpartum recovery.




Understanding the Pelvic Floor
The pelvic floor is a group of muscles and connective tissues that form a supportive hammock within your pelvis. Imagine it as the unsung hero cradling your pelvic organs—the uterus, bladder, and rectum. These muscles play vital roles in urinary continence, bowel control, and even sexual arousal.
Interestingly, the pelvic floor muscles are often misunderstood, and assumed to be weak. Many pregnant and postpartum women are told to do Kegels, or squeezing of the pelvic floor muscles. But often this can exacerbate problems as the pelvic floor muscles are not weak, but instead are very tight. This is why an assessment by a skilled physical therapist is so important.

Benefits of Pelvic Floor Therapy During Pregnancy…Hint, it’s not Kegels!
During pregnancy, the pelvic floor faces increased pressure due to your changing body and growing baby. This strain can stress the muscles and joints of the pelvic floor, pelvis, hips, ribcage, and back. Over the course of the pregnancy, the added pressure and postural changes can overload the pelvic floor muscles and can contribute to pelvic floor symptoms including incontinence, constipation, pelvic pressure and prolapse, as well as lower back, hip, and pelvis pain.

Pelvic floor physical therapy can provide ways to minimize the effects of these changes and promote comfort during the course of your pregnancy.
Appropriately stretching and strengthening the muscles of the pelvic floor–this does not mean doing Kegels all day–can be effective in decreasing pelvic floor symptoms. Many people have trouble connecting to their pelvic floor and find Kegel exercises very frustrating. Fortunately there are many other ways to work these muscles including exercises like lunges, squats, bridges, breath work, mobility, and more.




At Stride Physical Therapy, our approach is to treat the whole person, recognizing when the pelvic floor may be stressed due to issues in other areas of the body. A simple breathing exercise may significantly reduce symptoms, or hip stretching to open up the back of the pelvis can do wonders. It’s not just about the pelvic floor.

Pelvic floor therapy can help alleviate pain and discomfort as well. Many pregnant people experience lower back, pelvic, pubic, or hip discomfort as their pregnancy progresses. Pelvic floor therapy includes exercises and stretches that promote efficiency and muscle balance, providing relief from these discomforts.

Another exciting benefit of pelvic floor therapy is in helping to prepare for birth. Childbirth is physically demanding, and the pelvic floor plays a crucial role. Pelvic floor therapy equips expecting mothers with knowledge of the vaginal and cesarean birth processes, ways to advocate for yourself during delivery, labor positions to encourage progress, and pushing tips to reduce risk of perineal tears.

Benefits of Pelvic Floor Therapy After Birth…Still Not Kegels!
Pelvic floor therapy continues to benefit you after childbirth. Whether you deliver vaginally or via a cesarean, gentle breathing and mobility exercises during early postpartum can help reduce joint and muscle pain, discourage scar tissue formation from perineal tears, episiotomies, and c-section incisions, and begin to build awareness of the core and pelvic floor muscles.

Pelvic floor therapy will also include exercises, manual therapy, and stretches that are aimed to improve bladder control and reduce the risk of/treat urinary incontinence symptoms, improve ease of bowel movements, decrease pressure on the pelvic area and risk of prolapse, and decrease pain with vaginal insertion including sexual intercourse. And it can also address aches and pains from feeding positions, carrying a heavy car seat, and day-to-day physical demands of being a parent and caregiver.

As you move past the fourth trimester, pelvic floor therapy can be helpful 3 months to 30+ years postpartum. Symptoms of pelvic floor dysfunction may arise anytime after pregnancy and delivery, and it’s truly never too late to make drastic improvement.




What Does A Pelvic Floor Therapy Session Look Like?
Since the pelvic floor is made of muscles, fascia, and joints, assessment of this area is very similar to assessment of other body parts. The integrity of the muscle and fascia tissue can be assessed with observation of movement, palpation (touch), and strength testing. For the pelvic floor muscles, this can be accomplished with observation of functional movements such as squats, lunges, forward bending, assessing hip and spinal range of motion, and even taking a look at the foot. More specific assessment can be done with an external and internal examination of the pelvic floor, but is not required for successful treatment. Internal exams are typically not performed during pregnancy unless there is a specific need.

At Stride PT, we understand the struggle of fitting in appointments as a caregiver. Babies and other children are welcome during your session. Each session at Stride lasts 60 minutes and you will be 1:1 with your therapist. You will also be the only client in the office, allowing for full private use of the clinic space. Because sessions are 1:1 for a full hour, we can provide a broader spectrum of treatment and generally only require follow ups every couple of weeks, rather than every few days. This decreases the stress of trying to get into the office 2-3x week.

When Should You Start?
It’s recommended to see a pelvic floor therapist in your second trimester. Typically you will be seen 3-4 times during your pregnancy unless more consistent care is needed, with the first postpartum visit occurring around week 4 and continuing weekly to monthly for the first 6 months postpartum. Courses of care can be longer or shorter depending on symptoms, response to treatment, and amount of oversight and guidance preferred. In general, a course of pelvic floor physical therapy outside of the immediate postpartum phase is about 6-10 visits over the course of 6-8 months.

I hope this blog was helpful in providing information on the benefits of pelvic floor therapy during pregnancy and postpartum. Often I find that this population is told that pelvic floor symptoms are just part of being a mom and to just live with it. And that can be a scary and depressing thing to hear as you pack an extra set of leggings in case you pee through yours while at the playground or at work. Pelvic floor therapy is typically extremely successful in helping to treat and manage symptoms, so tell your friends, your sisters, your moms that they don’t have to just live with it anymore!




Learn more information about how to work with Dr. Riley and her team at www.strideptw.com, or email her directly at [email protected]. Follow Stride PT on Instagram @strideptw.

This post is sponsored by Stride Physical Therapy.

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