A look at pelvic floor therapy from Gail O’Neill

Jonathan Welch, Contributing Editor

The following article was written by Gail O’Neill, PT, a specialist in pelvic floor physical therapy at ShiftPT in New York City. ShiftPT and Gail are friends of the YinOva Center, and offer valuable information and care to our community.

Finally, your bundle of joy has arrived! Those first several weeks just seem to fly by, don’t they? Adjusting to feeding schedules and sleeping routines (or lack thereof) can be overwhelming at best.  Sadly, many women also live with pain, especially during intercourse, and even embarrassing urine leakage (incontinence). While medication, and in some situations even surgery are recommended, these are certainly not the only treatment options.
 

There is a solution that could be right for you.

Women’s Health Physical Therapy (PT), also know as Pelvic Floor PT, is a specialized type of therapy that can alleviate and in most cases eliminate some of these problems following your delivery.  There have been numerous published studies to support the effectiveness of Women’s Health PT.
 

Most women don’t talk about it.

Many women are a bit reticent to discuss these very important issues usually due to embarrassment, and also because they don’t believe there is a solution. Usually following childbirth, the tissues should heal by your 6-week check up.  If you are still having pain, you must tell your Dr. If he or she is not aware of this type of PT, you may want to suggest this as a plausible avenue for treatment.
 

What you need to know.

It is normal to feel vaginal discomfort the first few times you have intercourse following a vaginal delivery.  But, it is important that you do not push past the discomfort to avoid pain.  This discomfort may be due to vaginal tears, episiotomy scars, forceps or vacuum delivery, the baby’s pressure on your pelvis during the birthing process, and/or low estrogen levels during breastfeeding.
 
Some women may experience urinary leakage when they lift, cough, sneeze or laugh which is termed stress incontinence.  This occurs when the abdominal pressure increases.  Normally, one’s pelvic floor muscle strength can counteract this, but following the birthing process, these muscles may be weakened and in some cases torn.   Your PT will help with retraining your pelvic floor musculature.
 
Some women may also experience joint pain.  This may be caused by physical strain while carrying the fetus, the secretion of the pregnancy hormone relaxin, which relaxes the ligaments, and the rigors of labor. There are many traditional types of PT treatments available to help with this.  They may include: stretching and strengthening exercises, hands on techniques, modalities and posture retraining.  These exercises will be specifically tailored to a body recovering from childbirth, as traditional exercise may not be appropriate.  She will also teach you breastfeeding, burping positions and proper lifting techniques to reduce the stress on your joints.
  

What treatment involves.

Your PT will use a variety of hands on treatment techniques to stretch, release, balance and desensitize some of the tissues involved. She may use biofeedback, electric stimulation, as well as manual techniques to help jump-start these muscles in order for them to contract normally.
 
PT visits are generally weekly.  Typically, postpartum pain patients require 10-12 visits for vaginal pain, 4-6 for incontinence, and 6-8 visits for joint pain (unless there is a pre-existing condition). At the end of the course of treatment, most women feel significantly or completely better. In the state of New York, you can see a PT without a script from a physician for as many as 10 visits spanning a four week period of time. The costs range per visit depending on treatment and many insurances will provide coverage for the visits.
 
 

 Gail O’Neill is a Licensed Physical Therapist and Pelvic Floor Specialist in Greenwich Village, New York City with over 30 years of Orthopedic experience in Physical Therapy. As a mother of three she is passionate about helping women who are affected by these common discomforts. 

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