Pelvic floor rehab, week two

Just when I started to feel like I was getting stronger, just when I felt like I was ready to start working harder at the gym, I get the news that I need to back off. My pelvic floor is somewhat thrashed from childbirth, and I need to fix it before I do further damage.

I honestly had no clue that I was in such bad shape. My pain is minimal and my problems are not all that obvious to me. I decided to schedule an appointment with a pelvic floor rehab specialist mainly for prevention, and because the subject came up at the mom-and-baby group I attended (in short, the doula who leads the group commented that it was a good idea for every new mom). I thought I was just being proactive. Turns out I really need this!

I'll explain the details of the diagnosis and the anatomical issues later on (I'll need to write that post on a quiet day when my baby is napping and I can think -- she is very rambunctious today) -- for now I'm going to talk about my symptom (yep, just one), treatment/prognosis, how it impacts my workouts and things I've heard others say that suggest that they they, too, might benefit from pelvic floor rehab.

The symptom: I pretty much just feel like I've been kicked between the legs, especially when I'm in certain yoga poses (like butterfly and warrior) or when I squat down to get something out of a low cupboard.

Treatment/prognosis: The short version of my diagnosis is that my pelvic floor muscles are weak, and that things never returned to the correct position after childbirth. Going back to the gym a mere five weeks after my baby was born probably didn't help my situation, but in my defense I felt totally fine and I really really really needed to be back with my gym community and I needed the physical challenges and adrenalin rush that I get from my workouts. Plus, I was cleared by my midwife to start working out again. Her only requirements were that my uterus had returned to its pre-pregnancy size (it had) and that all my stitches were healed (they were). As for treatment, I am seeing the physical therapist once a week for about six weeks for starters. Depending on how it goes, I'll then see her once a month (to make sure the therapy is holding).

This will probably surprise some people, but part of the physical therapy is more akin to something you would experience at a gyno's office. I know it probably sounds weird because this is a physical therapist and not a medical doctor -- but to me it just makes sense. My PT (who specializes in the pelvic floor and has even written a book on the subject) is not just guessing as to what is going on inside ... she actually knows. And she's been able to give me very specific instructions on how to properly do kegels, etc. I'm not doing hundreds of kegels a day or anything, either. Just a few. I also have some stretches and two exercises I do every morning that are supposed to to re-align everything. Workout-wise, the rules are 'low impact' and 'no heavy lifting.' If I'm disciplined and follow her instructions, I should be back to normal before I know it. It is difficult (mentally) for me, though, to scale back my workouts. Yesterday, I jogged on the treadmill while everyone else did a benchmark workout of push presses (I think it was push presses -- might have been something similar) and hurdle hops. I was envious. Extremely envious. But I know it is for the best, and I'll do what I need to do to get better. My plan is to keep attending my normal classes even if I can't do the workout. The treadmill is always an option, and I probably need some treadmill time anyway so I can start re-training myself to run. 

Do you need to see a PT for this? I often hear moms talking about how a little bit of pee comes out when they jump or run, and I have heard the phrase "I feel like my insides are falling out" many, many times. I think we've all been led to believe that this is just par for the course, but it doesn't have to be. Sure, these symptoms are technically normal, but they are also signs of pelvic organ prolapse! Yikes! I guess what I'm saying is if you feel like your insides are falling out, take off those running shoes and get to a pelvic floor specialist! Right away! Because your insides probably are falling out. I don't have these symptoms (or pelvic organ prolapse), and I still have a done of work to do to repair my pelvic floor.

Just a couple more quick things before I call it a night: I've had a couple of people ask me to write about my progress as I go through this therapy -- and I totally plan on it! I hope I can provide some useful information for others who might be in the same boat.

Finally, I received some comments regarding kegels, squats and the best way to strengthen the pelvic floor when I initially posted about this last week and I wanted to mention that -- while I completely trust my PT and believe that what she is prescribing is exactly what needs to be done -- I appreciate the feedback and I will definitely consider what everyone has to say. So, thank you!