Celebrating Your Journey to Pelvic Wellness: A Comprehensive Guide to Nurtured Pelvic Health & Wellness
Rachel Kelly, MSOTR/L, CBS, PCES, CCST-I
Hello! It’s a pleasure to join the team and provide pelvic health therapy. If you’re still reading past the first line, perhaps you’re considering pelvic floor therapy. I can imagine you have many questions and may even feel a bit uncertain about how the process may unfold. I hope this blog can offer some background on what to expect. Pelvic floor dysfunction can be a challenging, even isolating, time in someone’s life. BUT, here you are, taking steps towards wellness and health—congratulations! Recognizing that something doesn’t feel right is one thing, but taking the time to explore solutions to help you feel better puts you on the right track. You might be wondering, is pelvic floor therapy right for me? What are the sessions like? In this blog, I’ll introduce you to what most pelvic floor treatments look like at Nurtured Pelvic Health & Wellness. If you have specific questions regarding your condition, don’t hesitate to call or schedule a free 15-minute discovery call at 201-338-0727 or email me at RachelKellyOT@nurturedpelvichealthwellness.com.
So What Does the First Visit Look Like?
You’ll enter the fantastically calming atmosphere of Core Therapies Family Wellness, where the receptionist desk will greet you with smiling faces. At your appointment time, we’ll spend a good amount of time talking. I understand that having an in-depth conversation with a healthcare provider may seem novel—it’s not very common in most healthcare settings. Providers often rush through history taking, but at Nurtured, we have the luxury of taking the time to truly understand your condition, its impact on you, and any relevant health history contributing to your pelvic floor dysfunction. We’ve all experienced those doctor’s appointments where you walk away feeling unseen or unheard, rushed out, or with more questions than answers. At Nurtured, our value is our clients, and we prioritize listening and putting you at ease because being seen and heard is crucial for healing. Beyond understanding you and your health history, a thorough subjective interview helps me zero in on what may be driving your symptoms and determine the most important elements to check during your physical exam.
After discussing your experiences, when they started, and most importantly, how they affect you, we’ll begin the pelvic floor therapy exam. This might be the point where some people understandably feel nervous. A typical pelvic floor exam involves checking the muscles internally and externally for tightness, spasms, weakness, and coordination. This is done as gently as possible with a gloved, lubricated finger. This exam provides valuable insights into how your pelvic floor muscles are functioning, shedding light on the potential causes of your symptoms.
Recognizing that you are the leader of your body, it’s vital to emphasize that consent and comfort are my top priorities. If you’re not ready for the pelvic floor exam, that’s okay. We can spend our time evaluating other parts of the body that affect the pelvic floor. Posture, visceral mobility, and hip strength and mobility can significantly impact the pelvic floor. For those not ready for a pelvic floor exam, these assessments can be a great starting point and go a long way toward identifying the drivers of your pelvic floor dysfunction. Interestingly, these aspects of the physical exam are so essential that I include them in many evaluations, regardless of completing an internal examination or not. The role, strength, and mobility of the hip alone in pelvic floor function merit a whole conversation!
After gathering your in-depth history and obtaining results from the physical examination, the journey toward wellness begins! Together, we’ll create a plan tailored to your lifestyle. Goals and treatment plans will be attainable, allowing you to drive your recovery. Some treatments may involve manual in-office work followed by specialized homework. In other cases, neuromuscular re-education may be necessary to teach individuals to move throughout their day without clenching their pelvic floor in response to stress or heavy physical exertion. Variety and individuality are key, as two patients with similar symptoms may have different causes, requiring specialized and thoughtful care.
At the end of your first visit, you should leave with a good understanding of what’s going on, how we plan to treat it, and a general estimation of how long it should take to feel better. I take time at the end of our first treatment to discuss exactly what we’ll be doing in follow-up visits and why these treatments are essential. It’s crucial to me that you leave treatment feeling confident in your next steps.
What a term, right? It sounds fancy, but it’s also straightforward and simple. It answers the question, “After therapy, what keeps my symptoms from coming back?” Neuromuscular education is a broad treatment modality used across different disciplines, from teaching stroke survivors to rise from a chair independently to helping office workers with sore necks sit more ergonomically at work.
In the pelvic floor world, neuromuscular education is a significant part of what we do and forms a crucial part of treatment, regardless of the practitioner’s treatment philosophy. At Nurtured, I use neuromuscular education in many ways with the goal of fostering pain-free pelvic floor function.
The first step of pelvic floor neuromuscular education is to teach the pelvic floor what “relaxed” feels like, what an effective contraction (kegel) feels like, and what an effective “push” for bowel movements feels like. In individuals with pelvic floor dysfunction, these movements can be challenging, and it’s not uncommon for them to believe they are pushing effectively when they are actually closing their anal sphincters—a phenomenon known as paradoxical contraction. By taking time to “teach” the pelvic floor how to contract and, more importantly, relax when needed, we can reduce clenching patterns that may lead to pelvic floor dysfunction in the future.
It’s so much more than kegeling! If someone tells you to “fix your pelvic floor, JUST do some kegels,” RUN! We require more complex training to meet goals like running without incontinence, jumping and dancing without the feeling of prolapse, and much more. No one should be afraid to laugh, cough, or sneeze because they might leak. You should be able to jump on the trampoline with your kids or take that run to clear your mind.
Consider someone who leaks a bit when lifting something heavy. When picking up something substantial, like your toddler, our core muscles need to stabilize our spine, requiring a lot from the pelvic floor. If the rest of our core is weak because we’ve only been doing kegels, we may find ourselves straining and holding our breath to lift our kids. Straining can put a lot of downward pressure on the bladder, resulting in leaks. To address this issue, we must treat the pelvic floor, but for the pelvic floor to have a real fighting chance to keep us dry, we must also address the rest of the core.
Additionally, strengthening outside the pelvic floor allows us to return to the activities and exercises we love, which we may have thought were causing the pelvic floor to over-tighten. As we’ve discovered, the pelvic floor is part of the core, and if the rest of the components are weak or not working at the appropriate time, the pelvic floor can overwork and over-tighten. It benefits us to approach strengthening from a holistic standpoint when rehabilitating the pelvic floor.
How Do I Know If Nurtured Pelvic Health & Wellness Is Right for Me?
This is the question I was hoping you would ask! First off, let’s chat—schedule the discovery call and let’s get you on the road to wellness. Pelvic floor therapy is a specialized niche in the OT/PT world. To become a diverse, well-rounded, and educated therapist, you must love to learn and carry the compassion and understanding of functional movements. Researching pelvic floor practitioners and practices can be overwhelming! I have spent years studying maternal health, pelvic floor, and developmental continuums. My philosophy is and will always be that my clients lead their treatment, with me as the guide. No one knows your body better than you. As a mother myself, I understand the overwhelming nature of pregnancy appointments, followed by the loud, overstimulating, medical delivery with nothing more than a 6-week checkup. I know that recovery and building a team of professionals are essential in your wellness and motherhood journey.
We help optimize your motherhood journey through personalized pelvic health care, taking you from a place of pain, leaking, or discomfort to a place of recovery and wellness. Becoming a mom is incredible, but it’s definitely not like the movies depict it! Recovery from childbirth can be challenging, not just physically. No one prepares you for the combination of physical and emotional challenges of birth recovery. And let’s be honest—a 6-week “checkup” just isn’t enough. Just because some symptoms are common during pregnancy and postpartum doesn’t mean they are normal and you have to live with them.
Still have questions? Call or email today for your free 15-minute discovery call at 201-338-0727 or email me at RachelKellyOT@nurturedpelvichealthwellness.com.