Finding Pelvic Sanity

How do we build resilience in our body so symptoms not only can go away, but stay away?  At PelvicSanity, we do this by addressing both the muscles of the pelvic floor, but also the 4 Foundations of pelvic health.

The pelvis doesn't exist in isolation.  It's affected by the rest of the body and other major symptoms.  These often are major underlying causes of problems in the pelvic area.

We need to addre...

Pelvic PTs are the pregnancy experts - we want to help you have a more comfortable pregnancy, a smoother delivery, and prevent postpartum issues after delivery!

1.  Have a more comfortable pregnancy

Working with a pelvic floor physical therapist throughout your pregnancy can reduce or eliminate issues like back pain, hand or foot pain, painful intercourse, lightning crotch, pubic symphysis pain, swelling in the legs, and more!

You don...

Tailbone pain is a common symptom and is integrally related to the pelvic floor.

All muscles of the pelvic floor attach at the tailbone.  When these are tight and irritated they can radiate or refer pain to the tailbone itself.  The vast majority of the time there’s nothing wrong with the tailbone itself.  It’s actually a pelvic floor issue masquerading as a tailbone problem.

Because of all the attachment to the pelvic floor, a hard ...

In the third trimester the ‘sixpack’ abdominal muscles separate to allow room for the baby to grow.  Within the first three months postpartum, in about half of women these muscles come back together properly.  In the other half a separation remains, known as a diastasis recti.

We hear about this often as an aesthetic issue.  It can create a ‘mommy pooch’ or it still might look like you’re pregnant.  And while that’s a totally fine r...

The answer will surprise you!  The myth that acidity in the body or bladder is responsible for IC symptoms is one of the most harmful out there.

In this 'sode we go through why the pH of urine has no effect on symptoms, how 'acid in' does not equal 'acid out', and what we should be doing instead.  We hope this 'sode helps to free you from 'food jail' and you can become more confident...

There's a wide variety of expertise when it comes to pelvic floor physical therapy.  Unfortunately many patients have to go to several different ones before finding a true expert.

You might think that finding a pelvic PT who has a lot of experience means you'll be getting great care.  But that's not necessarily the case.

In this 'sode we discuss why experience doesn't necessarily equal qua...

Incontinence is certainly common.  More than half of people have incontinence after a baby, it can accompany pelvic pain, prolapse, low back pain or following a surgery.  

But it’s never normal, and never something you have to live with.

Sometimes this is normalized - we joke about it with friends, or hear about it from our mothers.  But we often don’t recognize the profound effect of incontinence on our lives.

We often abstain from e...

For many people (almost 90% of those diagnosed with IC) tight muscles in the pelvic floor irritate the nerves running through the area.  One of the most important of these is the pudendal nerve.  

So what symptoms might be caused by pudendal nerve irritation?  One is urethral burning or pain.  One branch of the pudendal runs right to the urethra, so it is often responsible for urethral pain or burning.

The pudendal can also be the ca...

Have you heard or been told you 'just need to Kegel'?  Here's why that's never the answer to pelvic health issues.

Kegels (or the voluntary squeezing of the pelvic floor muscles) are often one of the only areas of pelvic health we’ve heard about.  It’s often surprising to people to learn Kegels are often ineffective, antiquated and can cause flares or actually exacerbate symptoms.  Here’s why they are r...

Why do most specialty pelvic health clinics see patients for a full hour, 1:1 with the therapist?

Ultimately it’s so we have time to ‘find the why’ for actual relief.  If you aren’t working with a qualified pelvic PT to ‘find the why’, one of three things happens:

1. You don’t improve at all
2. You see little, temporary improvements that don't 'stick' 
3. Symptoms do improve, but end up cropping up somewhere else

For most...

If you (or someone you know) has had a C-section, make sure to listen to this full 'sode!  

As anyone who has had one will attest, a C-section is a major surgery.  And in the US, almost 1 in 3 give birth via a C-section.  But we are so cavalier about recovery!

After every other major surgery you are immediately referred to physical therapy to aid in the recovery.  Make sure the wound heals correctly.  Ensure ...

With recent evidence Elmiron can cause long-term eye damage, many people with IC are reconsidering their use of the drug.  In this ‘sode we dive into the evidence for Elmiron’s efficacy and safety to help you make an informed decision.

Elmiron remains the only FDA-approved oral medication specifically for IC and many urologists prescribe it automatically because of this.

However, it’s unclear how much of a positive effect Elmiron has...

In pelvic physical therapy you’re dealing with dysfunctional tissue, reduced blood flow, increased inflammation and in an area the body is wired to pay close attention to.  

But pelvic physical therapy should never hurt.  We can’t treat pain with more pain.  And the idea of ‘no pain, no gain’ not only isn’t true, it’s actively harmful.

Now, it can be uncomfortable, but there’s a major distinction.  You shouldn’t be trying to ‘bear’ t...

In short, yes!  There's a reason every other surgery - foot, ankle, knee, hip, shoulder, back, elbow, hand, and many more - automatically results in you going to physical therapy to recover.

Physical therapists are the experts in guiding recovery.  Making sure you continue to move well.  Guiding your body's healing response.  Ensuring scar tissue doesn't stick or 'adhere' and create problems.
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Not everyone with IC experiences the same condition.  Symptoms vary.  The way they manifest is different.  Some people respond to certain medications while others don’t.

This led researchers to propose several different types of systems to break IC into sub-categories called ‘phenotypes’.  The entire point of a phenotype is it needs to be 1) easily identifiable and 2) able to guide your treatment options.

Early attempts to phenotype ...

In short, our answer is ‘yes’.  With all of the physical challenges of pregnancy, delivery and the early post-partum period, we believe everyone should get pelvic floor physical therapy.  But let’s dive into why that is!

First, let’s recognize in America we are significantly behind the rest of the world with this.  In many places in the developed world pelvic floor physical therapy is automatically prescribed to every single person ...

It’s a question we get asked at PelvicSanity all the time - ‘how long before I’m better?’

The answer?  It depends.  But let’s dive deeper and discuss some of the factors that make pelvic floor physical therapy so complex and what you can expect.  We’ll also give you some takeaways to think about when you’re in pelvic PT.

One of the reasons we don’t know is there are so many variables that affect how long it takes to improve with pelv...

Pelvic floor dysfunction can cause a wide range of symptoms, include many types of pain, bowel issues, urinary/bladder issues and sexual dysfunction.

Many times patients feel like there’s so many different things wrong, when in reality it’s all stemming from the pelvic floor.  By addressing and treating the underlying problem, we can make a substantial difference in these symptoms.  Issues the pelvic floor can cause include:

1. Pelv...

One of the most common questions we get asked is whether your symptoms are truly IC or are they pelvic floor dysfunction.  

It’s important to know that ‘IC’ is a description of symptoms.  It just means you’re experiencing pain you perceive to be coming from the bladder and urinary urgency/frequency.  But it tells us nothing about the ‘why’ of your symptoms or what treatments to try.

It’s also important to realize that IC is not a bla...