“I was dancing at a wedding, and I thought of you!”

“I really need to make an appointment to see you!”

These greetings make my day at a local coffee shop on a random Tuesday. A lively discussion ensues as two other women standing in line chime in, commiserating about the challenges of maintaining continence at the gym. I know you envy my job.

I reassure my new coffee besties that all is not lost. This issue can usually be treated effectively in my office with pelvic health physical therapy and is not uncommon in women who have a history of pregnancy and childbirth.

Along with urinary incontinence, painful intercourse and diastasis recti are conditions I frequently treat in women who are postpartum. By “postpartum” I mean anything from a few weeks after delivery to years later when that baby is having babies of their own.

For some women these issues are new to their bodies since childbirth, and sometimes they have had difficulties in these areas even before having kids. As one of my esteemed colleagues Holly says, “If you had dysfunction before a major body change, why would that dysfunction go away?”

Let have a quick chat about these issues as you finish your coffee…

Urinary Incontinence (UI)

UI, a super-common issue, can occur with activities like coughing, sneezing, laughing, jumping and, yes, dancing at a wedding. That’s called stress urinary incontinence.

Urge incontinence is when a person feels the sudden urge to urinate right now. They are often afraid they will not make it on time. Subsequently, they are plagued by frequent bathroom trips and a fear of long car trips where bathrooms may be inaccessible.

Pain

Pelvic pain or pain with intercourse can occur after delivery. It may be the first time they are experiencing this kind of pain, or if intercourse was painful before pregnancy, it likely didn’t get better after childbirth. The hormonal and physiological changes that occur years later during perimenopause and menopause can re-exacerbate these types of symptoms.

Diastasis Recti (DRA)

And last but not least, diastasis recti, the most insta-famous postpartum issue, beloved by fitness gurus, prenatal/postpartum influencers and coaches on the ‘gram. DRA is separation of the abdominal wall muscles that can occur during pregnancy. Postpartum, women may be bothered by this problem, experiencing difficulty engaging their abdominals the way they used to pre-baby. It is often a struggle just to hold themselves upright due to feeling weak in their core and trunk.

These issues may be inconvenient, embarrassing, painful or feel like TMI to talk about (not for my coffee crew, obviously). The good news, for my patients anyway, is that I specialize in TMI at my pelvic health PT office. Patients are provided with gentle, effective, individualized treatment and, most importantly, the tools they need to help them help themselves attain their goals. Whether they are six weeks postpartum or 60 years postpartum, it’s not too late, I’m here for it.