You Don’t Have To Pee Your Pants!

Why-You-Shouldnt-Do

Pelvic Floor Health With Dr. Justine Veloza, DPT

Why are we told that peeing our pants after birth is normal? Why are we led to believe that we just have to live with it? In part one of this blog series, we talk with Dr. Justine Veloza, founder of FitMomsPT, all about pelvic floor health.

We are so happy to introduce Dr. Justine Veloza. She has her doctorate in physical therapy and she is a postpartum pelvic health specialist. And she is here to talk to us about pelvic health!

Why are you so passionate about pelvic floor health?

Dr. Justine:

“I think sometimes, when we became parents we change our passions and what we want to do. So I experienced carrying a baby and going through delivery and all the postpartum symptoms that many women deal with. And how many parents can be told that the symptoms they are experiencing is their new normal, when that’s not true.”

So what kind of like symptoms do you help parents with?

Dr. Justine:

“Well, with, with pregnant moms, I see a lot of low back pain, joint pain, hip pain, pubic pain, all those kinds of things. So it’s a lot in that whole pelvic area, which makes sense because as you’re going through pregnancy, your body is releasing the relaxing hormone, which makes your joints more loose. So it is very common for women to have those pains. Plus they’re carrying, X amount of extra weight and all that stuff. So that’s the most common things in pregnancy.”

“And then in the postpartum period, it really varies. Anything from rib pain and mid back pain from different positions for breastfeeding and whatnot, to neck pain. There can also be incontinence, and there can be the diastasis recti.”

“Everyone’s symptoms are different. Painful sex is one of them that’s quite common and lingering. Pelvic pain, post delivery is also common for a lot of new moms.”

“And those are the things that are important and if we can get a handle on it during pregnancy, great! But then in the postpartum period, it’s not something to be ignored, especially because a lot of moms are dealing with it. Especially if it’s their first child.”

What advice would you give to a pregnant parent who is experiencing these symptoms?

Dr. Justine:

“Well, the best thing would be obviously to see a physical therapist. Because that is the best way that you would know where the pain is coming from. Our bodies are often good at changing the location of the pain. So pain that you may feel in one area may not be exactly where the pain is coming from. So an assessment by a physical therapist will help you determine where the cause of the pain is.

pelvic floor health

“If something’s out of whack, if something’s out of alignment and if you can change how you’re moving or whatnot, that can be really beneficial. And sometimes that’s good for helping either take pressure off one area or kind of give an area a little bit more stability that the body might need.

“Another thing I recommend is getting in a pool. So whether it’s joining a local gym, or some physical therapy clinics have a pool. Antigravity can take a ton of weight off and allow you to exercise and move with a lot more freedom and a lot less pain.

“And how wonderful would it be if this was part of your labor and delivery package? If you could get one or two physical therapy sessions before you give birth. We could target any pains or issues you may have, give parents some birth prep ideas, and even do some sessions postpartum so we can see how you’re doing.”

What advice would you give for a new mom who is experiencing painful intercourse after her baby is born?

Dr. Justine:

“That’s really common. There are a lot of factors that could affect that, for example the type of birth, whether it was a C-section or vaginal. I have a couple of recommendations. First, trying some sort of lubricant would be recommended. Coconut oil is actually a great natural choice if you aren’t into using a chemical based lube, especially since they can break down condoms.

“I also highly recommend making sure that you’re hydrated because dehydration can dry out your tissues. Plus with all the hormonal changes that can also make your skin dry. With all those hormones raging through the body, your lubrication system down there may not be what it was before.

“A lot of people tend to have constipation postpartum. And if things are backed up in the intestines, then that can put some undue pressure when you’re trying to have sex as well. So making sure you’re doing appropriate things for your gut, such as gut healing, drinking the water, eating high fiber foods etc.

“You could also try like different positions because some positions that were comfortable before may not be comfortable right now, but trying something new, may be more enjoyable.

“But the biggest thing I would say is relaxation. We want the pelvic floor muscles to relax and not be tight. Maybe working on some breathing techniques, maybe going a little bit slower, doing more foreplay to kind of help lubrication more so down there. And it may just take some time.

“It may take some manual work from a physical therapist. One who is certified to work with pelvic floor muscles where they can help to either calm down those muscles or help stretch out the area.”

Many new parents are told that their symptoms and experiences are normal. Do you have any thoughts on that?

Dr. Justine:

“I see this a lot, too. You have multiple kids, and you deal with all these symptoms. And you are told that it just is what it is. It’s the normal. So we need to change that paradigm to yes, it’s common but NOT normal.”

Speaking of that, can you talk a little bit about incontinence? It’s one of those symptoms that so many parents experience and they are told, “Oh that’s normal”.

Shelly:

“When it comes to incontinence, everybody always says do kegels, kegels, kegels. But then I’ve read that they don’t help. What is your take on that?”

Dr. Justine:

“Yeah, there was definitely a huge kegel push awhile back. I remember kegels were just the thing, everyone was told to do them. And it’s definitely NOT the thing!

“So there are different types of incontinence and certainly some of them may be indicated to do kegels, but not all of them! And kegels will likely make some problems worse if people keep doing them when they shouldn’t. So what a lot can happen, is the pelvic floor muscles can be overactive. So they’re on overdrive. And so you’re just doing kegels, which is continually shortening and contracting those muscles over and over again. Then those muscles can’t relax.

“So kind of getting back to the incontinence part, there are two types of incontinence. You can have stress incontinence, which is when you’re laughing, you’re coughing, you’re jumping, and you pee. Because that stress on your pelvic floor muscles causes you to leak.

“Then, there’s urge incontinence, which is typically more of a habitual thing. So every time, as an example, you come in the door, you have to run to the bathroom, or it’s sort of like that you get the urge instantly. It’s like zero to a hundred. You have to go right then and there, or else you’re going to pee on the floor.

“Or you can have a little bit of stress and a little bit of urge. With the stress incontinence, we find that the pelvic floor muscles are often tight and weak. So in that sense, where we often want to down train those muscles and really focus on the relaxation of them, because like any muscle in your body, your pelvic floor muscles should be able to contract and relax and lengthen.

“In those cases, more often than not, I think teaching people how to stop doing their kegels and focus more on relaxing those muscles and retraining them when to contract and when to have their normal resting tone, and when to be nice and relaxed is most effective.

“The other end of the equation is the urgent continence, which is when you feel that you have to go right away. That is often due to an overactive bladder. So we find that say, for example, you’re in the habit of peeing every time before you leave the house. And you know, before you get in the car, you’re going to run to the bathroom and pee “just in case”. Now you’re getting your body out of its normal neural pathway where it would normally say, okay, I have a little urge to pee, but I don’t really have to go yet.

“But the “just in case” peeing turns into that habit where you’re now going more often than you actually need to. So you’re messing with that connection from your brain to your bladder. So one suggestion I would make is to be consciously aware of your pee urges, and think: Do I really have to go? Or do I just think that I have to go because I’m used to going at this time?

“This is one of those situations where offering like blanket advice, like “do kegels” to everyone can be harmful more than healing. My suggestion would be to, if you can, when you’re pregnant, make sure you’re going to see a pelvic floor health provider. It’s so important to be your own advocate and insist that your issues are addressed by a specialist.

“Be your own advocate because as you can see, not everyone is versed in this, and how important it is to address your issues by a specialist, someone who can help you deal with them appropriately versus the blanket advice of, ‘oh, just go do some kegels 10 times a day and you’ll be fine’.

Finding this information helpful so far? Then join us for part 2 of this post.

You can also connect with Dr. Justine at her website, FitMomsPT or on Instagram.

Looking for more support with all things pregnancy and baby? Get it here.

See you next time!

Shelly

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