pelvic floor

postpartum physical therapy

Postpartum Recovery

Have you ever heard of an athlete getting back on the field after a major injury WITHOUT a period of rest followed by intense rehab? Of course not! But somehow the expectation for women after their pregnancy is to mysteriously “bounce back” to normal activity, appearance, and function without any guidance. Most mamas even attempt to do this while caring for one or more very adorable, yet extremely needy human beings.

Wow!!  Just writing that paragraph made me feel anxious!  Thankfully our society is beginning to recognize the fact that child-rearing is hard work and calling in reinforcements is acceptable and often necessary.  Thank you doulas, lactation consultants, counselors, chiropractors and more for all that you do!  I would like to propose that a Women’s Health Physical Therapist should ALSO be part of your postpartum team.

Women’s Health Physical Therapists specialize in the changes that occur within your musculoskeletal system (muscles and bones) during and after pregnancy.  They often have additional training in pelvic health which means they have specialized skills in how to assess the pelvic floor’s function from an external as well as an internal perspective.

Let me tell you a story about how one woman’s body changed after having her first baby; let’s call this woman Susie. In the delivery room, Susie’s baby made its way through the birth canal so quickly that Susie’s perineum had very little time to stretch to make a clear path for her baby to exit.  Susie ended up with significant perineal trauma that required stitches to repair.  After the delivery, it was painful for Susie to walk around her hospital room and sitting proved to be very uncomfortable as well.  She faithfully rested and used her ice packs for pain relief in hopes that with time she would feel better.  As time went on and she saw other new moms grocery shopping, going for walks, and starting to exercise again, Susie started to become worried that she was falling behind in her postpartum recovery!  Not only was she still having pelvic pain that got worse with activity, she was now having rectal pain that filled her with dread each time she felt the urge to have a bowel movement.  Susie was given the go ahead to return to sexual intercourse and begin exercising again at her 6 week follow-up appointment with her OBGYN, but she knew there was no way she could tolerate these activities without experiencing a lot of pain.  Susie had proactively participated in Physical Therapy before delivering her baby, so she bravely asked for another referral.

Although a woman’s body is going to be forever changed after participating in the miracle of creating life, mamas shouldn’t feel like they’re left with a body that is broken.  Physical Therapists want to give you tools and strategies that keep you strong so you can participate in activities that make you healthy and happy inside and out!  We want you to lift and chase after your little ones, return to intimacy in an enjoyable way with your partner, and be able to participate in activities like barre classes, 5ks, and nature hikes. Sometimes it is a common misconception that women “pee when they sneeze” BECAUSE they had a baby, it’s “normal for sex to hurt” BECAUSE they had a baby, or “vaginal heaviness” occurs BECAUSE they had a baby.  While it’s true that these things commonly HAPPEN after we’ve had babies, they aren’t normal or inevitable after having children, and it will likely require more than just lots and lots of kegels to solve these problems.

Let’s check in with Susie again to see how things turned out after going to several Physical Therapy appointments. Susie learned that her pelvic floor and surrounding muscles were very tight (kegels were NOT recommended) and that she needed to learn how to combine breathing, stretching, and relaxing positions to maintain a relaxed and healthy pelvic floor.  Her Physical Therapist performed manual techniques to break up scar tissue from her episiotomy which improved the elasticity of her perineum. They even taught her how to work on these things at home on her own between sessions.  With hard work and guidance from her Physical Therapist, she was able to enjoy sex with her husband again, have bowel movements with less pain, and exercise with confidence because she had learned safe ways to move her body.

Physical Therapy for mamas can be done during your hospitalization, at an outpatient clinic, or even in your own home! And while there are lots of therapists just waiting for mamas to walk through their doors, it isn’t standard for Physical Therapists to be included in postpartum care in the United States.  Good news though, they are accessible and sometimes even covered by insurance when you seek them out. You’ll know you’ve found an exceptional Physical Therapist when they ask about your specific goals, give you tasks to complete at home between sessions, and you notice progress after each session.

Knowledge is power, and I hope that this information empowers you to feel comfortable talking to your providers about Physical Therapy or seeking it out on your own.  Mamas do incredible things and they deserve to have the resources they need to live their best life.

Newly postpartum and ready to get started? Download this FREE handout to start your postpartum recovery journey today (even useful for mamas still in the hospital!)

If you’re ever looking for free information from the perspective of a mama and Physical Therapist, I put out videos weekly on my YouTube channel. I also offer 1 on 1 Physical Therapy Evaluation and Treatment sessions for moms living in West Michigan and offer an Online Postpartum Recovery Course for moms that don’t have the time or resources to get out to appointments.

Investing in your health is one of the best investments you can make. Become a STRONG mama so you can grow a STRONG family!

Dr. Nicole Bringer, DPT
Owner of Mamas & Misses, LLC
Phone: (616) 466-4889


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pregnancy physical therapy

Physical Therapy During Pregnancy

Maternity clothes✓ Registry✓ Hospital tour✓ Doula✓ Photographer✓

What could you possibly be forgetting? What about getting YOURSELF prepared?

Likely from the moment you found out you were pregnant you have been focused on the tiny human growing inside of you. While prenatal vitamins, nursery preparations, and choosing the perfect name are all very important parts of preparing for the birth of your baby, so is preparing YOUR body to birth this baby!

Hopefully in the midst of your nesting you have decided to create a birth plan.  As you consider what positions you want to labor and deliver in and what interventions you feel comfortable with during your birth experience, I would challenge you to consider what you are doing to achieve those goals.  Hiring a doula and recruiting a rockstar support person is a great place to start, BUT there is more!

Research has shown that the percentage of first time moms that experience perineal tearing during delivery is somewhere between 80-90%. Research also shows that 66% of women that deliver their babies in sidelying have NO perineal trauma and 61% of women that deliver on hands and knees have the same TRAUMA-FREE experience.  (Simarro 2017, Walker 2012, Soong 2005, Shorten 2002) Instead of crossing your fingers and hoping for the best when it comes to your perineum, what would it look like to practice different delivery positions with your partner BEFORE you go into labor? What about the evidence that says perineal massage 1-2x per week starting at week 35 can DECREASE your risk for tearing and episiotomies? Have you been taught how to perform this technique and are you taking the time to do it? (Seehusen & Raleigh, 2014) With my first son, I totally missed the boat on perineal massage. I ended up with a nasty episiotomy. You better believe I’ll be making perineal massage a priority this time around!

Our bodies become a temporary home for our babies during pregnancy. Our mama bear instincts have already kicked in, and we want to make sure we are creating a healthy and happy environment for our babies to grow within. Exercise and intentional movement is a great way to foster this type of environment for our little ones. Did you know that exercise helps prevent or manage gestational diabetes, high blood pressure and preeclampsia? Exercise also helps us sleep better,  reduce our stress levels, and minimize back pain.  If your pregnancy is non-complicated and you do not have activity restrictions, you should be exercising! The American College of Obstetricians and Gynecologists recommend exercising at a moderate intensity 3-5x per week. Sometimes we become paralyzed when we’re not sure where to start and what’s safe.  Trainers, instructors, and Physical Therapists with certifications and experience working with women during pregnancy are great resources for mamas hoping to create safe exercise habits.

Let’s not forget about investing in our pregnant bodies to make life easier for ourselves in the postpartum.  During your pregnancy your belly is doubling or even tripling in size.  As we gain 25+ pounds, we expect our pelvic floor to step up to the challenge and make sure we don’t pee our pants when we sneeze at the grocery store. There are two studies that give us good reason to keep our pelvic floors strong during pregnancy.  The research found that women experienced less urinary incontinence at 35 weeks gestation, 6 weeks postpartum and 6 months postpartum when they did pelvic floor exercises DURING their pregnancy compared to women that DID NOT do pelvic floor exercises. (Boyle et al., 2012, Price et al., 2010) Sidenote: sometimes the phrase “pelvic floor exercises” is confusing. Does that mean kegels? Yes and no. Clear as mud I know! Kegels are pelvic floor exercise where we lift and squeeze our pelvic floor muscles, but it’s also important for our pelvic floors to have the ability to relax and lengthen. Sometimes women experience pelvic pain and incontinence because of overactive pelvic floors (need help relaxing) and sometimes it’s because they have underactive pelvic floors (need more strengthening). Even if you have excellent pelvic floor strength and no concerns about incontinence, it’s still helpful to create a mind-body connection with your pelvic floor.  During labor and delivery the goal is to relax and open your pelvic floor while pushing so that your pelvic floor remains healthy even after childbirth. Bonus points if you practice your breathing and pelvic floor relaxation while pregnant in the positions you hope to deliver your baby in.

I’ve been a mom in your shoes, running around with my To-Do list trying to check off all the boxes before my baby arrived.  As you prioritize your list and consider your baby budget, remember that your body IS this baby’s home.  The way that you prepare your body WILL make a difference on the day that your baby decides to make its grand entrance.  Exercise, pelvic floor awareness, perineal massage, and labor positions are all important pieces of the pregnancy puzzle.  It’s tempting to become intimidated or overwhelmed at this point because you’re just not sure where to start.  Start by consulting a Women’s Health Physical Therapist.  Now that you know what your goals are, you have some great questions to ask them!  Physical Therapists should be another member of your prenatal team, and we want to help you make your planned Birth Story a reality.

My practice is Mamas & Misses, LLC and we offer In-Home Physical Therapy sessions for women local to West Michigan as well as phone or video consults for those who live further away.  One of our missions is to provide knowledge to mamas that will empower you during your pregnancy and postpartum experience; therefore, we have lots of FREE info on our YouTube channel as well as our Instagram account @mamasandmisses_pt.  

Dr. Nicole Bringer, DPT
Owner of Mamas & Misses LLC
Phone: (616) 466-4889



Boyle, R., Hay‐Smith, E. J., Cody, J. D., & Mørkved, S. (2012). Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database of Systematic Reviews, 10, CD007471. doi: 10.1002/14651858.CD007471.pub2

Price, N., Dawood, R., & Jackson, S. R. (2010). Pelvic floor exercise for urinary incontinence: A systematic literature review. Maturitas, 67(4), 309-315. doi: 10.1016/j.maturitas.2010.08.004

Seehusen, D. A., & Raleigh, M. (2014). Antenatal perineal massage to prevent birth trauma. American Family Physician, 89(5), 335-336.

Shorten A, Donsante J, Shorten B. Birth Position, Accoucher, and Perineal Outcomes: Informing Women about Choices for Vaginal Birth. Birth. 2002;29(1):18-27.

Simarro M, Espinosa JA, Salinas C, Ricardo O, Salavadores P, Walker C, Schneider J. A prospective randomized trial of postural changes vs passive supine lying during the second stage of labor under epidural anesthesia. Med. Sci. 2017, 5, 5. doi:10.3390/medsci5010005

Soong B, Barnes M. Maternal position at midwife-attended birth and perineal trauma: is there an association? Birth. 2005;32(3):164-169.

Walker, C., Rodríguez, T., Herranz, A. et al. Int Urogynecol J (2012) 23: 1249.


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Pregnancy Yoga

Pregnancy Shouldn’t Be Painful

Gold Coast is thrilled to present a guest post by Sally Talbot, PT, Senior PT and co-owner of Health Motion Physical Therapy.

Pregnancy is a wonderful and amazing time.  However, creating a new life does create some major changes in the body. Pain in different areas during pregnancy is a common complaint. states that back pain occurs in 60-70% of pregnancies. While pain can be common, it is NOT normal and does not need to be tolerated. Pain can be stressful, and we know that increased stress for a mother can cause increased stress for baby.

Pain with pregnancy is not normal, and something can and should be done about it. Physical therapists are very helpful at safely decreasing pain and increasing function in pregnant women, helping them have a more enjoyable experience.   

Here are some common pain complaints often associated with pregnancy and how PT can help: 

Low back or sacroiliac pain:  With increased weight gain (all out front), the center of gravity shifts and pulls the back into more of an arched position. Try standing this way – it is not comfortable. Also the abdominals are weakened due to being stretched with the increasing size of baby. This causes more work for the lower back. It is also common for the pelvis to become mal-aligned during pregnancy due to increased ligament laxity. All these factors put more stress on low back muscles and joints and can cause pain. Physical therapy can restore alignment of the back and pelvis and loosen tight muscles and strengthen others to make sure you can feel your best. 

Mid back pain: Increasing weight of the breasts requires more work from the mid back to sit up straight and to lift and carry things. This overwork can result in pain and, if left untreated, it can continue well into the postpartum period, especially if mom is breastfeeding. Holding that newborn is harder than it seems. Physical therapy can assure that the joints of the upper back are moving well, loosen tight muscles, and stretch others to help improve posture and decrease pain. 

Groin and pubic symphysis pain: Later in pregnancy, as the baby drops lower in the pelvis, there is more pressure on the pelvic joints (SI joint and pubic symphysis) and nerves that serve the groin and legs. This can cause pain, making it hard to walk or turn in bed. Weakness or muscle imbalance can contribute to this and make it worse. This is the one diagnosis that most people think that they have to live with – not necessarily true…..  Maintaining good pelvic alignment is key with this – PT can do that as well as recommend positions and strategies when that new bundle of joy gets on your nerves literally.   

Headaches: Headaches can be more common with pregnancy due to changes in posture, increased weight of breasts, hormonal changes, or general fatigue. Tight muscles and weak muscles will make these headaches worse. Even if headaches are hormonal, treatment to the muscles and joints of the neck and upper back can lessen the severity and intensity of the headaches and the need for medication.  

Carpal Tunnel Syndrome: Numbness in the palm of the hand focusing on the thumb and first 2-3 fingers can be a common complaint later in pregnancy, especially at night. Increased fluid retention can cause compression of the nerve that passes through the carpal tunnel in the wrist. This can be greatly improved with physical therapy 

How PT can help. A physical therapist will be able to thoroughly evaluate the issue you are having and locate the source of the problem and all the contributing factorsThey will then create a specialized program to correct the cause of the issue and help you adjust to the changes that your body is going through. This program will includemanual therapy to loosen tight muscles or align the spine and pelvis better, modalities (such as electrical stimulation – yes it is safe!) to speed healing and recovery and provide pain relief, positioning or bracing solutions if needed, and exercises that will help the body keep up with the increasing demands of the pregnancyPhysical therapy decreases the need for medication and missed days from work/life. Help is available. 

If you are having pain and wonder how/if physical therapy could help you, call and a come in for a free consultation. Just mention that you saw this blog post. You can also schedule through the website at   

Health Motion Physical Therapy
South East: 3826 44th St, SE Kentwood, MI 49512  616-554-0918
North East: 3001 Fuller St NE Grand Rapids, MI 49505  616-451-4284

Remember PT is safe for mom and baby.  You don’t have to hurt.  


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Hulst Jepsen

Podcast Episode #27: Let’s Talk About the Pelvic Floor

Today on Ask the Doulas, we talk to JoEllen Bender of Hulst Jepsen Physical Therapy in East Grand Rapids.  She is a physical therapist who specializes in women’s pelvic issues.  Listen as she gives some tips and dispels some myths about the pelvic floor.  You’re doing kegels right now, aren’t you?!

Listen to the podcast on iTunes or SoundCloud!


Alyssa:  Hello and welcome to another episode of Ask the Doulas!  I am Alyssa Veneklase, co-owner and postpartum doula.  Today we are talking to JoEllen Bender of Hulst Jepsen Physical Therapy.  Hello.

JoEllen:  Hi.

Alyssa:  We actually had an event recently.

JoEllen:  Yes, we did.

Alyssa:  And I learned so much about what you do for pelvic floor.  I wanted to talk a little bit about what that actually means and what you do for your patients, but when we say pelvic floor, what does it even mean?

JoEllen:  So the pelvic floor specifically is a group of muscles that are at the base, where there’s the vaginal and anal opening.  It spans pretty wide, so it’s from both hips and then the front of your pubic bone back to your coccyx or your tailbone, and that’s pretty much the typical pelvic floor musculature, but it spans and helps the whole body.  So if you think about it, all the pressure that comes from the bottom of the body, so your legs when you hit the ground – your pelvic floor is your core.  It’s a shock absorber.  And then everything from above; so if you lift something, it also is a shock absorber for any of that pressure or weight.  So it’s a pretty big area.  The muscles themselves are in a smaller group, but it helps with so many things throughout your day.

Alyssa:  So it doesn’t just have to do with peeing when you do jumping jacks?

JoEllen:  No, it doesn’t.  It’s so much more.

Alyssa:  So you’re saying even when you’re working your core, you’re working your pelvic floor?

JoEllen:  Exactly, yes.  And that’s when issues can come in if you don’t use your pelvic floor and you specifically just use those six-pack muscles, those rock-hard abs type of muscles.  So it’s very important to train the pelvic floor along with the core.  I know when people typically think “core,” it’s those muscles in the front from your chest down to your pelvis, your hips, but it’s so much more than that.  You have to add the core, the base of it, your pelvic floor in there, too.

Alyssa:  So what does a typical woman come to see you for?

JoEllen:  So there’s a whole host of things.  A lot of it will be low back pain.  There will be pelvic pain, constipation, coccyx pain.  You could also have – there’s multiple diseases like vulvodynia, endometriosis, polycystic ovarian syndrome, lots of those types of things.  But then the main thing that I like to specialize in is postpartum or pregnancy, so that is the bulk of my client baseload, but there’s a whole host of things that you could come in for with pelvic pain or things related to that.

Alyssa:  So a pregnant mom comes in.  Is she just doing preventative work, or is she usually having some leaking, or does it usually have to do with the bladder?

JoEllen:  It can be to do with the bladder.  There’s so many things that a pregnant mother could have issues with, so we would –

Alyssa:  Like pelvic pain?

JoEllen:  Exactly, yeah, so we can combat any of that.  A lot of the typical symptoms would be low back pain.  You start to grow a baby in the front there; it offsets your balance and your weight, and you’re using different muscles.  Elastin in the body increases by 30% when you get pregnant, which increases the laxity of your connective tissue and your joints, your ligaments, all of that type of stuff.  So back pain, I would say, is the biggest.  Incontinence, leakage, would be probably second, and then a lot of times they’ll even come in with lower extremity swelling.  So we can help with some of that, too, increase that lymph flow and all of that.  So whatever they come in with, we try to meet them where they’re at and then just progress through the pregnancy as they need.

Alyssa:  And then same with postpartum?

JoEllen:  Correct.

Alyssa:  Things have now shifted; you’ve had your baby, and there’s probably a whole host of other issues that now come along with the pelvic floor.

JoEllen:  Exactly.  So some of them can be the same of what happened pregnancy-wise, but then postpartum, I would say, biggest is probably leakage, incontinence; sometimes constipation still will happen frequently, and the low back pain is pretty constant, too.  Most of the time, if it’s more preventative, it will be someone that wants to return to, let’s say, running, or some type of exercise, and now all of a sudden, they’ve had this impairment of leakage or pain or something like that.  So then we’ll just take them through more of a postpartum exercise routine or things that you can reintegrate your pelvic floor to help get you back to the things that you want to do.

Alyssa:  Okay, so that was my next question.  What does that look like?  What do you do as a pelvic floor physical therapist?  And I know when we had our event together, you kind of mentioned that there were external things as well as internal, right?

JoEllen:  Yes.

Alyssa:  So how do those differ?

JoEllen:  So internal would mean that we would go in vaginally, one gloved finger.  It’s all up to patient comfort, and we can feel those internal muscles.  There are ways that you can feel the more internal muscles externally, so if a patient came in and they weren’t comfortable with internal, of course we could always stick to external.  It doesn’t mean that you always have to go internal when you see a pelvic floor physical therapist.  I think a lot of people are worried about that and so they don’t come in, but we meet you wherever you’re at.  So internal would be more releasing the muscles or giving tactile cues on how to find your pelvic floor or contract it.  Externally, you could do the same, simple type of things, but it would be more like those tactile cues on how to find your pelvic floor or contract certain muscles or relax certain muscles.

Alyssa:  So everyone thinks of Kegels; I mean, that’s what I think of.  But it’s so much more than that, right?

JoEllen:  Exactly.

Alyssa:  And did you tell me that you can even do Kegels too much and have the opposite effect?

JoEllen:  Right, so if you hold your pelvic floor at a higher tone, a higher resting tone – so it’s not in the good type of strength; it’s more of that high-tone irritability that can cause pain.  You can’t get a full release to then get a full contraction, so you need the muscle to go through its full length of motion, meaning it needs to drop down and fully relax so that you then can contract it.  If you’re doing Kegels all day, it’s the same as any other muscle.  Let’s say you contract your bicep all day, and then all of a sudden you need to use it.  Let’s say you feel like a leak’s coming on or something; it’s just going to give way and then you are going to leak; it’s going to go out.  So same thing with the bicep; use it all day, and then you go and try to pick up your purse or something heavy: it’s just going to give, and it’s not going to be able to do what it needs to do.

Alyssa:  Okay.  So are there different exercises then that you said – you mentioned the core, but the lower core?  So there’s different exercises like crunches and certain things that you would tell people to do?

JoEllen:  Yes; not typically crunches, though.  So there’s different types of muscles that are more postural and the ones that can transmit forces from, let’s say, your right side to your left side, which are the ones that we really want to get after.  So those would be your deeper muscles, your typical pelvic floor muscles, and then those smaller abdominal muscles, not that six-pack, typical type of ab muscles.

Alyssa:  These are abdominal muscles that you can’t necessarily touch by doing crunches; it’s a different exercise?

JoEllen:  Correct.  You can’t really see them; it’s a deeper type of muscle area.  So a lot of times the first thing that I’ll take someone through is breathing because the top of the pelvic floor is actually your diaphragm, so it creates this cannister within you.  The top is the diaphragm; the bottom is the pelvic floor.  When you inhale, your diaphragm contracts and drops down, and your pelvic floor can then relax and drop down, so that would be the lengthening of the muscle.  When you exhale, then the pelvic floor comes up; it contracts, and your diaphragm comes back up, also.  So it’s kind of like a piston; they both drop down together, and then they come back up together, so the way to activate the pelvic floor in the beginning would be first by trying to find your diaphragmatic breathing; get that good expansion.  A lot of people have that high chest-breathing; everybody’s stressed lately, and as a mother, postpartum, they have so many things that they have to think of, and it’s more of a stressful time.  So they breathe with that chest, when really, we need to activate the pelvic floor which would be breathing with your diaphragm.  So that would be first exercise, and then we would just progress from there.

Alyssa:  So is there anything else about the pelvic floor for either prenatal or postpartum, things that maybe people think of as a misconception or that you would want people to know about?

JoEllen:  So my big thing is, it seems to be that all of a sudden at six weeks you’re just magically better and you can return to whatever you want to do.

Alyssa:  Postpartum, you mean?

JoEllen:  Exactly, yes.  I wish people would not say that because it took nine months for you to get to where you are, and your body changed drastically.  It’s going to take about nine months to get back to where you were before, so I don’t want moms to think, oh my gosh, I’m not back to where I was.  Or they see another mom that is now running marathons.  Everybody changes so much differently, and we’re going to meet you where you’re at and then get you back to where you were, safely, rather than you trying to push yourself and then cause all these other types of issues.

Alyssa:  That’s good advice.  So how do our moms find you?

JoEllen:  So I am at Hulst Jepsen Physical Therapy.  It’s an outpatient clinic.  The address specifically is 2000 Burton Street SE.  We’re Suite 1, and that’s in East Grand Rapids.

Alyssa:  So are you near Anthropologie?  Is that a good landmark?

JoEllen:  We are pretty close, right in that area, yeah.  So the best way would be to call.  The number is 616-608-8485.  And then you would just schedule with me, JoEllen Bender.  Just ask to schedule for pelvic floor physical therapy, and then we can get you started on whatever types of issues you’re having or if it’s preventative during pregnancy or any of that.

Alyssa:  Now how far – this is something I didn’t ask.  How far postpartum can you see a mom?

JoEllen:  They could come in as early as they wanted, and then we would just space out treatment based on the timeframe that exercises would be safe to begin.  So they could come right after, and we could work on some breathing and postural type things, and then after that, I would be comfortable starting more of the typical strength training types of things probably around the four- to six-week area.

Alyssa:  And then what about a mom whose daughter turned five and still can’t do jumping jacks without peeing?  What about someone like that?

JoEllen:  Come in ASAP!  There is still hope!

Alyssa:  Speaking from experience…

JoEllen:  I would love for anybody like that to come in.  There’s always – I mean, don’t think you’re too far gone or anything like that.  We can always work on it, and you’ll get back to what you want to do.

Alyssa:   Good, awesome.  Well, thank you for all that information.  Get ahold of her if you have any questions, and then as always, if you have questions for us, you can email us:  Find us on Facebook and Instagram, and you can listen on iTunes and SoundCloud.  Thanks.

JoEllen:  Thank you for having me.


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pelvic floor

Getting To Know Your Pelvic Floor

We are pleased to present a guest blog by Melissa VanKampen, PTA. Melissa has been working in the field of physical therapy for 18 years with the last 8 focusing on pelvic health in particular. She works for Northern Physical Therapy in Coopersville, MI. though Northern has six locations with several of them offering pelvic health therapy. If you have any questions or concerns regarding YOUR pelvic health please feel free to contact Melissa at melissavankampen at or 616.997.6172.

We have all heard the term “pelvic floor” especially in the last 5 years, everyone from Good Housekeeping to Cosmo has an opinion on what to do with it, what it should look like and what is “normal”. Most women don’t find it an easy subject to address even with friends let alone their health professional. When they do muster the courage to bring it up, they are told it is normal or it is just something they have to live with. So let’s find out what your pelvic floor really is and does for you.

What is your pelvic floor? It is a group of muscles that connect from your tailbone to your pubic bone with many fascial attachments. It has 3 muscle layers that have distinct functions and plays a role in everything you do throughout a day.

The pelvic floor has 3 basic functions:
Organ support: It is the bottom end of the canister that forms your “core” with your diaphragm being the top and the abdominals forming the body of the can. These muscles working together keep your intestines, bladder, and uterus where they should be in your body. Symptoms of heaviness, pressure , aching in your pelvis, or the feeling that something is “falling out” signal that those muscle may not be working as well as they should be.

Continence: If you are leaking urine at times or in places that you don’t want to be, you probably have some form of INcontinence. This is not a normal process of aging or childbirth. You may also experience fecal incontinence. This is often because the muscles are not strong enough to hold against gravity or they may be experiencing another kind of dysfunction. Other signs of dysfunction are the feeling of having to urinate all the time, or not feeling that you empty your bladder when you go.

Sexual appreciation: the ability to experience arousal, intercourse and orgasm. Pain with intercourse is a sign that the pelvic floor muscles may be spasmed or you may have some scar tissue from a surgical procedure.

All of these functions can be affected by diet, lifestyle, childbirth, surgical procedures, hormonal changes, disease processes , or biomechanical dysfunctions. A trained pelvic therapist will go through a thorough history to determine what the cause of your symptoms may be. They will then develop a custom treatment to restore balance back to your body. That is why it is so important to begin a conversation with a health care professional such as your doctor or pelvic health trained physical therapist to address how they can help you with your specific needs. Trust your instincts, you know what is “right” for your body.


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