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keeping your pelvic floor healthy? by jessica reale

Did you know that in countries like France or Germany, women routinely work with a physical therapist to rehabilitate the pelvic floor after having babies? In fact, I have often had clients from these countries who live in America seek me out for treatment, surprised that their physicians had not recommended it to them postpartum. Unfortunately, America is a little behind the curve when it comes to pelvic floor health. Many women are given blanket recommendations of “do Kegel exercises” when they are 42


pregnant, but advice tends to end after that. Postpartum women experiencing problems like bladder leakage or painful sexual intercourse are told, “Well, you’ve had a baby…of course things are different,” and are left alone in managing these problems without receiving the help that they need. As a pelvic floor physical therapist and board-certified specialist in Women’s Health, this is so disheartening, and my hope is to shed a little light on this and make women aware that they deserve more. What exactly is the pelvic floor? The pelvic floor muscles sit inside the pelvis like a bowl, running from the pubic bone in the front to the tailbone in the back, circling around the urethra, vagina, and anus. There are three layers of these muscles, and together, they do several important jobs for our body. You can remember these as the “4 s’s”. First, they play both a “supportive and stabilizing” role in that they work together with a system of muscles, ligaments and fascia to support the organs in the pelvis and stabilize the pelvis, hips, and low back. The pelvic floor coordinates with the respiratory diaphragm, abdominal muscles and low back muscles to help to modulate intra-abdominal pressure and create stability with movement. When this system is not working properly, women can experience problems like pelvic organ prolapse (this is what is happening when someone tells you that

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