Many women joke about this serious, but fixable, issue.
We all have a friend, mom, or aunt who jokingly warns you that after you have a baby you’re going to pee your pants a little. You know, when you sneeze, laugh, run, or jump on a trampoline. Well, good news is here. According to Jessica Rector, founder of PT for your Privates, you do NOT need to pee your pants. Not now. And not in older age, either! Also, just because this issue is common, does not mean it is normal or has to be an accepted reality.
She says, “When you have a loss of bladder control, or urinary incontinence, it’s a common issue. But it should not be something you have to deal with forever. But it’s not a normal body function. Treatment can help you heal rapidly, and a symptom like this should only last a few months.”
Even if you don’t experience urinary incontinence now, it can be something that pops up as you get older.
As she puts it, “The stronger you are today, the stronger you’ll be as you age. If we can get your muscles back to optimal strength, ideally you won’t have those issues when you’re 70. Or if you do, they won’t be so bad.” Ready for more good news? She treats people up to 95 years old. Because your muscles can always get stronger. So if symptoms do appear later on, you can always go back to physical therapy.
When Jessica sees women with this issue, she helps them retrain their coordination. The idea is being able to use their pelvic floor again naturally, without even thinking about it, throughout the day. For example: when you bend and lift, your pelvic floor should be contracting because that provides the most stability.
Do kegels help?
Surprisingly, not everyone should be doing them. She says, “Sometimes kegels cause pain. Which is why it’s important to have someone evaluate your muscles. That way, they can tell you what’s going on for your body specifically. Some people have weakness in their pelvic floor, some hold extra tension, some have irritating scar tissue. Everyone’s body responds differently. The best thing for everyone to hear is however your body responds to pregnancy is normal for you. And if things feel different after giving birth, that’s ok. It takes time for the body to heal.”
If you are one of the women kegels does help, you should keep doing them daily forever. Just like you should keep exercising forever. That maintenance phase helps keep up your muscle endurance. That being said, it’s also important to know how to do them correctly.
Jessica says, 40% of women who think they’re doing kegels, are doing them wrong.
This can be a problem.
Doing them wrong, doing them when they cause pain, or even doing them too frequently can all create issues. Remember, this information is not intended to scare you. It’s meant to empower you to get the help you need and deserve from a highly-trained specialist.
And if you do begin PT, be patient with yourself. It usually takes a couple weeks to notice results and she often treats patients for around 3 months–usually seeing a patient every week and then tapering off treatment as progress is made.
To set expectations for your healing timeline, generally speaking, plan on it taking a year for your pelvic floor and body to heal from pregnancy and childbirth. Especially with difficult deliveries or for women trying to get back to high-intensity workouts.
Here’s what all mothers have in common.
And whether you have a vaginal delivery, c-section, or VBAC, every mother carried her baby and extra weight for 9 months. That means core muscles lengthen and weaken and the pelvic floor lengthens, too. “What’s strong in a stretched out position is not what’s strong in a shortened position. Even if you’re in optimal fitness during pregnancy. Because now your body is getting used to a new shape without baby inside.“
Like every other physical therapist I’ve talked to, Jessica strongly believes every single pregnant and postpartum woman should go to PT. Not just if you pee your pants. Even if you feel completely fine.
Say it again for the women in the back! Yes, that includes whether or not you have physical pain or discomfort after giving birth. Every woman should be checked out to make sure your muscles are strengthening correctly and recovering well, to ensure you don’t have any childbirth-related issues cropping up years down the road.
Yes, this is completely different from what your OBGYN is checking you out for at your 6-week follow up visit.
If you’re anything like me, you’re wondering why you were cleared to essentially go back to living your life as normal at that checkup if you actually needed PT. The answer is simple. it’s not that your OBGYN doesn’t know what they’re doing. It’s that they’re basing their recommendation off different information. Like if your tear/cut has healed. Their training also doesn’t include learning how to evaluate those muscles well. Hence, this entire group of specialists whose job it is.
She also says lots of times, we have little injuries but feel fine and the body just has to do “the best it can.” The goal is to heal correctly now, so you can prevent scenarios of weakness later in life. Like the women she sees who are suddenly dealing with incontinence or even prolapse decades after childbirth. Because every woman has muscle weakness to a degree from carrying additional weight in abnormal positions for 9 months.
After all, “Pregnancy and the postpartum period are supposed to be joyous parts of life. Coming to physical therapy takes away some of that trauma and normalizes it. We can solve problems much faster than when women don’t come. Unfortunately, people are often too embarrassed to talk about things, or the negative symptoms get overshadowed by the beauty of having the baby.”
On the extreme end, she sees some women in their third trimester who have so much pain they can’t walk. But you don’t need to wait until after giving birth, or your third trimester, or have to be in pain to begin treatment that can set you up and prepare you for what’s to come. Specific things to watch out for during pregnancy are back or hip pain, leaking, or vaginal pressure–all signs you’re lacking strength and stability.
What’s the key takeaway?
Overall, she wants women to be prepared for what they are about to experience when having a baby. And inform them that there is help. Or in the words of her tagline: she’s “Making private matters public knowledge.” She says that pain can be nipped in the bud as muscles are trained to get stronger. So you don’t have to live with that pain.
If there is anything you or I learn from Jessica (and Rhiannon’s previous article on general postpartum PT), it should be to advocate for ourselves. And be proactive about our physical recoveries, even doing whatever we can preventatively. So even if your OBGYN doesn’t bring it up–especially if they don’t bring it up–ask them for a referral as soon as possible. Because you deserve to be well, recover quickly, and not pee your pants.
Follow Jessica on Instagram for some great information about PT: @PTForYourPrivates. Or shoot her an email at Jessica@ptforyourprivates.com to book a video consultation. Or to show some love for her commitment to women’s health and for helping spread this critical information to mothers of the world. Do you ever pee your pants a little? Let me know if this article helped you in the comments below.
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