Congratulations, mama. Your new baby is home and you are adjusting to a new way of life. The people closest to you, family and friends assume if baby is healthy and thriving, then you are doing the same. But your body feels as if it was hit by a bus and anything but “normal.” You lay in bed breastfeeding like a full-time milk machine dreaming of your pre-baby body. Sex is unimaginable and you’re wondering when you can get back to working out.

At your six week check up, your OBGYN or your midwife takes a peek down there and lets you know everything “looks good.” But even six weeks out, you still don’t feel “fine down there.” Who do you reach out to and who can help feeling like yourself again? Your body has undergone so much change, especially with your pelvic floor muscles – those muscles that support your pelvic organs and control your bladder and bowel functions. It’s not uncommon to feel pain, tension, pulling, burning, or as many women share “razor blades” down there.

At Urban Wellness Clinic, we see new mamas struggling with a bulge in their abdomen, neck and back pain, along with sleep deprivation and all the new mom feels. We are there to be a listening ear, and hold space for any tears. For the physical aches and pains, we listen to your birth story and looks for compensations in the body related to the delivery whether it was vaginal or a c-section. Often times back pain, leg pain, and bloating in the belly is coming from a source you didn’t consider: your pelvic floor.

What is the pelvic floor and why is it important?

The pelvic floor is a group of muscles at the bottom of your pelvis to help hold the organs in place. These muscles are essential for finding your core strength and integral to proper breathing habits, not leaking every time you sneeze and losing the tummy bulge.

Diaphragmatic breathing, which we focus on heavily here at Urban Wellness Clinic, includes strength to the central body, ie our deep core. Without strength and stability here we are walking compensations that can lead to unwanted signs and symptoms, such as: flared ribs, unstable joints, weak muscles, chest breathing, upper back and shoulder tension, headaches, chronic low back pain, plantar fasciitis, you name it.

The ‘canister’ of strength you want to build includes four parts: the diaphragm, the transverse abdominis, the multifidus, and the pelvic floor at the bottom. The pelvic floor can be broken down even further with the number of muscles involved anatomically in this part of the body, but rather than bore you with a lecture on muscle innervation and insertion, understanding why we include this in our list of differential diagnosis is important.

The pelvic floor is, naturally, most affected by pregnancy. However, other factors can also play a role in causing pelvic floor pain. Perhaps you deal with high stress and clench your jaw? Maybe you were lifting heavy weight with improper form and strained these muscles? Too much stretching can also create a lack of stability in the pelvic floor.

What I mean to say is, there are a lot of reasons you may be feeling pelvic floor pain or strain outside of childbirth. Regardless, it plays a role in something as simple as how we retrain our breathing and could be the culprit for the pain you are experiencing elsewhere.

Signs and Symptoms to Look Out For With Pelvic Floor Dysfunction

If you’re experiencing any of these symptoms, it could be from damaged or weakened pelvic floor muscles.

• Urine Leakage when you cough or sneeze
• Painful urination
• Inability to complete a bowel movement or feeling as though you have not fully emptied
• Low back pain
• Pain in the pelvis
• Muscle spasms in the pelvis
• Pain down into the groin and inner thigh

If you are experiencing one of these symptoms it does not automatically mean you are dealing with a pelvic floor issue; however, the pelvic floor should not be ignored.

Vaginal Birth vs. Cesarean Section

For the majority of your pregnancy, you had extra weight adding downward pressure on your pelvic floor.

We recently had a patient visit our office who was complaining about plantar fasciitis in both feet so painful she couldn’t stand in the shower for longer than a couple of minutes. Running across the street after her toddler was unthinkable due to the pain and multiple rounds of physical therapy didn’t help. Rather than look where everyone else had narrowed in their focused in and only looked at her feet, we used Neurokinetic Therapy to find out why the plantar fascia was a chronic issue. We muscle tested her pelvic floor, low and behold, ended up being the reason for her lingering plantar fasciitis. She had an episiotomy during childbirth and her scar was affecting the integrity of her core strength. We referred her to a pelvic floor physical therapy and co-treated to get her core stronger and after four weeks she was strength training with kettlebells.

But, what about those who have a c-section? Most women believe if they’ve had a c-section then their pelvic floor should a-ok since the baby didn’t come out from “down there.” But his couldn’t be further from the truth, and the education around how to care for yourself after a c-section is hardly ever discussed.

After a physician has cut through abdominal muscles, the c-section scar itself can create unseen compensations in your body. The connective tissue underneath the skin is compromised and you can end up with something as intense as plantar fasciitis or any one of the other aforementioned symptoms.

Our Approach to Pelvic Floor Pain at UWC

At Urban Wellness Clinic we use a number of different methods to approach pelvic floor pain and issues you may be experiencing post-childbirth.

Dynamic Neuromuscular Stabilization (DNS)

If you have little ones in your family, then you have witnessed the incredible form and stability they learn the first two years of life as they learn their movement patterns. Their developmental movements are a mix of diaphragmatic breathing and stability in all the right places. Learning from them is a great way to create more strength and stability in your own body.

The DNS approach places your body in these healthy developmental positions to help our bodies remember how to properly recruit certain muscles. We teach you gentle and effective ways to rebuild core strength (which does not include 100 sit-ups a day) to continuously build the strength back in your pelvic floor.

This method is also the driving force for the program known as Birth Fit Functional Progressions. A series of 5 exercises meant to provide stability from the ground up and the core outward ie strength from the inside out.

Neurokinetic Therapy

Neurokinetic Therapy (NKT) allows us to understand where our focus should be for YOU. As mentioned before, pelvic floor pain isn’t the only symptom, low back pain can also be a symptom you are suffering from due to pelvic floor issues. Muscle testing will provide us with the answers you are looking for and help drive a treatment plan specific to you while also allowing you to gain a whole-body approach to care.

Strength Training

Along with deep core strength, there is also a need for strengthening the whole body. Slowly incorporating strength training back into your regiment or maybe even introducing it for the first time, will provide your body with added stability. What’s more? Strength training is proven to help balance hormones in men and women! Adding a component of weights to your routine can be the missing link the body needs to recalibrate.

Trusted Referral Network

We want you to feel your very best and know that sometimes it takes teamwork to get to where we want to be. As we provide you with the tools and rehab to reach your health goals, we can also provide you with our trusted network of pelvic floor specialists in the New York City area.

Our goal is to help you feel the best you can feel and we believe that education and progression is the best way to get there! The providers at Urban Wellness Clinic will help you find the answers you are looking for while also providing you with the right tools to take home so that you can continue to get better and stronger day by day. Give us a call to schedule your next follow up at 212-355-0445 or shoot us an email at hello@urbanwellnessclinic.com.

Yours In Health,

Dr. Monisha Mallik