Pelvic Floor Issues: Me Too!
Not THAT “Me too”! “Me too” meaning I’m a Pilates instructor (Jenny Armstrong) who teaches people to use their core, and even I have issues with my pelvic floor and core! This is a story about my postpartum journey, and it’s still ongoing. But it’s not only for people who have had children. It’s not only for women. It’s for anyone who has an aging body, for anyone who has gotten busy and not been able to exercise as much, for anyone who has struggled with time management and stress, and who hasn’t made time for relaxation, rest, and self care.
Helen was born on February 10, 2019, and when I went to my six week checkup I was cleared for exercise, work, everything! The midwife said that my pelvic floor strength was excellent. I was feeling pretty great, different from before I had Helen and tired, but pretty good!
I went back to work but at slightly reduced hours compared to before having Helen, since she’s a picky one and won’t take a bottle, instead holding out for me to get back home. My schedule got busier, Helen’s got bigger, and after school time got more complicated between nap-times and karate and my teaching schedule and sitters and child care-oh my! Suffice it to say, I haven’t spent a lot of time trying to get back into shape.
I’m not sure when I realized all was not well. Maybe when I would put Helen in the front pack and carry her around for naps or to hike and afterward my pelvic floor would feel tired. Maybe when lifting the heavy Pilates apparatus which I do in between every class Monday, Tuesday, Thursday and Friday. Maybe it was when I did a trial Beachbody online program and I was pushing myself to workout after the kids had gone to bed and I was sore in some weird places. One day I woke up and realized that I had pain when going number 2, and a feeling of pain and swelling “down there” and that’s what took me to the doctor almost 11 months (back in December 2019) after having a healthy and relatively uncomplicated birth. The urinary incontinence didn’t start until a couple weeks later. The first MD diagnosed me with a prolapse and prescribed kegels and stool softener. She also said she could refer me to urogynecology or PT. So I did the easiest thing just started doing kegels in earnest and stool softeners and that’s when it started to get worse.
I ended up calling our provider about doing Pelvic Floor PT, and due to high demand and few providers, they were booking out to APRIL! Luckily, I have a friend who is a PT and she got me an appointment within a week. Phew!
I’ve been teaching Pilates for about 12 years. I was also a dancer in high school and college and beyond so I’ve dealt with my own injuries from tendonitis to back pain and ankle sprains. In addition to teaching group classes in yoga, Pilates and Pilates apparatus, I also work one-on-one with people specifically about issues surrounding the pelvic floor. After having my first child I recovered fully, and felt stronger than I had before I had him. A number of years ago while doing my 500 hour yoga teacher training, I joined forces with another yoga teacher to conduct workshops about the pelvic floor. So as I mentioned, I practice kegels and core strengthening in my work, and EVEN I developed issues!! My PT friend who got the appointment very gently suggested that it’s a good reminder that self care is important and that it’s ok to be the patient, too! But I still felt so scared and embarrassed and disappointed going into that appointment. How did I go from recovering and being 6 weeks postpartum and given the green light for anything, to this : stress incontinence (peeing when you jump or pick up something heavy), pain, swelling, and constipation. How did this happen to me? And prolapse? That is supposed to happen to people postpartum who push too soon in their recovery (think a marathon runner who returns to running right after having a baby), or who had really hard labors and felt the damage right away. I may not be actively working out, but I do a lot of abdominal work with my classes and clients. And none of the changes I have made lately have been huge.
In talking with the PT and through the course of her physical exam, it became obvious that I have incredibly tight muscles in my pelvis that are exhausted from holding on all the time. That is what is causing the urinary incontinence and constipation. Think of a bicep. If you curl it and really squeeze the muscle, pretty soon it begins to become mildly uncomfortable. Now imagine holding it all day, never letting go. Most muscles are happy at rest somewhere in the middle in terms of tone-not clenching and not completely slack. It turns out I’ve been holding onto my muscles (not only in my belly) not only while I’m doing abdominal work, but while teaching, while walking around in my day to day life. At some point they are exhausted and they give in to the pressure from above, sometimes under pressure from having to pee, but other times just from lifting my baby, or standing up and moving around. And while I’m not fully better, I feel like I’m already feeling some improvement. While I “practice what I preach” about taking care of myself, about making time for relaxation, I’m learning in a whole new way to help others with similar issues.
So although I understand the urge to act somewhat incredulous to hear that I’m having issues, I have learned that it is all too common to have some form of pelvic floor dysfunction. Common, but not normal. Whether it’s trouble going number two, low back pain, hip pain, incontinence, erectile dysfunction (ED) for men, Diastasis Recti after giving birth or prolapse, all of this is related to the muscles in this very important part of our body and how they are functioning in connection with the body as a whole. Let’s bring it out of the dark and take away the taboo about this private part of the body. Let’s not settle for having these issues forever!
By Jennifer Armstrong, UVAC Pilates Instructor and Personal Trainer