- How I Recovered from Postpartum Painful Sex, Part 1
- How I Recovered from Postpartum Painful Sex, Part 2
- What It’s REALLY Like to Get Physical Therapy for Painful Sex & Pelvic Floor Disorder
- Real Hope: Pelvic Floor Rehab at Home
- Mind-Body Rehab for Painful Sex & Pelvic Floor Disorders — The Ultimate DIY Guide
You already know that after a peaceful, non-traumatic birth, I was blind-sided with extreme sexual pain—so painful I’d never have intercourse again if something didn’t change—and that I was nearly a basket case over it, and that I recovered fully (thank God) through physical therapy, biofeedback, and homework. (Catch part 1 and part 2 of my story if you missed it.)
I’ve described what it’s like to get pelvic floor physical therapy for painful sex and/or pelvic floor dysfunction.
Now I’m going to share, step-by-step, exactly what all that “homework” entailed. This work that I did in my own home with with the guidance of the physical therapists, my own reading (I’ll include the book and blogs I used), and a Restorative Exercise Specialist was every bit as important as what happened in the PT office, not only for my recovery but also for my long-term health.
I’m so excited to share this information because it’s relevant not just for cases like mine, but for anyone with a pelvic floor—that would be you—who wants to stay (or get) healthy, functional, and pain-free.
Applying this information can . . .
- Help women or men prevent pelvic floor dysfunction of many kinds
- Help moms recover from pregnancy and birth
- Help moms heal from perineum tears or episiotomies
- Help women or men recover from pelvic floor dysfunction, whether mild or severe
Want to hear something sobering? In my recovery from severe post-partum pelvic floor dysfunction, I discovered that I’d had a dysfunctional pelvic floor for years—and never knew it! I didn’t know that small bit of discomfort wasn’t normal until it was gone.
Thus, I’m thankful for my severe postpartum symptoms. They got my attention! I was motivated. I did the work to recover. I’m doing the maintenance. I have a shot at staying healthy down there into my old age.
Without a wake-up call, I could have gone on suffering at a low grade, a “normal” level, for decades and been told by everyone, “Oh, that’s just what happens after you have a baby.” Actually, in talking to a few women about my symptoms before I sought professional help, that’s exactly what I heard. My symptoms were just worse than other women’s, not different.
Ladies, a little sneeze pee (stress incontinence), uncomfortable sex, frequent UTIs, and minor pelvic pain may be common, but they are NOT normal. Not before babies, not after babies.
(Men, you can add testicular pain and various sexual dysfunctions to that list.)
You’ll see as this Pelvic Floor Rehab at Home series unfolds that many facets of our modern lifestyles set us up for pelvic floor dysfunction, sooner or later. Perhaps we can’t counteract all of it, but I’m living proof that we can dramatically improve our quality of life.
Zero sex to better-than-pre-baby-sex? Yeah, that counts.
Obviously, not all parts of this series will apply to all situations (e.g., not everyone needs perineal scar rehab), but there’s plenty here for just about everyone’s pelvic region, whether hypertonic, weak, both, or just plain confused.
Let’s get started, shall we?
Big Fat Disclaimer
Oh wait, I forgot the Big Fat Disclaimer: I am not in any way a health professional, and I strongly urge you to seek the care of one if you believe you may be experiencing pelvic floor dysfunction. Read here about my experience with pelvic physical therapists. They did me a world of good! I’m merely sharing here what worked for me and providing references and tools so that you can do some exploring of your own. Keep in mind that there are other causes, whether primary or secondary, of many of these symptoms.
Whew. Now let’s dive in!
What Does Pelvic Floor Rehab Mean, Exactly?
As with any other dysfunction or injury, thorough rehab means not only helping tissue recover health and function, but also correcting factors that led to the dysfunction in the first place (psst! this is the prevention part, in case you missed it).
Why does a pelvic floor (PF) become dysfunctional? Many factors converge to create dysfunction, and a good rehab program will be multi-faceted because you’re almost always looking at a compound cause. Even if a traumatic event, like a tear from birth or a severe infection, suddenly puts a PF over the edge, it was likely already compromised and vulnerable.
So it is with pregnancy and healthy birth. Pregnancy and normal birth do not in and of themselves cause PF dysfunction. They just push the PF to its limit, and if that limit is lower because of lifestyle factors—as is the case with almost all of us in the West, especially the U.S.—then yikes.
I’m writing this series from the perspective of recovering from an extremely hypertonic (too-tight) PF, but the rehab may be almost identical for those with a weak PF. In fact, the two conditions are often the same. Incontinence or the inability to do a strong, sustained kegel doesn’t automatically mean you’ve got a slack hammock holding your organs. You might really have a crazy tight one (even if it’s not tight enough to make intercourse painful) that can’t contract fully because it’s already too short!
And to make matters worse, the very prescription given for “too-weak” can exacerbate the “too-tight” situation, leading to yet more weakness over the long haul.
Let me explain: If you pee when you sneeze or laugh, for example, you’ve probably been told to do kegels. Doctors and midwives alike prescribe them. Yet, if you’re experiencing stress incontinence because your muscles are too short and tight to contract efficiently, then “exercising” the muscle by repeatedly contracting it may only lead to shortening the muscles further, which leaves them even less capable of contracting efficiently!
Then, for those like me with a PF in spasm, a kegels regimen in isolation will only reinforce the spasm.
So much for a spot-focus, huh?
That’s why what I’m about to share is a multi-part series. There is absolutely a place for a spot-focus, like with breaking up perineal scar tissue (and believe me, I’ll cover that) but without addressing the whole person, you’re always fighting an uphill battle.
Many will get short-term results without a global approach, but personally, my goal is long-term quality of life. And as it turns out, many of the changes required to restore—and perhaps create for the first time—a healthy pelvic floor are changes that are good for the rest of me too. Win!
My Guides for this PF Healing Journey
I didn’t make this stuff up. Honest. I got lots of help and did much reading. The program I’m about to describe is my own mix based on the following guides:
Pelvic Physical Therapists & Biofeedback Specialists
I’ve already written about my in-office experience with these kinds of professionals here. Specifically, I worked with the amazing women at the Pelvic Health & Physical Therapy Center in Houston, TX. Now I’ll share the homework they gave me.
Ending Female Pain: A Woman’s Manual – The Ultimate Self-Help Guide for Women Suffering from Chronic Pelvic and Sexual Pain by Isa Herrera MSPT
This is a fantastic book! I felt really overwhelmed when I first started reading it (I did a tap to calm myself), but it’s chock-full of info and is what I’d recommend, along with the blog below, to anyone who doesn’t have access to a pelvic physical therapist.
Katy Says Blog by Katy Bowman, biomechanist
The information on this blog (now available in book form as Alignment Matters!) enhanced my PT homework and gave me a different, whole-body perspective on what on earth was happening to me. It also helped me avoid common pitfalls pre- and post-pregnancy, like doing too many kegels.
Debbie Beane, Restorative Exercise Specialist
Debbie, who has been trained by Katy Bowman, helped me in person (soooo valuable) to apply some of the principles and exercises that Bowman teaches.
What I’ll Cover in This Series
I’m going to work from the widest to the narrowest angle.
1. The Mind-Body Angle — many people may want to skip this step, but it’s NOT optional for either prevention or recovery. It is a part of all the above experts’ recommendations for PF recovery, and I can vouch for it myself. I’ll cover mindfulness, self-regulation, meditation, fear-tension-pain cycles, relaxation, processing emotions, and more.
2. The Whole-Body Angle — the PF does not function in isolation, so it’s essential to correct overall body habits (posture, movement, etc), muscle length (stretching), and muscle strength and coordination.
3. Spot Focus — this is the nitty gritty stuff, the hands-on work with vibrators, dilators, massage, etc. to relax muscle tension, restore proper blood flow to tissue, and break up scar tissue.
There you have it. That’s the background and roadmap for all the following info on my at-home pelvic floor healing work. See you next time!