Postpartum Diastasis Recti – A Pelvic Floor PTs Perspective

As a pelvic floor physical therapist, almost every new mom I treat has concerns over diastasis rectus abdominis (DRA) or “diastasis recti.” This condition happens during and after pregnancy because of the stress placed on the rectus abdominus (the famous “six pack” muscle) as a fetus grows within the uterus. DRA typically develops in the second or third trimester, when the fetus is growing most rapidly. Certain factors, like older age and having multiple pregnancies, may make a woman more susceptible to developing DRA. Simply put, the connecting tissue between the two sides of the abdominal wall called the linea alba, stretches and separates. Some women heal on their own, but others may not.

While brushed off as commonplace (which it is!), DRA is not insignificant. Any woman experiencing changes within her body is justified in her concerns, whether they are physical or aesthetic. Concerns I often hear are, “Is this just something all women have to accept? Why did no one tell me this could happen?” And the most common one… “Will it ever go back to together?”

The good news is that women are smarter and more empowered than ever before, and many are now seeking help from a pelvic floor physical therapist. If you are affected by postpartum DRA, pelvic floor physical therapy can be a highly effective approach!

Why is it important to treat diastasis recti?

The abdominal muscles support your posture, help control movement, and protect the internal organs (i.e. bladder, uterus, and rectum). If you are affected by DRA, you may therefore be at an increased risk for injury. The symptoms associated with DRA combined with the the many stressors that come with having a new baby can negatively affect a woman’s quality of life.

What does diastasis recti or DRA feel like?

The separated abdominal muscles usually do not cause pain, but the sequela of DRA can lead to dysfunction within the body. Symptoms usually develop gradually over the course of a woman’s pregnancy, and may linger following labor and delivery. Symptoms associated with DRA include:

  • Weakness within the midsection.
  • A visible and palpable gap between the rectus abdominis muscle.
  • Pelvic-floor muscle dysfunction.
  • Urinary or bowel problems (incontinence, leakage, constipation, etc).
  • Poor posture.
  • Occasionally low back, pelvic, or hip pain.

What is a diastasis diagnosis?

A physical therapist will review your medical history and symptoms. This includes questions related to your pregnancy, labor, delivery, breastfeeding habits, and physical recovery. They will also assess orthopedic factors, including your posture, range of motion, and muscle strength. Lastly, they will do a gentle abdominal muscle examination to note the degree of separation.

What should I expect in terms of treatment?

If you do develop DRA, the earlier you see a physical therapist, the faster you will be on your road to improved function! Treatment strategies include:

  1. Education. Your PT will be your coach and your teacher. They will guide you through a safe and effective plan of care and teach you movements to avoid early on (i.e. not to perform traditional sit-ups or crunches).
  2. Bracing. Sometimes taping or bracing the abdominal region can provide external support for women with DRA. It can also work as a cue when relearning the correct position for your midsection.
  3. Postural Training.  One of the most important components when treating DRA is improving postural control. This will involve activating core muscles such as your transverse abdominus (a deep abdominal muscle) and your pelvic floor without overusing the rectus abdominus muscle. In addition to strengthening, stretching plays a big role in postural control. While we often think all the muscles become weak during pregnancy, others may actually become overactive and tight. Your physical therapist will help you restore this balance. Lastly, they will help you transfer your gains to real life and review proper form when performing daily activities, such as lifting and carrying your baby.

In sum, DRA is a very prevalent condition that can be addressed with guidance from a skilled PT. If you have any questions related to diastasis recti or would like to get started on a PT program, I am happy to help!

 

Written By: Lacey Salberg

Lacey Salberg PT, DPT
Contact:
Park Sports Physical Therapy
Dr. Lacey Salberg, PT, DPT
lacey@parksportspt.com

Pelvic Floor Could be the Issue

Pelvic Floor could be the issue.  Does your low back pain linger, even after trying every trick in the toolbox? You’ve gone to massage therapy, acupuncture, and even the chiropractor – but nothing seems to work. While these professionals are good at addressing the spine and the hip muscles, they may be overlooking an important culprit of low back pain – the pelvic floor.

When people think of pelvic floor dysfunction, they often think of difficulty with bladder control or leakage of urine upon exertion. While this is certainly an issue for many women (in fact urinary incontinence affects over 50% of postmenopausal women and 30% of women postpartum), the pelvic floor does more for your body than simply control your bladder.

 

Your Pelvic Floor muscles form your Core.

The pelvic floor muscles form the base of what is commonly referred to as the ‘core’. These muscles line the pelvis and attach to the tailbone. They work with the deep abdominal and back muscles, as well as your breathing muscle (the diaphragm), to support the spine and control the pressure inside your abdomen. The pressure created by the abdominals and diaphragm exits through the pelvic floor. Without a strong floor, the integrity of the lumbar spine and sacroiliac joint may be comprised, leading to back injury or dysfunction. The opposite may also be true. When the back is in pain, the pelvic floor muscles may tighten as a protective mechanism, leading to trigger points and stiffness in the region. Recent research shows that this is more prevalent than we realized.

Of women with low back pain, more than 95% had pelvic floor dysfunction as well. This included pelvic tenderness (71%), weakness (66%) and even pelvic organ prolapse (41%).

 

Try physical therapy!

So what can you do about this? Try pelvic floor physical therapy!

A pelvic floor physical therapist understands the close relationship between the pelvic floor and low back pain. An initial evaluation and thorough history will rule out other potential causes of your back pain. At Park Sports PT our pelvic floor specialist, Lacey Salberg, PT, DPT, is very familiar with these cases. For example, Lacey was recently treating a patient who came in with classic low back pain and sciatica symptoms. The patient first saw Lacey after weeks of unsuccessful treatment from other healthcare professionals, who all attributed her pain to a tight piriformis muscle. Because Lacey took a pelvic floor approach, she discovered that the sciatic pain was actually due to tightness of an important pelvic floor muscle – the obturator internus. After a few weeks of treatment with Lacey, involving muscle energy techniques and soft tissue release, the back pain and sciatica symptoms resolved completely.

In conclusion, for targeted long term relief of lower back pain, both the pelvic floor and lower back must be looked at together. For questions or to make an appointment with our pelvic floor physical therapist, click here.

Written By: Lacey Salberg

Park Sports PT is a Participating Member of the Hospital for Special Surgery Rehabilitation Network.

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Link to study:

https://www.ncbi.nlm.nih.gov/pubmed/29268147

Pelvic Floor Therapy

Pelvic Floor Therapy and Dysfunction.

Pelvic Floor Therapy can be an important part of a healthy life.  So when it comes to posture, comfort, intimacy, and wellness, a healthy pelvic floor is one of the most vital parts of your body. Many women face daily discomfort, lack of intimacy, physical pain, and more due to a dysfunction of the muscles, ligaments, and nerves that support the pelvic region.

A healthy and re-energized pelvic region can greatly restore your well-being and help to eliminate symptoms that are negatively effecting your life.

Pelvic Floor Dysfunction (PFD) may be brought on by a variety of reasons. These include pregnancy, childbirth, menopause, prior surgery or radiation, heavy lifting and straining, obesity, and congenital weakness. This can lead to vulvar pain, localized pelvic discomfort, prolapse, low back pain, leakage, incontinence and much more. Most do not seek advice from a physical therapist. Those who do however, can see life changing results.

At Park Sports, we are dedicated to life changing results.

Park Sports Therapy Approach to Pelvic Floor Dysfunction.

What to Expect When Getting Started.

At Park Sports, we understand the seriousness of your decision to seek help. We offer evidence-based and individualized treatment plans backed by a wealth of knowledge and a history of success.

Our pelvic floor therapist Lacey Salberg PT, DPT has received extensive training from the Herman & Wallace Pelvic Rehabilitation Institute, a leader in pelvic floor education and awareness. Lacey will take the time to discuss your health concerns. She will also fully evaluate your condition and create personalized plan, uniquely designed for your comfort level, your lifestyle and your body. You will receive one-on-one sessions in our private treatment room as she coaches you towards your health goals.

Working Together.

We consider your health a team effort. Part of your therapy will include an at home exercise program that will help you progress through your treatment plan. As you make advancements, it is possible that your initial plan may need some adjustments. Your therapist will listen carefully to your body and closely monitor your functional gains. If necessary, she will discuss modifying your treatment plan to better achieve your health goals.

Long-Term Planning.

Once you reach your goals, your therapist will provide an at home plan. This plan will help you maintain your new functional gains and pelvic floor health. Of course we will always be available to provide advice and assistance. As your health and wellness partner – our goal is your long-term happiness.

Pelvic Floor Therapy at Park Sports Brooklyn

Park Sports Pelvic Therapy Floor Services.

Our practice offers a full range of services for Pelvic Floor Dysfunction including:

  • Comprehensive musculoskeletal and orthopedic evaluation, including assessment of the pelvic floor muscles and hip alignment.
  • External and/or internal manual therapy techniques such as myofascial release, soft tissue mobilization, neuromuscular facilitation, and scar massage.
  • Biofeedback for muscle re-training and recruitment.
  • Bowel and bladder training and diaries.
  • Therapeutic exercises such as postural re-education, muscle relaxation, core stabilization, and flexibility exercises.
  • Home exercise program instruction.
  • Self-management techniques to improve overall quality of life.

Contact Park Sports.

Contact us today to learn more about Pelvic Floor Therapy at Park Sports and to schedule an initial appointment. Let’s meet and discuss your questions, concerns and needs. We offer a premiere service with proven life changing results and we look forward to serving you.

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Why Men Should See A Pelvic Floor Therapist

Written by Alex Ariza
Reviewed by Irene Hernandez, PT, DPT

Everyone has pelvic floor muscles. So why is it that almost all information relating to pelvic floor therapy focus solely on women?

There are obvious reasons why Pelvic Floor Therapy is normally associated with women’s health issues. For starters, Pelvic Floor Dysfunction is far more prevalent in women than men, especially pregnant women.

Although this is true, there is still a fair amount of men suffering from symptoms associated with pelvic floor dysfunction. What’s worse is that most of them don’t even know it.

In fact, many times even medical doctors can misdiagnose pelvic floor dysfunction with much more serious conditions and diseases since symptoms can feel very similar to them. Sometimes this can lead to prescribing unnecessary medications and antibiotics, and in more extreme cases, surgery.

All of this could be preventable if men were more informed about their bodies and if medical practitioners knew more about pelvic floor issues.

When men suffer from erectile dysfunction, painful urination, frequent & involuntary urination, painful ejaculation, constipation, or pain after having a bowel movement, the last thing they would suspect is a problem with their pelvic floor muscles. And who can blame them?

Pelvic Floor Therapy for Men

At Park Sports Physical Therapy, part of our mission is to educate our patients about their bodies and the reasons they feel the symptoms that they do. We also stress the importance of preventative care, and the steps they can take through exercise and posture to keep them functional.

Our pelvic floor specialist, Irene Hernandez, DPT, specializes in treating both women AND men. We strongly encourage our male patients suffering from any of the conditions or symptoms listed above to come in for an evaluation.

Learn more about the pelvic floor and the different conditions associated with pelvic floor dysfunction by visiting this page.

The pelvic floor plays a few roles. For one, it is a group of muscles that form the “bottom” of your body’s core. This keeps the organs in place and from dropping out of the pelvis.

The second major responsibility of the pelvic floor is the control of the sphincters. This includes the anus and urethra. Weak pelvic floor muscles can result in incontinence – or the inability to hold in urine and/or feces. An over contracted pelvic floor will make it difficult to make a bowel movement, leading to constipation, or the inability to release urine.

The third major responsibility of the pelvic floor is sexual function. For men, dysfunction of the pelvic floor can lead to erectile dysfunction (ED). There are many other factors that can play into ED, but seeing a pelvic floor specialist can alleviate and correct muscles related to healthy sexual function.

Male Pelvic Floor Medical Illustration - Illustrated by Amy Stein - Heal Pelvic Pain
Male Pelvic Floor Medical Illustration – Illustrated by Amy Stein – Heal Pelvic Pain
Original Source: https://www.healpelvicpain.com/

Schedule Your Pelvic Floor Evaluation Today.

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Introducing Our New Pelvic Floor Therapist

Written by Alex Ariza & Irene Hernandez, PT, DPT

At Park Sports Physical Therapy we are always on the lookout for talented specialists who will be able to help our patients dealing with specific conditions and injuries.

We would like to introduce you all to our newest pelvic floor therapist, Irene Hernandez, DPTPark Slope location – 142 Prospect Park West.

Your pelvic floor plays a major role in controlling urination and bowel movements. For many women, incontinence, or the inability to control the bladder releasing urine, is a common problem, especially after  childbirth. Unfortunately, due to the nature of this condition, many people do not address pelvic floor dysfunction. New mothers, expecting mothers, and men living in Brooklyn will now have access to Pelvic Floor Therapy.

Our Pelvic Floor Therapist can help patients suffering from the following:

  • Pregnancy: pelvic and/or back pain, pubis symphisis dysfunction, swelling and varicosities in legs and genital area
    • Post-partum: treatment of episiotomy and tears, rehabilitation of the strength and function of pelvic floor muscles after child-birth, re-training of the abdominal wall to close diastasis rectus abdominis
  • Bladder dysfunction: incontinence of urine, excessive frequency and / or urgency of urination, painful or difficult urination (start stop, incomplete)>
  • Bowel dysfunction: incontinence of feces or gas, constipation due to tightness and not associated to dietary of GI problems
  • Ongoing pain in your pelvic region, genitals, or rectum.
  • Endometriosis pain: A disorder in which tissue that normally lines the uterus grows outside the uterus.
  • Pain during or after intercourse in male and female: vaginismus, vulvodyinia, vestibulodynia, pain with erection or ejaculation, erectile dysfunction caused by muscle tightness
  • Prolapse of female organs: descend of uterus, bladder or rectum into the vagina
  • Post-opt prostatectomy: rehabilitation of pelvic floor for men

If you want to learn more about pelvic floor therapy and if you would like to know if you need this specialized form of care, please contact us by calling us at (718) 230-1180 or filling out the form below.

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