I am going to be chatting with Marla Maislin, MPT, a pelvic physiotherapist based in the GTA, on Wednesday September 30th at 8:00 pm EST on IGTV (you can find my Instagram page here). We are going to be talking about more than just postpartum pelvic health – there will be a little something for women in every stage and more info on when it is helpful to seek help from a pelvic physiotherapist. Check my Twitter and Instagram for more info as it becomes available.

*Disclaimer: This blog is intended for informational purposes only. The information on this blog should not be used as a substitute to medical advice or medical treatment. As always, your Primary Care Provider, a doctor, or another health professional is your best resource for specific questions and medical advice. If you believe you or a loved one are experiencing a medical emergency, please contact 911.*

The following information comes from a webinar by Marla Maislin, MPT unless otherwise sourced.

I was, in the mean time, lucky enough (once again) to attend a webinar hosted by the Parenting Series where Marla spoke about pelvic health! Usually I share a pretty detailed overview of the webinars I attend, however because I am going to be chatting with Marla myself, I figured I would let her talk since she’s the expert!

I know there is a lot of interest among my readers regarding pelvic physiotherapy – wanting to know what it is, what it involves, and how it can help you in pregnancy, postpartum or just as a woman in general. So I thought I’d give you a little taste – share a few facts about pelvic health & pelvic physiotherapy.

You’ll have to tune in on IGTV on the 30th though to get the details directly from the expert!

Wait.. what is the pelvic floor?!

The pelvic floor is a group of muscles that support our lower abdominal organs such as our bladder, rectum, and uterus (picture a hammock inside your body, stretching across your pelvis…).

These muscles, according to Marla, also assist with stability and posture; control of the organ-associated sphincters; as well as of course, sexual function. Marla put it well when she said they help to “hold things in or let them out”.

They are a part of our core muscles – Marla reminds us that your core is more than just your “abs”. It also includes the pelvic floor muscles, the diaphragm, and the multifidus (some of the muscles of your lower back). Together, your core does many things, one of them being to help control the pressure within the abdomen.

Here is a good video of the anatomy of the pelvic floor if you are having trouble visualizing it.

What happens to the pelvic floor in pregnancy?

The body makes many changes to accommodate pregnancy – there are changes in your rib cage, your back, your linea alba (the fibrous tissue in the centre of your abdomen) and even more changes occur internally to of course your uterus and all the organs surrounding it – among SO many other things. There are whole textbooks and courses based on this stuff – but we’re focusing on the pelvic floor.

As a result of these changes, Marla explains, the muscles of the pelvic floor stretch and diastasic recti (DR) occurs.

Who is pelvic physiotherapy for?

1) Women who had vaginal deliveries.

Did you tear during delivery? Marla says that all vaginal scars should be examined after birth in your postpartum follow ups. Unfortunately, as a result of the pandemic partially, this isn’t happening for many women. A pelvic physiotherapist can help to address any issues you may be having with any vaginal scarring from childbirth.

2) Women who had C-sections.

Wait – pelvic physiotherapy can help women with C-sections too? YES. You still carried a baby and your pelvic floor muscles were stretched, your linea alba stretched. Pelvic physiotherapy can help with that.

It can also help address C-section scars. Marla says that pelvic physiotherapy can help address a wide range of issues with C-section scars such as numbness and tingling, or the appearance of a “shelf” along the scar.

3) Women who have bladder issues – postpartum or not.

Your bladder function is strongly related to your pelvic floor function. If you have incontinence of any kind or bladder pain, urinary urgency or frequency, a pelvic physiotherapist may be able to help you address these issues.

Fun fact: Marla said it’s actually not normal for you to have to go to the bathroom in the night in the postpartum period (whereas it is normal during pregnancy of course). If this is an issue you’re dealing with – you guessed it, pelvic physiotherapy might be able to help.

4) Women who have low back pain.

Again, the pelvic floor is related to the low back since they are both involved in your core function. Pelvic physiotherapy can help to address this – it’s not normal to have consistent low back pain after pregnancy.

5) Women who have an overly tight pelvic floor.

Pelvic physiotherapy isn’t just for those who have stretched floors from pregnancy, but can also help with a variety of issues related to tight pelvic floor muscles such as prolapse, pelvic pain and constipation.

Marla says this group of women should avoid Kegels – since they help to tighten/strengthen the pelvic floor.

Fun fact: she also said that most women do Kegels incorrectly. Pelvic physiotherapy can help teach you how to master this skill and improve your pelvic strength – Kegels can even help you to heal postpartum and are very beneficial to do in the early days, Marla says.

6) Women who have Diastasis Recti.

It’s actually normal, per Marla, to have some degree of DR postpartum – since that is how the body helps to accommodate the growing uterus and baby.

However, Marla says that unresolved or severe DR can cause lots of issues later on – so it is good to have it addressed if you notice you may have it.

7) Women who are experiencing pain during intercourse.

Pain during intercourse, also known as dyspareunia, is not normal according to Marla. She says there are a variety of possible causes including but not limited to a tight pelvic floor; vaginal tears or scar tissue – or even C-section scars; vaginal dryness; PTSD/birth trauma, or fatigue and stress in the postpartum period.

Pelvic physiotherapy has several techniques that can help address this issue, based on the cause, such as stretches for the pelvic floor and trigger point release.

So what can pelvic physiotherapy do for me?

A lot – such as possibly help to address all the issues above! For a full list of the services that Marla offers, see her website here.

I’ll let Marla tell you on September 30th at 8:00 pm EST on IGTV – my Instagram username is @kateontheblog. Check it out!