This is a new one for us! We’ve had physical therapists (PTs) as podcast guests before, in the context of children. But today, we’re talking with our guest, Jenny Archer, a PT who specializes in the pelvic floor.
You were referred to us by our doula friend, Sarah Perry (who’s been a repeat guest on our podcast) and has used your services herself!
I was only recently introduced to the existence of pelvic floor PT by my daughter, who’s due with our first grandbaby any day now. She’s been telling me about her prenatal visits to a pelvic floor PT in South Carolina, and of course …. I had questions!
Today, Jenny Archer’s going to answer some of those for us—and maybe for you, if this is a new field for you as well. Jenny’s the owner of Archer Physical Therapy in Nashville, TN.
Welcome Jenny! Introduce yourself. (where you’re from, married with kiddos, how long you’ve been doing this work)
(also, content: going to be using some anatomical terms pretty freely in this episode, so if that weirds you out or if you don’t want little ears listening, this is fair warning!)
How did you get started in this field? (your story, education)
Maybe we should start with a definition of the pelvic floor?
The pelvic floor muscles span the bottom of the pelvis (between the tailbone and pubic bone) and support the pelvic organs (bladder and bowel, and uterus).
Symptoms of a Weak Pelvic Floor? What might lead someone to your office?
- leaking urine when coughing, sneezing, laughing or running
- failing to reach the toilet in time
- passing wind from either the anus or vagina when bending over or lifting
- reduced sensation in the vagina
- tampons that dislodge or fall out
- a distinct bulge at the vaginal opening
- a sensation of heaviness in the vagina
- a heaviness or dragging in the pelvis or back
- recurrent urinary tract infections, or recurrent thrush
- vulval pain, pain with sex, inability to orgasm.
The pelvic floor can be weakened by:
- supporting the weight of the uterus during pregnancy
- vaginal childbirth, which may overstretch the muscles
- the pressure of obesity
- chronic constipation and straining to poo
- constant coughing
- some forms of surgery that require cutting the muscles (including prostate cancer treatment in males)
- lower levels of estrogen after menopause
- pelvic floor muscle tension caused by painful periods, endometriosis.
Just looking at some of these symptoms, I know there are probably many women suffering in silence, feeling embarrassed, ashamed or defective—when these are actually very COMMON situations. (Common does not equal normal.)
What a relief your patients must experience when you’re able to help them!
PREGNANCY
Prevention is always better than remediation, IMHO. We know pregnancy can do a number on your body.
So, give us a run-down of what your team might do for prenatal visits.
Bump to Birth: Alignment, posture correction, kegel guidance, push practice, perineal massage
When’s a good time to start? Around 20 wks.
POST-PARTUM
Fresh to 6: Feeding Posture, Bowel & Bladder screen, kegels and core, breath training, lift & carry, pain assessment
What if you didn’t do the pregnancy work and now you’ve had your 2nd or 3rd child and things down south aren’t what they used to be? Is it too late? Never too late. Can address C-section issues with women 30 years after the procedure!
What happens at a visit? Is it invasive? (You do have telehealth options, so I suppose that couldn’t involve hands-on exams, etc.) Can be some internal but not always. Depends on the issue!
I noticed you also provide dry needling? What is that and why/when would you use it?
Switching gears, how do you help children with bed wetting or constipation? What ages are we talking here? Archer PT focuses on ages 5+ but pediatric pelvic floor PTs can work with kids under 5. Bed wetting is considered a symptom of constipation unless proven otherwise via xray. With children, no internal work is done. It’s all manipulation and exercises with pelvis, abdominals, and gluts. This is typical with Type A, high-strung or anxious kids who tend to hold their breath and artificially hold their muscles tightly.