
The Femina Physical Therapy Blog
Featuring original articles by our staff about current events and trends
Explore our insightful blog articles on pelvic health, where we delve into essential topics that empower and educate. From understanding pelvic floor disorders to strategies for conquering infertility, our content is designed for those seeking knowledge and support. We discuss the latest research, expert advice, and practical tips to enhance your well-being and foster a deeper connection to your body.
Featured From the Blog:
Why a Multidisciplinary Team is Best for Treatment of Bloating and Abdominal Distension

Bloating and Abdominal Distension Often Benefit Greatly from Multidisciplinary Treatment
Bloating, abdominal distension, loose stools, constipation, abdominal or pelvic pain, fatigue, brain fog, weakness, nutritional deficiencies…
These symptoms may be caused by a variety of gastrointestinal or pelvic conditions. If you are experiencing any of these symptoms, this article is a good place to start when deciding who to have on your care team, and what treatments can help!
Bloating is the sensation of excess abdominal gas or a feeling of being distended without obvious visible abdominal distension. Some people have a feeling of fullness or discomfort in the upper abdominal area. Abdominal distension is the visible increase in abdominal girth. A multidisciplinary treatment team of primary care physicians (PCPs), gastroenterologists, dieticians/ nutritionists, and physical therapists is ideal to help manage these symptoms and find the root cause. For example, symptoms of bloating and abdominal distension affect 66 - 90% diagnosed with IBS. Getting the proper diagnosis can help direct the best treatment options for you.
Read more: Why a Multidisciplinary Team is Best for Treatment of...
Restorative 20 Minute Home Yoga Practice For Chronic Pelvic Pain

Yoga Practice For Chronic Pelvic Pain Can Be a Very Helpful Routine
As stated in my last blog post, yoga can be so beneficial as a pain management tool due to its ability to modulate the sympathetic nervous system3,4 which plays a large role in chronic pain. The exact mechanism of how yoga helps with chronic pain is still being studied, however, it is reasonable to believe the full body relaxation promoted by a yoga practice helps to decrease tension in key muscle groups- including the hips and pelvic floor which are often tight in people with chronic pelvic pain.
Currently, evidence has mostly focused on one hour long practices as an intervention, although there are some studies that report improvements in pain with shorter practices, such as the routine below. As with any mobility/stretching routine, benefits will be seen with more frequent practice, however even twice weekly can help decrease pain.
Read more: Restorative 20 Minute Home Yoga Practice For Chronic...
Understanding Relaxin: Why It Doesn’t Cause Pain in Pregnancy

Pregnancy is a time of significant physical and hormonal changes, and among the many hormones involved, Relaxin plays a crucial role. However, there’s a common misconception that Relaxin is responsible for pain during pregnancy. Let’s take a closer look at what Relaxin does and why it doesn’t directly cause pain.
What is Relaxin?
Relaxin is a regulatory hormone involved in growth, metabolism, and tissue remodeling after an injury to our bones, ligaments, muscles or tendons (Dehghan 2014). During pregnancy, Relaxin levels begin to increase in the first trimester to help the body prepare for childbirth by relaxing the ligaments in the pelvis and softening the cervix (Aldabe 2012, Daneau 2014). The ligaments of the pelvis will begin to relax around the 10th-12th week of pregnancy (Aldabe 2012). This process allows for greater flexibility in the pelvic area, facilitating delivery and accommodating the growing baby.
Read more: Understanding Relaxin: Why It Doesn’t Cause Pain in...
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It’s that time of year when many of us are considering a diet change as a New Year’s Resolution. But with all of the wildly different diets out there, don’t let your new diet affect your pelvic floor health negatively.
Avoid Constipation
Constipation can contribute to pelvic pain, risk of prolapse, back pain, and pain with sex, among other issues.
As we’ve written about on this blog before, managing constipation is one of the cornerstones for maintaining pelvic health, especially if you suffer from pelvic pain, prolapse, or pain with sex. Constipation will lead to storage of old stool in the colon, which can contribute to pelvic, abdominal, and back pain. This added pressure can lead to pelvic floor tension and contribute to issues like pelvic pain and pelvic floor spasms. Last, but not least, constipation leads to straining on the toilet, which greatly increases your risk for issues like pelvic organ prolapse (read more about prolapse in this previous post).
Read more: Don’t let your New Year’s Diet Hurt your Pelvic Health
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Communicating with your partner about your sexuality may reduce your pelvic pain and increase your sexual function.
A 2016 study by McNicoll et al. suggests that Sexual Assertiveness, or the ability to communicate openly to your partner about your sexual experience, may reduce the pain experienced with provoked vestibulodynia (PVD), increase sexual function, and encourage your partner to communicate you in ways that help boost your sexual health.
How Sexual Assertiveness May Reduce Your Pain
Pelvic pain and pain with sex may come from several different avenues, including vaginismus, vulvodynia, vestibulodynia, endometriosis, or tissue changes caused by menopause. The 2016 study by McNicoll et al. specifically worked with women with provoked vestibulodynia.
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What can a mother do to prepare her pelvic floor for pregnancy and childbirth?
First, you might be asking yourself “what is the pelvic floor”?
The pelvic floor is a group of muscles inside the pelvis that form a hammock from your pubic bone to your tailbone and from sit bone to sit bone on the sides. The function of these muscles are to stabilize your pelvis and spine, support your organs (bowel, bladder and uterus) and maintain continence. In pregnancy and childbirth, these muscles go through a lot of changes. The goal of this article is to try and achieve optimal pelvic floor function throughout pregnancy and after.
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Mommy tummy aka diastasis recti abdominis (DRA) is a prevalent issue.
One in three American moms have DRA that persists greater than a year.
So what is a diastasis recti? It is the stretching of the linea alba, a connective tissue that runs down the midline of the abdomen and connects the abdominal muscles. The stretching happens during pregnancy in almost 100% of mothers to make room for a growing baby. Many of these moms are told this is a normal part of pregnancy, even by their healthcare providers.
DRA is not just about appearance, it is also connected to pelvic floor dysfunctions as well as pelvic and low back pain. In a study by Kari Bo et al., they found that mothers in the US with DRA were also more likely to have the following:
Read more: Mommy Tummy - Not Something You Have to Just Live With
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Involuntary loss of urine during athletics is more common than you thought
Athletic incontinence is a type of stress incontinence that happens during an athletic event. Stress incontinence is an involuntary loss of urine due to a pressure or force like coughing, sneezing or jumping. When most people think of urinary incontinence they do not usually picture young athletes, however it is surprisingly common.
A study of young, elite athletes found 43% experienced urinary leakage while participating in their sport. The study also investigated which sports had higher incidences of incontinence:
Read more: Pelvic Floor Physical Therapy for Athletic Incontinence
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What studies say about returning to running as postpartum exercise
Most of the therapists in our office are moms, and we intimately understand wanting to get back to exercise after delivery. Caution should be taken when returning to running postpartum - we see this clinically and research also shows postpartum movement strategy changes that can increase your risk of injury.
A recent pilot study by Provenzano et al., 2019 compared the biomechanical changes of runners pre-pregnancy (or <14 weeks gestation and postpartum). They found at six weeks postpartum subjects had decreased trunk and pelvic rotation, decreased running speed, with increased step width and stance time compared to pre pregnancy measurements. They also found decreased motion in the hips with increased motion at the knee as a compensation.
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Laxity in Pregnancy is what may be causing you those aches and pains
The Role of the Relaxin Hormone
As discussed previously on the blog, pregnant people undergo some major changes in their bodies, including producing different hormones that play various roles during pregnancy. One hormone that affects the musculoskeletal system in a pregnant person’s body is called relaxin.
Relaxin is a hormone produced by the corpus luteum (an endocrine gland made in the ovary when a follicle has matured and released an egg during ovulation) and the placenta (an organ developed in the uterus during pregnancy that provides oxygen and nutrients to your baby). Relaxin inhibits uterine activity and helps relax the pelvic joints so your hips can widen in preparation for birth. Relaxin peaks during the first trimester. However, relaxin can also contribute to laxity in other areas of the body during pregnancy, not just the pelvis.
Read more: Joint Laxity and Pregnancy | What is it and What can you...
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- Written by: Heather Jeffcoat, DPT
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There really is an app for everything… even pelvic floor exercises!
And research proves supervised pelvic floor home exercise programs can reduce treatment time and result in significant improvement over in-office therapy alone.
So why don’t all my patients have pelvic floor apps? Especially at the beginning of treatment, those exercises can be difficult enough to squeeze into a daily schedule without the added anxiety of scrolling through hundreds of options to find an affordable and reliable one; and no one wants to base sensitive healthcare decisions on anonymous user reviews.
Wouldn’t it be great if a medical expert could cut through all the clutter?
Read more: There’s An App For That? Medical Pros Rank Top SmartPhone...