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Tips & Techniques to Get You Back to Full Strength

P is for Prevention (not Pee)

Ashley Dougvillo 
November 22, 2021

Did you know that pelvic floor physical therapy was a thing? It sure is, and it is a discipline that I hope continues to gain some traction in the world. The stats for pelvic floor dysfunction are high with approximately 25-45% of women suffering from urinary incontinence.  However, if we as a community were to continue to support the PREVENTION piece, we would see an overall shift in quality of life for women.

First off, let’s focus on pregnancy and postpartum.  Throughout pregnancy there is an increase in weight that is loading the pelvic floor as baby continues to grow.  Everyone starts pregnancy with a different pelvic floor - maybe some individuals have weakness, some individuals have a lot of tone or tightness, and some individuals are starting with no dysfunction.  Many women are asymptomatic regardless of their presentation which is just something to consider.  (However, if you have a past history of incontinence with activities or increased urgency with urination, I would highly suggest reaching out to a pelvic floor PT as part of your prepartum planning process.)

Now we have successfully had our wonderful new baby.  This is where the real change needs to begin.  Standard of care should be for at least one session with a pelvic floor therapist when cleared by your OB/GYN or midwife.  Your pelvic floor, regardless of method of delivery, has undergone a change.  Let’s look at a quick comparison here.  A 30-year-old tears their rotator cuff muscle and receives surgery where they reattach the tendon to the head of the humerus (shoulder).  Typically, they start their recovery in a sling and then slowly over anywhere from 4-6 months they rehab.  During this time, pending the physical nature of their jobs, they are off work.  Now let us switch gears, a woman has a vaginal delivery in which her muscles may have undergone extreme change, tearing, stitching, etc. and at approximately 6 weeks this same individual may be released back to all their prior activities.  I hope we can see the discrepancy here.

There must be a shift at some level, and my goal is to get the word out that pelvic floor PT is an option to help women get on the path to recovery.  I see so many women who have been struggling with incontinence (or other pelvic floor dysfunction) since their children were born 30+ years ago.  I feel confident in saying that if they had received intervention at an earlier stage, they would have PREVENTED the severity of their dysfunction and improved their overall quality of life.  The great thing is - you don’t need a referral to get this started, and you can get started regardless of what stage of life you are currently in.  In most states physical therapy is direct access, meaning you can reach out to a provider and set up your appointment without a doctor’s referral.  Let’s all continue to work toward keeping the focus on “P” being for PREVENTION and not for pee.




Meet the Author
Ashley Dougvillo joined Smith Physical Therapy and Running Academy in 2019. She graduated from Marquette University in Milwaukee, WI in 2008, receiving her Bachelor of Science degree with a concentration in Biomedical Sciences. She then went on to attend Northwestern University in Chicago, IL to complete her Doctorate of Physical Therapy in 2010. She is a Certified Manual Therapist and has additionally obtained specialty certifications in the Pose Method of running, kinesiotaping, FMS/SFMA, ASTYM, and Women's Health.