Below the Waist: The Importance of Pelvic Health


Ten years ago, Rachel Fruchter (pictured at right), a registered nurse from Newton, gave birth to a healthy son. While she had an easy pregnancy, she pushed for nearly three hours before she delivered him by emergency cesarean section. This experience may have been the beginning of the changes to her pelvic floor.

“Pelvic health did not occur to me after giving birth. No one discussed the extent to which giving birth might affect my body.”

She is going public with her story to help other women who experience pelvic health issues after having a baby.
For years after giving birth, Rachel experienced urinary symptoms, pelvic pressure, and discomfort having sex.

“I figured these were normal postpartum sensations and would go away over time.”

Finally, her gynecologist suggested she see a pelvic health therapist — a physical therapist (PT) who is specially trained in helping people resolve issues of the pelvic floor, which include incontinence, constipation, and pain.

“This was helpful. One of the things I received was biofeedback, where tiny electrodes were attached to my bottom that displayed via a computer how my pelvic floor muscles were working. I did exercises at home to strengthen them,” she explains.

After her symptoms improved, Rachel took a break from physical therapy.
Fast-forward to 2018, when Rachel began to experience painful rectal pressure, burning with urination, and feeling like she had a urinary tract infection when she did not. A friend recommended she see Anna Benedix, PT, DPT, WCS, CLT, pelvic health physical therapist at Emerson’s Center for Rehabilitative and Sports Therapies in Westford. With Anna’s expertise and weekly appointments, Rachel’s bladder symptoms have improved significantly — some are gone completely.

“I wish there was more open dialogue about changes that can happen to your body after pregnancy and giving birth,” says Rachel.

“Women don’t have to wait until there is a problem to see a pelvic health physical therapist after childbirth. Being proactive and seeking support and care for your body postpartum can be very beneficial. There is support available and things you can do to help. If women notice any changes, they should ask their doctors as soon as possible about pelvic health therapy. It is not necessary to experience painful symptoms. An experienced pelvic health physical therapist can make a tremendous and positive difference in your life.”

What 25 Million People Experience and Few Talk About

Pelvic health dysfunction is quite common. More than 25 million Americans suffer from some form of pelvic dysfunction, and 80 percent are women. Many women experience symptoms while pregnant or after giving birth. However, symptoms can happen at any age and be unrelated to pregnancy.

While sometimes Kegel exercises can help reduce pelvic issues, they are not always done correctly and are not a solution to many pelvic-related symptoms. According to Anna, the most common symptoms are:

  • Cannot keep it in: involuntary loss of urine when not intending to pee, involuntary loss of gas or stool, a bulge in the vagina or rectum, or abdominal separation after pregnancy
  • Cannot get it out: difficulty passing bowel movements, frequent urination, or difficulty urinating
  • Pain: pain with intercourse, tampon use, or internal exams; tailbone or pelvic pain; pain from C-section or vaginal delivery; vaginal burning/irritation

If you have any of these symptoms, contact your doctor and ask for a referral to a pelvic health physical therapist.

What Happens in the Treatment Room?

During the first visit with a pelvic health physical therapist, the PT will ask for a comprehensive medical history and learn about the patient’s lifestyle. Then the PT typically performs an internal — often with no tools or speculum — and external pelvic exam to understand pelvic floor muscle strength and tension, skeletal alignment, flexibility, and hip and core strength. Because pelvic health is foreign to many people, much of the visit is spent educating the patient.

The PT and patient will discuss an individualized treatment program that may include pelvic floor muscle strengthening or relaxation, biofeedback, stretching, alignment, and mobilization to help support the muscles. The treatment may also include posture and core exercises and behavioral modifications, along with exercises to do regularly at home. Patients typically have a series of appointments over consecutive weeks or months.

Anna encourages people: “Come visit us! We are experienced, friendly, trained professionals committed to helping people live healthy lives. Give pelvic health physical therapy a try — chances are you will be glad you did.”

To request an appointment with a pelvic health therapist, visit Emerson Hospital’s pelvic health home page or call 978-287-3777.

Listen to therapist Rachel Kim, PT, DPT, discusses pelvic pain and pelvic floor dysfunction, including how common these conditions are and treatment options, in this Health Works Here podcast. Never miss an episode! Subscribe to the Health Works Here podcast on iTunes.