“An Unexpected Journey” My Path to Pelvic Health, Pregnancy, and Postpartum Physical Therapy

Unlike many of my DPT classmates, I was never athletic in my younger years. I participated in many sports as a child, but never excelled and was usually on the bench for games. I always liked the idea of being active, athletic, and “healthy”, but never found something that I clicked with. Luckily, I discovered an interest in yoga my freshman year in college—I enjoyed the non-competitive nature, the focus on introspection, and the warm community environment. This interest transformed into a multitude of other modalities including cycling, running, martial arts, and weightlifting. Eventually, I followed the call to help others (like most people in healthcare) and share my knowledge so I became a yoga instructor, personal trainer, and am on the way to becoming a physical therapist! I developed an interest in pelvic, pregnant, and postpartum physical therapy while working as a yoga instructor and hearing many of the prenatal student’s frustration with the lack of information they were receiving and how generalized their medical care seemed to be. They voiced concerns about the too-short visits they had with their provider and the conflicting information they received from various sources. They felt they weren’t getting the proper care they needed, and I saw a place for physical therapists to serve as a trusted, evidence-based information source, holistic healthcare practitioners, and a confidante. I think physical therapists are in a unique position to provide individualized, one-on-one care to pregnant and postpartum individuals that can help them throughout this life-changing process.

I recently had the opportunity to take APTA Pelvic Health’s OBF course and learned a great deal about the physiological changes the pregnant and postpartum person undergoes, as well as how physical therapy fits into the pre-habilitation and rehabilitation of the pregnant person. I also was able to clarify so much information that had previously been confusing. For example, I had previously learned that postpartum people with a diastasis recti abdominis (DRA) should not, under any circumstances, perform a plank or do abdominal curl-ups (aka a “crunch”). I took this information at face value and never investigated the literature as the message had been repeated over and over to me across various courses and training. The reasoning behind this was that, in theory, the tension created on the DRA in these exercises would make it worse, instead of improving it. In the course, we were treated to an hour-long lecture on DRA, including potential impairments related to DRA, how to measure it, other surgical interventions, and physical activity/exercise guidelines to help treat DRA. To my surprise, the studies cited in the lecture on exercise for DRA frequently included an abdominal curl-up and/or a plank with good results! Of course, careful consideration and clinical judgment should be taken with each intervention chosen and everybody is different. But, with this new information, I can now implement more abdominal strengthening exercises with patients and clients with greater discretion and provide more individualized care.

Author: Audrey Brown

November 2022 Course Scholarship recipient

Author Bio: Audrey is a 3rd year DPT student at Drexel University in Philadelphia, PA. She is honored to be chosen as a scholarship recipient by the Academy of Pelvic Health to further her education in treating pelvic health, and pregnant and postpartum populations.