Hannah is the mom of a 19-month-old boy and works full-time as a manager at a tech company. She loves books and learning, and before having her son, she enjoyed hiking, triathlons, and boot camp classes. She stayed active throughout her pregnancy and was cleared for exercise at six weeks postpartum. Unexpectedly, her bladder prolapsed at eight weeks postpartum. She has been working very consistently through Sarah’s programs with the hope of participating in her favorite activities again soon. Let’s hear some more of her story!
When did you start looking for help with your postpartum recovery online?
I stayed active throughout pregnancy. I ran until about 6 months pregnant when I started feeling pain and separation around the pubic bone. I also attended weightlifting boot camp classes up until the day I went into labor - not that I knew that was going to be the day. It was a terrible idea to do a workout that day, but at least I got a cool photo out of it.
I had a long and difficult labor, and recovery was tough - I had regular pain through my episiotomy site until about six weeks post-birth. I had always relied on exercise as a mental health outlet, so when my doctor cleared me to run again after six weeks I eagerly got back into swimming, boot camp, and short runs. Exercise felt fine at first but at about 8 weeks postpartum, I felt something “pop” during sex, and from then on I had some classic prolapse symptoms nearly constantly: heaviness or pressure, the feeling of having a misplaced or slipping tampon, and urinary urgency, though never incontinence.
When I visited my doctor, she said everything looked normal, but I’m enough of an advocate for myself, and knew my body well enough, to know that wasn’t true. A specialist diagnosed me with bladder prolapse and told me just to do some kegels and it would be fine. I pushed for a referral to physical therapy, but the earliest appointment I could get was a few months away, so I took matters into my own hands and turned to the internet. Among all the fearmongering information, I found Sarah and signed up right away.
How were you feeling after such an unexpected injury?
Emotionally, I went through some of the normal cycles of frustration and sadness about the injury, but I feel lucky to have found Sarah’s programs early. I’ve seen and heard from women in other support groups who initially regarded their prolapse as something that would change their life forever, or something that reflected on their wholeness or worth as a woman, but thanks to Sarah’s expertise and positivity, I’ve been optimistic even on the bad days. I’ve been able to regard my prolapse more like any other sports injury--unfortunate, sure, but nothing to be ashamed of and something to be rehabbed through hard work.
Plus, I’m a researcher by nature, and having so much information at my fingertips helped me know what questions to ask my in-person physical therapist, and helped me continue to advocate for myself when I wasn’t getting the treatment I wanted. (“Just do some kegels” is not sufficient medical advice!)
Physically, aside from my pelvic floor, my body felt fine: my abs were only at a 1.5 finger separation within a week of the birth, breastfeeding was easy for me, and despite not getting enough sleep I was functioning at work. I wasn’t having any leaking and I rapidly dropped to my pre-baby weight. We are only as strong as our weakest links, though, and my pelvic floor was weak and easily exhausted through walking, or even prolonged standing, so I found I had to dial back all physical activity aside from Pelvic Floor Perfect to start rebuilding from the vagina up.
It sounds like the depth of information in the programs is a huge motivator for you. Can you share any big moments in your recovery that have helped you keep moving forward?
If I had to point to one moment, it was a one-on-one consultation with Anna (an expert on the Core Exercise Solutions team) where it took her about thirty seconds to point out an anterior pelvic tilt I wasn’t aware of, and I went from feeling the work in my pelvic floor and quads during a glute bridge to feeling my glutes and hamstrings and (magically) not my pelvic floor.
Mostly, though, instead of big breakthroughs I’ve accrued small insights that add up into one important realization: my prolapse was really a canary in the coal mine for other injuries waiting to happen. While on the surface everything with my body looked and felt fine, my pelvic floor as my weakest link was really telling me that it was time to get serious about my health. In my late 20s and early 30s, prior to pregnancy, I had seen physical therapists for shin splints and neck aches. Sarah’s programs helped me connect all the dots of how my whole kinetic chain was suboptimal, from stiff ankles to head-forward posture to locked knees to anterior pelvic tilt.
It is eye-opening to see how everything is connected! So does this mean you did more than just go through the Pelvic Floor Perfect program?
If I thought I was going to get away with just strengthening my pelvic floor, I was totally wrong. My symptoms of pelvic floor heaviness while sitting or standing didn’t abate until I had been through Posture Perfect and Happy Hips in addition to Pelvic Floor Perfect by about 10 months postpartum. In fact, my symptoms of urinary urgency didn’t abate until after I started a stretching routine for the hip flexors and adductors, and my symptoms of pressure while walking have improved through working on strengthening my lower abs and glutes. I still can’t walk without the slipping-tampon feeling, but based on the work I’ve done in the past year, I know there’s a solution out there that I just haven’t found yet.
You have experienced so much change and progress! I am impressed with your determination - even though it is not a quick fix you keep asking questions to get to the bottom of how you are feeling.
Some days I want to berate myself for how long rehab is taking. Even at 18 months postpartum, faithfully doing my exercises 3-5 times a week, my pelvic floor still dictates how far and how fast I can walk, or how long I can carry my son. Whenever I get down, though, I remind myself how many layers of weakness and malfunction I’m pulling back. While some people use the programs to exclusively rehab the stresses and strains of pregnancy and childbirth, I’ve got at least twenty years of misalignment I’m trying to correct. I remember seeing a chiropractor for a rounded mid-back and head-forward posture as early as middle school. I tell myself that the investments I’m making now are not only going to help me build a super-strong pelvic floor but will also help me stay active and fit as I age.
That increased hope for staying active and healthy in the future is so motivating! Have you noticed things in your routines and work-life that have contributed to that history of misalignment?
Learning more about my body and focusing on the layers I need to correct has also helped me reflect on the root causes of the problems. I spend most of my time sitting at a computer or lying on a couch looking a laptop, so it’s no wonder I end up with aches and pains through my upper traps as they strain to hold up my head. I’m working on sitting less, sitting up straight, and, when I have to sit, sitting on the floor for extra stretching time.
What does your fitness routine look like now?
I’m still hyper-aware of my pelvic floor and prolapse symptoms most days, as I’ve mentioned, but I’ve embraced the mindset that I shouldn’t let prolapse symptoms stop me from exercising altogether - as long as my form is right and the exercise doesn’t increase my symptoms.
Shortly after I completed Pelvic Floor Perfect, I started on MomFit, which I’ve done 3- 4 times a week alongside Happy Hips and Posture Perfect and other tailored rehab work. I’m now on Momfit 8 and am objectively stronger than I was prior to having my son - I can do 5-6 pushups in a row with no cheater muscles kicking in, I can do single-leg squats to a chair without the TRX, and I just recently did a negative pull-up with no assistance for the first time ever!
Wow, MomFit 8! That is some serious progress and commitment!
Yes! Also, once Pelvic Floor Perfect helped me feel confident enough in my form and breathing, I also returned to swimming and biking, and in the last two months since weaning my son I’ve seen significant improvements to my speed and endurance for each. I finally made it to the top of my local 1,500 foot climb on my bike without needing to recruit strength from my core by bearing down, and I’m now officially in the next lane up in my Masters swimming workouts, swimming with the “Sharks” instead of the “Otters”, which wasn’t even the case pre-baby!
That’s awesome! What are your goals going forward?
I like setting goals, so I’m still working on getting back into running. I didn’t pass all of the strength tests for that so I need to work on my ankle and calf stability first. I’d like to walk without pelvic floor symptoms, to do a full pull-up and a full squat with my heels on the ground, and there are still two faster lanes at the pool to aim for - Humpbacks, you’re next!
Even more concretely, I’ve done Momfit 8 six times now so I’m already looking forward to Momfit 9 and whatever crazy things Sarah will have me try next.
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Dr. Sarah Duvall, PT, DPT, CPT and the CES Team have helped thousands of women create the strength and stability needed to overcome common and not-so-common pelvic floor issues.