Pelvic Pain Awareness with Women in Motion

May is National Pelvic Pain Awareness Month, and we reached out to a local mom and founder of Women in Motion Physical Therapy and Wellness. Meet Michelle Little, PT, DPT, OCS. She shares #HERstory of how two miscarriages and the vaginal birth of her rainbow baby gave her a deeper understanding of the many journeys women go on to become a mother, and validated the importance of physical therapy support during and after pregnancy. Make sure to read the full interview to learn why she advises against Kegels and says “sex should never be painful.

HOW HAS GOING THROUGH PREGNANCY CHANGED YOUR PRACTICE? 

My husband and I had two miscarriages before we welcomed our Rainbow baby Mia. Going through 3 pregnancies in a short period of time helped me better understand the mental and physical recovery after two very different losses and vaginal delivery.  My personal experiences helped me to have a deeper understanding of the various components of each individual’s postpartum journey. Many women that seek physical therapy services after a baby are also healing from past surgeries, miscarriages, or even just years of a sedentary lifestyle from work or grad school. 

After Mia was born I also realized that even the best plan of care and program isn’t helpful if it’s not realistic for that patient. I work really hard with my team in making sure that we are meeting each patient where they are and creating a program that fits their lifestyle. 

Overall, I would say my personal experiences have validated that we need more support for women and families during the prenatal and postpartum period and that postpartum isn’t just the 3 months after the baby is born but rather life after baby. 

WHAT IS SOMETHING YOU WISH WOMEN KNEW ABOUT PELVIC HEALTH WHILE PREGNANT:

I tend to see a lot of general advice on social media and education pamphlets for Kegels (pelvic floor contractions) during pregnancy.  However, this is incorrect for a few reasons. Kegels are an isometric contraction, they aren’t functional. This would be like trying to strengthen your hips by squeezing your “butt cheeks” but not working on hip joint mobility, glutes, hamstrings and quad strength, and training the muscles functionally based on that individual’s physical demands. My point is the pelvic floor doesn’t just squeeze; it also needs to relax. In fact, lengthening the pelvic floor is important for peeing, pooping, penetration and having a baby! So, the pendulum doesn’t need to swing to extremes. Pregnant women need to have a well-functioning pelvic floor and this includes: good tone, strength and endurance for pelvic organ support and pelvis/SIJ low back support, and learning to relax the pelvic floor prenatally is very important to have better coordination for pushing babies out. 

WHAT ARE SOME GENERAL PELVIC HEALTH PIECES OF INFORMATION YOU WISH HAD MORE AWARENESS OF?

Clinically I see many women that have suffered from pelvic pain for years. I think it’s important for women to understand that sex should never be painful. There are certain times in our lives when there are physical and hormonal changes that may increase the risk for pain to occur but these are things that can be addressed through pelvic physical therapy.  Understanding the cause of the pain is very important. Pelvic Pain can be a result of muscle spasms, nerve trauma or upregulation as we often see with vulvodynia or vaginismus. Estrogen deficiency (common during lactation or perimenopause) can greatly affect the vaginal wall resulting in friction pain. Lastly, perineal trauma or granulation tissue can often result in painful scar tissue impacting penetration.  If you are having pain with sex, speculum exams or tampon/menstrual cup usage please talk to your provider about the many benefits of Pelvic PT. All of our clinicians at Women In Motion Physical Therapy and Wellness are now also trauma-informed providers. 

Michelle Little is a physical therapist board-certified orthopedic clinical specialist with post-doctorate specialists in orthopedics and pelvic health. She is the founder of Women In Motion Physical Therapy and Wellness. Michelle and her team offer physical therapy and wellness services in our Charlottesville community with a specialty in women’s health through all phases of life. 

Doctor’s Note: 

Along with Women in Motion, Passages Physical Therapy and Physical Therapy at ACAC Charlottesville are also Pelvic Floor Physical Therapy Referrals in Charlottesville we recommend to our patients. 

We recommend checking with your insurance to see who is in-network for your plan. (Some of these practices may not take insurance, or they may provide a superbill for you to submit yourself. Please confirm these details with your insurance before booking an appointment!)