Expert Advice: 10 Questions about Pelvic Health with Dr. Beth Henigan PT, DPT, OMPT, PCES

As part of our Expert Spotlight Series, our founder Lauren welcomed Dr. Beth Henigan DPT, OMPT, PCES, the creator of Babies to Barbells, a hybrid program designed to help women with pelvic floor and core dysfunction return to the lifestyle they love.

Dr. Beth is a pelvic floor and orthopedic manual physical therapist who specializes in sport and performance training, and she's also a mom of 2. Her personal experience with C-section and VBAC recovery, high risk pregnancies, and a NICU stay inspired her to move beyond traditional care to better support women’s health through all stages of pelvic health and wellness.

During their chat, Dr. Beth shared some of her expertise on postpartum pelvic floor health and highlighted the need for supportive care, education, and empowerment for mothers to reclaim their bodies and confidence.

We loved learning from Dr. Beth, so today, we're bringing you her responses from 10 questions we asked her. Catch the entire chat on YouTube, or check out 5 highlights from the conversation!

 

 

From OMPT Dreams to Pelvic Health Advocacy: A Journey of Transformation Through Motherhood

1. Can you tell us a little about your background and what inspired you to become a pelvic floor physical therapist? 

If you would have asked me if I saw a future in pelvic health as a new grad, I would have said no. My dream was to become an OMPT and work with a sports team. But after having my own kids, that changed. My first was a preemie, I had an emergency C-section, and my pregnancy had been complicated. 

I was so frustrated with the lack of care after a major surgery. I made my own post-op protocol and just kept thinking that if I, as a PT, am having to do research and learn more, how does the average mom do this? Then with my second pregnancy I thankfully had a VBAC but the recovery was hard in so many other ways: low grade prolapse, tons of tension, and recovery from being deconditioned. I felt better informed as a clinician, but I was so frustrated with my body.

 

Your Pelvic Floor is Part of Your Core

2. How do you explain the importance of pelvic floor health to someone who’s never heard of it before? 

I think the best way to explain it is to highlight that it is part of the core, like literally the bottom of the core. It helps support our body, it controls urine and bowel movements, it's vital for pleasure, and it's a muscle group that is often overlooked or oversimplified but it's one we need to take care of if we want to be active through all stages of life.

 

Daily Habits and Exercises for Pelvic Floor Health

3. What are some simple exercises or habits people can incorporate into their daily routine to improve pelvic floor health? 

There are so so many, like:

• Good posture, especially getting a good stack so the ribs are stacked right over the pelvis and we see a long tall spine
• 360 breathing
• Learning how to relax and contract the pelvic floor
• Hip mobility
• No butt gripping
• Hydration
• Not pushing to pee
• Exhale on the hard parts or when we have a BM

 

How Can Pelvic Floor Therapy Help Throughout Pregnancy, Postpartum, and Beyond?

4. How does pelvic floor therapy benefit women during different life stages, such as pregnancy, postpartum, and menopause? 

For pregnancy, the goal should be to get coordinated but learn to lengthen and create space, as well as know when to modify. When things are a problem in pregnancy, we shouldn't just wait till after to address it. If you are leaking in pregnancy or struggling with prolapse, there's a lot we can do to improve symptoms. 

In the postpartum stage, I don’t know too many people that would not benefit. I wish that at least an evaluation was the standard of care because OB GYNs are great, but they are busy and there are not enough of them. They look at organs but their evaluations aren't looking at each muscle individually or assessing prolapse in multiple positions. They may not understand the training principles of progressive overload or may not have the time to build someone up. They may not be looking at the whole body and how that can contribute to prolapse. Pregnancy makes a million changes in us. We're overwhelmed as new moms, and we could all use a little TLC in PT! 

Menopause is big too. During this time, estrogen levels drop. And we tend to see thinner, more fragile tissues in the vulva and the pelvic floor. Pelvic floor muscles atrophy. A lot of women who might have been well compensated prior to menopause end up with leaking or pelvic organ prolapse symptoms that reemerge or start for the first time. A lot of people are shocked by the pain that can come along with low estrogen and tissue changes. Strength training overall becomes more important in menopause.

 

 

Empowering Moms to Reclaim Their Identity and Autonomy

5. What’s the most rewarding part of your job? 

Giving moms back their sense of self and their confidence. Motherhood is such a transformation, and your role changes so much after the birth of your baby. It's easy to lose yourself, and when you add pelvic floor changes, it can feel like you are forced to give things up. You might be too afraid to go to group fitness because you might leak, too scared to lift heavy because a doctor told you 15lb was your max. I want them to feel like they have the understanding and tools to make smart decisions for their body. Giving them back that autonomy and control is just so huge!

 

Encouragement for Seeking Help with Pelvic Floor Issues

6. What advice would you give to someone who’s hesitant to seek help for pelvic floor issues? 

Go! I think some people can feel intimidated by internal care, but it's ok to say you aren't ready for it. Care is 100% driven by your comfort and consent. And we have seriously seen it all–there's nothing to be embarrassed about. So much of what we do is education, learning how to move again, or habit change. Yes, manual care and stretching and exercise are important, but even going one time and having an evaluation is a good idea; you should walk away feeling like you better understand your anatomy, how your body works, and how to help support it.

 

The Role of Partners in Pelvic Floor Recovery

7. How can partners support someone who is going through pelvic floor therapy? 

This is a good one. Support can come in so many forms. First: creating the space for partners to go to therapy; making sure she has the time to not only go to her appointment, but also to do the work she needs to do at home. 

Second: learn with her. Maybe that means you come to an appointment (if she wants), or maybe that means you listen to her when she recaps what she's learning. Know that if there's a pain component, intimacy comes in many forms and there are some great toys and products that can be great stepping stones to get back to the relationship you both enjoy. Time is huge too. If we are talking postpartum, she needs time to heal (not just 6 weeks). She needs time to herself and time to connect with you. She needs support in her love language so she feels safe. Encourage and advocate, and don't let the barriers that come with motherhood be the reason she doesn't get the care she needs.

 

 

Pelvic Floor Health Matters Throughout All Life's Stages

8. What’s one thing you wish everyone knew about pelvic floor health? 

Also a good one. Probably that pelvic floor dysfunction can show up at any stage of life, even if we are never pregnant. But you can absolutely see improvements in function at all stages too.

 

Yes, There is Hope: Exploring Treatment Options for Pelvic Floor Issues

9. Besides physical therapy, are there other treatments or interventions you often recommend for pelvic floor issues? 

Yes! Love a good pessary, and support garments are amazing. Finding a good urogynecologist can be huge. But I also love to incorporate manual therapy to address movement issues elsewhere, like addressing a stiff upper back and ribs to help restore posture and pressure management postpartum. I love the hybrid program set up I have because I get to have one-on-one therapy appointments but also have moms in a group class to socialize. They have custom programs focused on progressive overload because the basic table exercises only take you so far. We live life in a million different positions, doing a million tasks. We really need to train for that.

 

Important Insights on Pelvic Floor Health and Management

10. Is there anything else you’d like to share with us? 

Yes, a few things that come to mind:

• It’s important to recognize there are things in and out of our control, especially when it comes to prolapse. Things like genetics or our collagen make up can put us at a higher or lower risk and are totally out of our control. 
• How we push during childbirth can impact the likelihood of tearing and prolapse. Trying to avoid “purple pushing” and focusing on relaxing and exhaling is huge. 
• Managing constipation in pregnancy, avoiding straining, and knowing what signs to watch for and when to modify with exercise. 
• Forceps come with a big risk of avulsion and therefore also prolapse. A vacuum may be safer for the pelvic floor but also might not be the right choice for that delivery situation. 
• Knowing when a c-section may even be the right call for some people!

 

Are you a pelvic floor healthcare professional? We’d love for you to be a part of the Hem Support Wear community! Learn more about our resources, including our clinic sample kits, healthcare-focused monthly newsletter, and more. If you’d like to be featured in our Expert Spotlight series, let us know!

 

 

**Medical Disclaimer: This post is intended to provide information and resources only. This post or any of the information contained within should not be used as a substitute for professional diagnosis, treatment, or advice. Always seek the guidance of your qualified healthcare provider with any questions you may have regarding your healthcare, conditions, and recommended treatment.