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pelvic floor physical thereapy

SARA REARDON- Becoming the @thevaginawhisperer

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Today I speak with Dr. Sara Reardon, a doctor of physical therapy and board-certified pelvic floor physical therapist specializing in the treatment of bowel and bladder issues, painful intercourse, pregnancy, postpartum recovery, and menopause. She is the founder of The Vagina Whisperer, an online platform with pelvic floor and core exercise programs for pregnancy, postpartum, painful sex and pelvic floor strengthening.  Sara is passionate about normalizing the conversation around pelvic floor health and increasing awareness of pelvic floor physical therapy as a treatment option to prevent and overcome pelvic health issues.

Sara shares her experiences as a new mom and how being a physical therapist informed those early days. 

We  talk about:

-Pelvic Floor PT

-Postpartum exercises

-preparing for breastfeeding

-listening to your instinct

-slowing downtime postpartum return to exercise

-doing exercise you love

-seasons of motherhood

-having patience with yourself

Time Stamps

1:00 introduction

2:19 experience going through  pregnancy and postpartum

4:43 what she would do differently

10:30 you don’t know what you don’t know

12:10 giving ourselves grace

14:05 Peleton love 

15:30 going through different seasons

21:15 overextending ourselves

30:07 continuing to evolve postpartum

33:10 being the Vagina Whisperer

41:55 Rapid Fire questions

CONNECT WITH CARRIE

IG: https://www.instagram.com/carriepagliano/

Website: https://carriepagliano.com

CONNECT WITH SARA

IG: https://www.instagram.com/the.vagina.whisperer/

Website:  www.thevagwhisperer.com

Free Guide 6 exercises to strengthen your pelvic floor: https://thevagwhisperer.com/strengthening/

The Active Mom Postpartum Podcast is A Real Moms’ Guide to Postpartum for active moms & the postpartum professionals who help them in their journey.

This show has been a long time in the making!

You can expect conversation with moms and postpartum professionals from all aspects of the industry.

If you’re like me, you don’t have a lot of free time (heck, you’re probably listening at 1.5x speed), so theses interviews will be quick hits to get your the pertinent information FAST!

If you love what you hear, share the podcast with a friend and leave us a 5 start rating and review. It helps us become more visible in the search algorithm! (Helps us get seen by more moms that need to hear these stories!!!!)

Listen on Buzzsprout:

is there perfect running form

Should we stop trying to have “perfect form”?

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Can “perfect” running form cause leakage?

Does that question even make sense?!?

Well, hear me out and then decide. 

I was talking to a mom about her experience with a physical therapist she went to see for some hip pain. Her kids are older, so she’s definitely not in the “near postpartum” window. She never experienced any pelvic floor issues, until she tried to follow a running form cue from this physical therapist. 

She tried to “fix” her form and now she has leakage when she runs!

Thankfully, that PT sent her to see me. (See? You ALWAYS need to have a referral system in place when it’s out of your scope!)

I talked to her about her symptoms and when she experienced them, and we were able to determine that trying to change her running form caused her to create more downward pressure. 

We are seeing some new research about professionals being unable to reliably identify which runners are efficient and which aren’t. If we, as professionals, aren’t able to pick out which runners are efficient, should we really be telling people they are running wrong?

If we are trying to change a mom’s running form to be more “efficient”, and in doing so cause them to experience pelvic floor symptoms, is it even worth it?

Has this happened to you, as a provider or a client?

Do you think there is a right way to run or specific cueing?

Do we know as much as we think we do? Do we understand the impact on other symptoms?

pelvic organ prolapse

Does Prolapse Need to be Terrifying?

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It’s talked about the least and feared the most…

PROLAPSE.

When I have conversations with moms about prolapse, the word I hear most frequently is “fear”.

The first time I learned about prolapse was in my very first pelvic health class and the idea that organs could just exit your body…well… my mental image went to that scene in the movie Alien (you know the one). 

Then, SURPRISE! 

After I had my children, I experienced prolapse and prolapse symptoms (even though I had two c-sections and you’re “not supposed to” have prolapse with c-sections. 🙄)

But we don’t talk about it because we’re afraid of it. So, the mystery surrounding prolapse only exacerbates the fear. 

It’s a vicious cycle.  

We were taught as providers that if strengthening exercises didn’t work, then the only way to fix a prolapse was surgery. 

But it’s way more complex than that! 

I’ll be talking more about it here soon. I would love for other providers to share their stories with me.

Tell me about your introduction to prolapse. 

Did you experience it yourself?

How do you address it now?

And moms, what was your experience of care and did it work?

How we perceive prolapse probably plays heavily into our prognosis. 

the secret youre missing

The Key to Postpartum Success

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It’s the time of the year when I really start thinking about transitions and the overwhelm that comes with them.

Summer is ending. New school schedules. Moves to new parts of the country. New jobs. 

It’s bananas, right? It can be so difficult to stick with a routine or a habit through a transitional phase. 

But the secret is consistency and showing up however you can. It doesn’t have to be perfect. You just have to keep showing up.

Sure, there is some trial and error involved (you won’t know it doesn’t work until it doesn’t work). 

Yeah, it’s a little boring sometimes, but it works. It’s allowed me to get in strength training a few days a week. It’s allowed me to get in my Sunday Runday. 

If you need help walking through that, or your current provider just hands you a list of exercises to do and expects you to magically figure out how and when to do them, reach out to me!

This is something I do with my clients to MAKE SURE they have all the tools necessary for success. We sit down and map out every single exercise and when it’s going to happen. We program EXACTLY what they need, no more no less.



supermom or meh

Are Moms Superhuman?

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Well, this was unexpected.

An article just came out in Sport Medicine, where the author investigated the idea of mom athletes not being superhuman…just regular human. 

I asked all of you over on Instagram whether you agreed or not and 75% said “superhuman” and 25% of you said “meh”.

I needed to hear more from the “mehs”.

A lot of you spoke to the double-edged sword that comes with being a “supermom”. 

And I get it. I remember those days of The Hustle being glorified. 

Do ALL of the things. For EVERYONE. All at ONCE!

But I think the tide is finally shifting. We finally have examples of female athletes returning to their sports after having a child, and returning at an incredibly high level. 

And while we ‘re cheering on these mama athletes, all of us know deep down inside what a shit show it has to be for these moms learning how to mom while having to perform at a high level. 

Just because you think I’m supermom, don’t add more to my plate. 

CAn we live in a world where we value our mothers and their performance in other areas, while also NOT expecting them to be perfect all the time?

That’s the challenge. 

And there’s no roadmap. 

WHen you’re trying to navigate life as a new mom, with a new roll, and a new body, you deserve the support to get back to a semblance of yourself without the unattainable expectations of the term “superhuman”,

I would love to hear from you. How do YOU navigate being that ideal with the realities of being a new mom? Especially, if you’re in the first 5 months where you’re still in the weeds. HIT REPLY to this email and let me know!



game changer or deal breaker

Embarrassing Pelvic Floor Moments

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Pee gushing into your sock as you frantically chase your 2 year old across the playground…

With your newborn strapped to your chest & your pooch in hot pursuit?

We’ve all been there!
​​What did it take for you to finally ask for help because you were peeing your pants. Or you felt like your uterus was falling out? Or that your abs were split wide open?

At some point, we all get fed up. 
At the beginning of the pandemic, I was feeling all of the stress and all I wanted to do was go for a run to relieve some of that stress. I got about 200 meters down the road and I had to stop and ask myself if the stress relief was worth the symptoms I was experiencing. 

  • Public bone pain. 
  • ​Urgency with urination. 
  • ​Super tight pelvic floor. 

​
​All of the greatest hits. 

It would have been really easy for me to say “Screw this, I’m out.” But because of my profession, I knew the why behind my symptoms. I knew I needed to get back to my relaxation exercises.

But not everyone is a pelvic floor physical therapist, so not everyone has the luxury of being able to troubleshoot the why behind their symptoms. 

I’ve had so many women come to me with stories of running across the playground with their children and peeing themselves. Or having to know where all the nice bathrooms are along the turnpike. 

What was it for you? What was your worst mom moment? What made you  FINALLY decide to ask for help?


pelvic prolapse confusion

The RIGHT Information from the RIGHT Provider

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This information given to you by your provider is incredibly confusing. 

Let’s back up the truck a minute. 

I was talking to a client who had just had prolapse surgery. And it sounds like she got the same advice she would have gotten if she were postpartum and had prolapse. 

Vague and confusing. Leave her frozen, because she doesn’t want to mess up anything. 

Here is what we know for sure: at 6 weeks, we generally have about 75% soft tissue healing. But what does that actually mean?

Do I…

Go for a swim?

Take a walk?

Light exercise?

None of that is helpful because each of those things can be wildly different for different people.

They are all context dependent. An easy run will be very different if you’re dealing with a former collegiate runner than it will be if you’re talking to someone who hasn’t ran in 10 months. 

As clients, we expect our providers to give us instructions because they are the medical experts! But quatifying “go for an easy run” is NOT their area of expertise. We think they have the exact criteria, but they don’t. This is where you need to seek advice from someone who understands dosing of exercise, progression of exercise, what other issues may be playing into the why behind their symptoms. 

That’s the stuff that’s incredibly important but it’s not your OBGYNs job! That’s my job! 

If you have questions that aren’t being answered by your OBGYN, that’s your cue to find someone who is knowledgeable about the sport you want to return to. 

The confusion comes because you’re asking someone who isn’t an expert in this area. There isn’t a lot of research, just clinical guidance

You have to find a rehabilitation provider who understands the whole picture AND the sport you want to return to.

summer survival guide no more mom huilt

Summer Survival Guide: keep up with your self-care

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“We’re on vacation.” The kids have camp.” “What day is it even?”

Inevitably, during summertime, I get emails saying a mom needs to cancel her appointment because she didn’t get time to do her homework.

NO! DON’T CANCEL! This is the most important time to keep your appointment, when you don’t think you made any progress. This is where we maintain consistency. 

Our families subconsciously try to sabotage us over the summer. And it’s not their fault. Summers are always bananas!

We need to have a survival plan in place so when the train goes off the tracks, we have things we KNOW work for us and we can get to when nothing else will fit. 

My number one irritation with physical therapists is we give moms a list of things to do, and then moms go home thinking that if it doesn’t work, that they are:

-doing it wrong

-they need to do it more

-they need another week to work on it

It’s entirely possible the things we give you won’t work, but we rely on your feedback to make adjustments. We may need to try something different! Doing that thing more probably isn’t the answer. 

One of the biggest barriers is when to do the exercises. We need to find a time that works in real life for a mom to get her work done. It doesn’t matter if it works on paper if it doesn’t work for your life. 

One of my superpowers is that I, too, live the shit show. So I TOTALLY UNDERSTAND when something will not work for you, even if it has worked for dozens of other moms. We can adapt, friends. But if you don’t give feedback that something is not working, then all lose. 

The moral of the story is: shit happens. It’s going to continue to happen. 

So stop banging your head against the wall when things don’t go to plan, ESPECIALLY during the summer when chaos reigns supreme.

Find the things you know work and the times they work for you. If you don’t know what those things are and you haven’t gotten them from you PT, then ASK! And if they tell you to just do it more or they give you a guilt trip, FIRE THEM. 

No more mom guilt. We’re done with that.

Is Overactivity Causing your Prolapse?

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SO MANY FIREWORKS! I feel like this past weekend everyone and their mother was setting off fireworks! 

I was talking to my neighbor about it and I told her I don’t think I’ve ever heard so many people setting off fireworks to celebrate the 4th of July before. She thought maybe it’s always been this way, but I’m just now noticing. 😳

Before I started working with postpartum women all the time, I don’t think I realized just how many women were dealing with leakage and prolapse symptoms. 

We are just now starting to consider overactivity a potential driver of leakage and prolapse symptoms, but it’s probably been there the whole time. We just didn’t notice. 

For the longest time, pelvic floor overactivity (a muscle being on too much) was basically only related to 

-pain with sex

-pain with tampon insertion

-hadn’t had kids yet

Internal exams were really only happening for these patients.

Anyone with leakage or prolapse was getting tested for muscle strength. THAT’S IT.

It’s only been the last 5-ish years we’ve been considering overactivity for leakage and only the last year I’ve been looking at PROLAPSE through the overactivity lens.

Think about it, if you feel like an organ is falling out of your body, you may reflexively be pulling in!

And you’re probably scared out of your mind that something is falling out of your body, so your brain is hypersensitive to that area!

We need to turn the prolapse paradigm on its head! The correlation has probably always been there the whole time, we’re just now paying attention. 

Tell me what you think.

If you have prolapse, have you had this discussion with your  provider?

If you’re a professional, have you considered this? Am I off my rocker?


can i run with a pany liner

Should I Run with a Panty Liner?

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DON’T EVER READ THE COMMENTS!

Okay, maybe sometimes I read the comments. 

A few people sent me an Instagram ad that featured a popular mom Influencer. The ad was for an Always Infinity panyliner. 

I couldn’t help myself! I went to the comments…and was honestly shocked at what I saw. 

Mom after mom was there extolling the virtues of pelvic floor PT. 😱

Boy, have things changed over the last few years!

I won’t lie. I used to be anti-panyliner. But I’ve realized that some people STILL don’t have access to pelvic floor PT and sometimes you just need to do whatever you can in that moment to get out the door for a run and maintain your sanity. 

Something else I saw in the comments was women saying they tried PT and it didn’t work for them. Well, another thing we have, along with more awareness, is more specialization. 

Some women need more specialized care, they need a PT that specializes in working runners. 

Before I commented, I wanted to take a second to let this sink in. So much has changed! 

-the willingness of women to talk about these issues publicly

-hearing these conversations in the context of sport or athletics

-for so many women to be championing pelvic floor PT when just a few years ago, most people didn’t even know what it is.

Many of the comments were upset that she was promoting pads and that pads aren’t the answer.

Maybe not, but they can be a stopgap to helping women stay active while they work on correcting the core issues. 

It’s okay to look back and see how far we’ve come, while still looking forward to see where we are going. 

Let me know what you think. Should we have more moms out there getting paid sponsorship from pad companies? Who should we be cheering on?


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