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Mommy & Me Yoga Got Me Out the Door. It Is Not a Return-to-Run Program

Mommy & Me Yoga Got Me Out the Door. It Is Not a Return-to-Run Program

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Here’s what your running-informed pelvic floor PT wants you to know before you hit the road.

Let Me Be Clear: This Is Not a Hit Piece on Yoga

I love mommy and me yoga. I really do. Back in 2011, with my first son, there was a Wednesday 11:30am class at a local studio that felt like the holy grail of early postpartum life. Getting there required military-level logistics: timing vaccinations, navigating unreliable naps, figuring out nursing in public, clearing a C-section recovery timeline that told us nothing was allowed until 6–12 weeks postpartum.

But I showed up. And it was less downward dog and more baby-wrangling, nursing on the mat, and the awkward first phases of what I now call “mom dating” — feeling out whether you could really be friends with these women after you got past the breastfeeding, cloth diaper, and sleep training conversations.

One of those moms moved away. One friendship faded when the boys stopped getting along as they got older. And one of those families? They’re still our family friends. Our boys, now 15, are still friendly. So are the little sisters. And the dads. I credit that class with keeping me sane in early motherhood and my longest mom friendship. I wouldn’t trade any of it for the world.

What I cannot credit it with is preparing my body to run again.

What Mommy & Me Yoga Actually Gives You

Let’s be honest about what that class was — and wasn’t — doing:

  • Community and socialization at a moment when isolation is real.
  • Mental health support — getting out of the house is genuinely therapeutic.
  • Some gentle movement — a starting point, not a destination.
  • Mom dating opportunities (which are underrated and essential).

What it was not giving me: progressive loading, single-leg strength work, impact preparation, intra-abdominal pressure management, or anything resembling the components of a return-to-run readiness screen.

Did I run anyway? You betcha. Lots of walking first, then stroller runs, and eventually a postpartum 10K at 7 months. Did I do it with any kind of systematic prep? Absolutely not. Because back then, we didn’t know better. We just handed women kegels and told them to wait.

Here’s What Running Actually Demands

Running is not just “moving your legs faster than a walk.” It’s a high-impact, high-pressure, single-leg sport. Every stride asks your body for:

  • Single-leg loading and stability
  • Significant intra-abdominal pressure management
  • Hip and glute strength to absorb ground reaction forces
  • Core coordination — not just strength, but timing
  • Pelvic floor load tolerance — repeat, progressive, dynamic

A gentle yoga class — even a great one — doesn’t build those capacities. It can lay groundwork, but it cannot be the only step if running is your goal.

What I’d Do Differently — And What I Tell My Patients To Do

If I were doing it over again with the knowledge I have now, here’s what I’d change:

  1. Don’t skip the Mommy and Me Yoga. They’re in there for a reason. Go. Even if the baby is fussy.
  2. Add targeted exercises at home. Tummy time is a perfect opportunity — your baby is on the floor, you’re on the floor. Drop into a plank. Add some glute bridges. It just needs to be the intention of building consistency.
  3. Complete a return-to-run readiness screen. Find your gaps. Pick three exercises that target those gaps. (Worth noting: this concept didn’t even exist until circa 2019). Build consistency, coordination, and strength.
  4. Use a walk-run program intentionally. Not “run or nothing.” The gradual approach isn’t weakness; it’s strategy.
  5. Don’t rush to reclaim your former self. I know you’re scared of losing your identity. But who you’re becoming is so much more than who you were.
  6. Date around a little. If you’re in the DC area, try local resources like SLAM, Fit4Moms, and Mind the Mat. The community piece of postpartum recovery is not a luxury — it’s part of the prescription.

The Bottom Line

Something is better than nothing. But know what you’re getting from each “something.”

Mommy and me yoga is beautiful for community and mental health. It is not a substitute for run-specific preparation. Make sure your actions match the goals you’re setting for yourself. If running is what you’re working toward, build a plan that actually accounts for what running demands.

Were you ever told a single class or activity was “enough” to return to running postpartum? Drop it in the comments — I’d love to hear your story.

When “It Sounds Right” Isn’t the Same as Being Right

When “It Sounds Right” Isn’t the Same as Being Right

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Why this kind of pelvic floor advice pulls you in—and why it doesn’t hold up

I saw a video today that made me stop scrolling. And if you know me, you know I usually don’t stop. I keep it moving—because the second I pause, I can feel myself getting irritated.

Not just because of the misinformation, but because it was packaged just well enough to take off. It wasn’t wildly wrong or dangerous in an obvious way. It was just… convincing enough to make you think: “Wait—should I be doing that?”

The kind of post that blows up for a reason

Here was the gist: A postpartum mom with multiple kids and zero symptoms gave a full breakdown of how she “supported” her pelvic floor:

  • Right-sided pelvic floor overactivity
  • Targeted inner thigh stretching
  • Internal release work with a wand
  • Side-specific strength and “pelvic balance” strategies

She has a Grade 2 prolapse, no symptoms, runs marathons, and lifts heavy. The post had hundreds of likes and shares. And somewhere, a mom is watching this thinking, “Okay… so what am I doing wrong?”

Throwing around words that sound smart but say nothing

I actually understand why this lands. When you’re dealing with leakage or pressure, you want a plan and a reason. This content uses just enough medical language to sound legit.

But let’s look at the phrasing: “Right anterior pelvic floor overactivity” or “Pelvic balance.” I’ve been hearing and using words like this for over 30 years. It’s basic directional terminology from PT 101. When you string them together, they sound like a breakthrough, but they don’t actually provide clear, measurable, or useful guidance. If I asked 10 clinicians to define “pelvic balance,” you’d get 15 different answers.

The right-side vs. left-side trap

This is where we go off the rails. We do not have evidence that:

  1. Most people have a dominant “overactive” side of the pelvic floor.
  2. Organ asymmetry drives predictable pelvic floor patterns.

We all have asymmetrical organs (unless you have two hearts—if so, call me). We are still debating what “tone” even is and whether we can reliably assess it with a finger on a muscle. Building an entire “fix” strategy off of that is a major stretch.

The hook: “She doesn’t have symptoms”

The natural leap is: “If I do what she did, I’ll get her result.” Except we have no idea what her baseline was, her genetics, her connective tissue profile, or her medical history. The definition of prolapse has shifted—it’s not just anatomy; it’s anatomy plus symptoms. Grade 1–2 prolapse can exist in people who have never had kids and have zero symptoms.

We don’t know if anything she did actually “prevented” symptoms or if that is just how her body presents.

Pelvic floor symptoms are a unique recipe

Pelvic floor symptoms don’t come from one variable. They come from a recipe of:

  • Load and capacity
  • Hormones
  • Sleep and stress
  • Medical and birth history
  • Genetics (and yes, your poop matters, too)

It’s not one stretch or “fixing” your right side.

What’s actually worth taking from this?

  • A multimodal approach makes sense.
  • Staying active matters.
  • You can have anatomical prolapse and feel completely fine.

If you followed my personal story step-by-step, there is zero guarantee it would work for you because bodies aren’t templates. Don’t expect to find the answers to your problems in mine. You’ll just end up throwing darts at a board hoping they stick.

You didn’t do anything wrong

If you have symptoms, it isn’t because you picked the wrong exercise or failed to “balance” your pelvis. Sometimes it’s just the roll of the dice—genetics and birth history.

You aren’t stuck or broken, but you do need a different question. Instead of asking “What did she do?” try asking “What is my body telling me—and how do I work with that?”

Just because someone sounds smart doesn’t mean they are. And just because they don’t have symptoms doesn’t mean they hold the answer to yours.

Postpartum Return to Running Is Not a Checklist (And We Need to Stop Pretending It Is)

Postpartum Return to Running Is Not a Checklist (And We Need to Stop Pretending It Is)

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Readiness to run postpartum has come a long way. And honestly? That part is really exciting.

Because not that long ago… there was no guidance. No conversation. No real support for women who wanted to get back to running after having a baby.

But now? We’ve swung hard in the other direction. Now there’s guidance everywhere. And not all of it is good. Because at this point? EVERYBODY and their mother—(or just-became-a-mother with a Canva account and an uncomplicated postpartum)—has a marketing lead magnet disguised as a postpartum return-to-run guide.

I have zero issue with marketing. I use it, too. But the problem starts when a 1–2 page PDF is supposed to tell a postpartum mom: “Yep. You’re ready to run.”

The Problem Isn’t the Marketing. It’s the Message.

I downloaded one recently: “5 signs your postpartum core is ready to run.” I was curious because we don’t actually have an evidence-based, standardized way to determine if your “core is ready to run” postpartum.

Even the 2019 UK guidelines—which are a helpful starting point—aren’t fully validated for postpartum yet. Before that, we used basic screens that included:

  • Double-leg hopping
  • Planks
  • Step-ups
  • Single-leg squats
  • Wall sits

It was a start, and it included impact, but it wasn’t the whole picture.

Breaking Down the Flawed “Signs”

Let’s look at what some of these guides actually suggest:

1. “You can breathe through movement without bracing” Running is not a squat. It’s reflexive and anticipatory. You don’t get to “prepare your breath” the same way when your feet are hitting the pavement. This “sign” simplifies physiology to a point where it no longer makes sense for running.

2. “10 single-leg calf raises with zero leaking” Calf raises tell me about your calf endurance (and usually you need 25-35 reps, not 10). They tell me almost nothing about how your pelvic floor handles the high-velocity impact of running.

3. “Your core connects before your limbs move” This is often tested by standing on one leg for 10 seconds. In reality, a wobble could be ankle instability or vestibular changes from pregnancy—not a lack of “core connection.”

4. “You can walk 30+ minutes symptom-free” This is a great baseline prerequisite. It shows you can tolerate low-level load. But walking is not running. Stroller walking and baby carrier walking are also completely different loads.

5. “You feel strong and confident” While nice, most early postpartum moms are sleep-deprived and in a hormone fog. I’d rather see a foundation of strength and core work 2–3x/week. Running alone isn’t enough; we need to stop treating moms like they are fragile and instead help them build durability.

When the Running Program Falls Apart

This is where things usually say, “Tell me you’re not a runner without telling me you’re not a runner.” I see 4-week progressions that increase running volume by 50% or 60% in a single week.

Standard training usually suggests a 10% increase. These guides stack more running, less recovery, and changing total times all at once. That’s a stress spike, not a progression.

A Smarter Way to Progress

Instead of changing every variable, I manipulate one variable at a time. Total time stays the same while we shift the ratios:

  • 1:4 (Run:Walk)
  • 2:3
  • 3:2
  • 4:1
  • 5:0 (Continuous)

Repeat each stage 2–3 times. If symptoms show up, they aren’t a failure—they are information. We adjust, find an in-between ratio, and keep going with a plan rather than just “pushing through” or “starting over.”

Run Readiness Is Not a Checklist

I’ve been a PT for 27+ years and a runner for 43. This isn’t theoretical; it’s lived. After hundreds of conversations with researchers and elite athletes on the Active Mom Podcast, I’ve landed here:

It depends. It depends on your genetics, your delivery, your sleep, your support, and your strength.

What I Actually Recommend

  1. Foundations First: Sleep, fueling, and mental health.
  2. Walk Tolerance: 30–40 minutes with minimal symptoms.
  3. Real Screening: Testing balance, strength, and impact tolerance.
  4. Phased Approach: Moving from return to activity → exercise → participation → sport.

A 5-question checklist isn’t enough. Learning to pay attention to your body and following an adaptive plan is a much better place to start.

You’re Not Broken. You’re Just Running on 2019 Information

You’re Not Broken. You’re Just Running on 2011 Information.

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Why pelvic floor physical therapy for leakage, prolapse, and perimenopause looks very different in 2026 (and what that means for active women)

I love seeing repeat patients.

Not because something went wrong.

But because life happened.

Another pregnancy.

Kids are older and suddenly you have 45 minutes to yourself again.

You’re diving headfirst into perimenopause and wondering why your body feels… different.

Or maybe three years ago there was a lot to do and pelvic floor PT slid quietly off the priority wagon.

Recently, I was lucky enough to see a woman I’d treated three years ago. The goal was to get back to herself again, and one of my favorite parts of this job is helping women return to their recreational sport — soccer, ultimate, curling (yes, really), sword fighting (also really), a 5K fun run. That said, life got to life-ing and after a few visits, it wasn’t the right time to keep coming.

Getting back to the thing that makes you feel like yourself again? That’s not small.

That’s identity.

Not being able to be yourself? We shouldn’t have to give up on that, no matter how many grenades life throws at us.

The Pelvic Floor Isn’t a Block of Concrete

Here’s some fun stuff that happened in the meantime since I first saw that patient…

There’s A LOT we’ve misunderstood for a long time about the pelvic floor.

We’ve hyper-focused on the pelvic floor muscles — strength, kegels, squeeze harder, hold longer.

But structurally and functionally, your pelvic floor works with:

  • Fascia
  • Ligaments
  • The vaginal wall
  • Connective tissue support systems

Together, they create dynamic support to maintain continence and organ support.

It’s actually a simple pressure equation:

  1. If pressure below > pressure above → usually no symptoms
  2. If pressure above > pressure below → leakage or pelvic pressure

That’s it.

But here’s where it gets interesting.

In 2024, Marie-Ève Bérubé and colleagues published research showing that after a run:

  • The levator hiatus (the opening) is larger
  • The bladder neck sits lower
  • The levator plate length is longer (aka the pelvic floor)

And this happened in runners with and without running-induced stress urinary incontinence.

Translation?

Your pelvic floor changes shape after running.

That’s normal.

It’s not supposed to function like a brick. It’s meant to be dynamic.

So when someone tells you to “just kegel before you jump,” it tells me they don’t understand how the pelvic floor actually works.

When you run or jump, your brain anticipates the impact and automatically activates your system. Mid-air, it decreases activation. On landing, it increases again.

You cannot consciously time that and you sure as hell can’t think that fast.

Anyone suggesting you can is asking your brain to override a anticipatory activation and reflex loop that fires faster than you can think.

Sometimes It’s Not About Strength. It’s About Support.

With this returning patient, we knew there were coordination and timing issues. Impact activities like hopping reliably caused leakage. We KNEW strength wasn’t the issue so kegels weren’t on the menu.

So we tried something that wasn’t even part of my skillset three years ago.

A pessary.

Think of it as an orthotic for your pelvis.

Before fitting, I had her hop in place.

Five or six hops in? Leak.

I assessed her pelvic floor, measured for a simple ring pessary, checked the fit, and had her try again.

She stopped at 30 hops…because she was tired…NO LEAKS!

We removed it to confirm.

Five hops.

Leak.

Sometimes clinical reasoning really is that clear. She didn’t have enough support or coordination. We added support, it was enough to address the symptoms.

Now the plan is straightforward:

  • Order her personal pessary
  • Ensure she can insert and remove it independently
  • Add vaginal estrogen for tissue health support
  • Shift focus to lingering hip/back discomfort
  • Progress cardiovascular capacity and recreational sports to get back to feeling like herself again.

Because once your pelvic floor symptoms are no longer the barrier, everything else becomes possible.

What This Means for Perimenopause and “Vintage” Moms

I’m seeing more and more women my vintage (aka we have kids in middle school, high school or even college).

When we had babies, pelvic floor PT barely existed. If you went, it was often:

“You had a baby. You’re weak. Let’s get you stronger. Here are your kegels. Good luck.”

Maybe they worked.

Maybe they didn’t.

Maybe they partially helped and you quietly blamed yourself for not doing enough.

Now you’re in perimenopause and symptoms are back — or they never fully left.

Here’s the truth:

We’ve learned a lot.

Not just in 10 years.

In the last 3.

In the last 6 months.

Pelvic floor physical therapy for stress urinary incontinence, pelvic pressure, and return to running in perimenopause looks very different today than it did in 2019, even 2023.

Understanding normal pelvic floor morphology changes with impact allows us to choose better solutions because we understand the WHY more than ever.

Sometimes it’s strength (it’s usually not).

Sometimes it’s coordination.

Sometimes it’s tissue support.

Sometimes it’s external support like a pessary.

Often, it’s a combination.

But it’s almost never just “only do more kegels.”

If You Tried Pelvic Floor PT Before…

And it didn’t work…

Or it kind of worked…

Or you stopped going because life got loud…

Or you blamed yourself for not being consistent enough…

Enough of the guilt trips.

You’re not broken.

You might just be operating on outdated information.

I love when past clients come back because I get to look at them with new eyes and new tools. The science evolves. My skillset evolves. The options expand.

And sometimes it really is that simple.

Does this sound like you?

If you’re in the DC/Arlington area, I focus on complex and second-opinion pelvic floor cases for active women and perimenopausal athletes.

Not local? I offer virtual consults and collaborate with colleagues nationwide.

It might be worth another look.

Because returning to your sport — your run, your league, your fun — isn’t just about exercise.

It’s about getting yourself back.

Email me directly: carrie@carriepagliano.com

Keep the Village. Add the Expertise

Keep the Village. Add the Expertise

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A hopeful, evidence-based approach to postpartum pelvic floor rehab beyond kegels and internet advice

Sometimes at 2am, when you’re sore, leaking, Googling, and wondering if your body will ever feel like yours again… the internet feels like the only place awake with you.

And I get it. I really do.

Because I’m a huge fan of the village.

I love that more women than ever are accessing pelvic floor physical therapy.

I love that we’re talking about leakage and prolapse out loud instead of whispering in locker rooms.

I love that postpartum moms aren’t just quietly accepting “this is your new normal.”

That part? That’s progress.

But here’s where I need you to gently tap the brakes.

Support is one thing.

Medical advice is another.

And somewhere along the way… we started treating them like the same thing.

When community quietly turns into crowdsourced healthcare

We’re crowdsourcing our healthcare now.

Facebook groups.

Reddit threads.

“Hey moms — what worked for you?”

And honestly? With the barriers to care — insurance, cost, geography, childcare, time — I don’t blame anyone.

If you’re not getting answers from the system, of course you’re going to go where you feel understood.

That makes total sense.

But when the question shifts from:

👉 “Has anyone else felt this?”

to

👉 “What should I do medically?”

That’s when I need you to hit pause.

The kegel thread that made me sigh

I’m in a few everyday-women-driven groups. Some diagnosis specific. Some running groups. Mostly kind, well-intentioned spaces.

Then I see a post like:

“Is it okay to do kegels laying down at 8 weeks postpartum or should I be standing?”

Totally fair question. Great place to start.

And then the answers roll in.

Not curiosity.

Not “it depends.”

Not follow-up questions.

Just certainty.

“Definitely…”

“You should…”

“So much better…”

“My PT said…”

Over and over.

In one thread, “my PT said” showed up six times in nine responses.

Like gospel.

Like universal truth.

Like one person’s rehab automatically equals everyone’s rehab.

And every time I read that, my shoulders creep up to my ears.

Because after 25+ years treating pelvic floors?

If there’s one thing I know for sure…

It’s almost never that simple.

Here’s the part most people don’t see

A “simple” kegel can be:

Exactly what one person needs

…and exactly the wrong thing for someone else.

Same diagnosis.

Same postpartum week.

Completely different treatment.

Why?

Because bodies aren’t templates.

We’ve got:

  • genetics
  • hypermobility
  • nervous system sensitivity
  • birth history
  • sleep and fueling
  • stress and trauma
  • prior injuries
  • strength history
  • beliefs about our bodies
  • and a brain constantly trying to protect us

This is the nuance.

This is the stuff you cannot crowdsource.

This is where clinical reasoning lives.

Pattern recognition.

Asking better questions.

Forming a hypothesis.

Testing. Adjusting. Plan A, B, C.

It’s not sexy.

But it’s how people actually get better.

Why this keeps happening

And listen — I say this with empathy, not judgment.

Don’t forget, I’ve navigated my own pelvic floor issues through pregnancy, postpartum, and now perimenopause too. I’ve been the tired mom on the bathroom floor Googling. I’ve been the one who just wanted someone to hand me a plan and say, “Do this. You’ll be fine.”

So I understand.

I think this happens because we’re human.

We’re tired.

We want answers.

We want clarity.

We want someone to just tell us what to do.

And at 2am, when your nervous system is spiraling, a social media reply feels faster than booking an appointment.

Plus?

There’s this sisterhood in suffering that’s powerful. It reminds us we’re not alone.

“I tried this and it worked for me” feels safer than “it depends.”

But here’s the problem:

Personal experience is not the same as medical guidance.

And lately, I’ve watched women with no medical or professional background take one personal rehab story… turn it into a course… sell it… and suddenly they’re seen as more trustworthy than trained clinicians.

No oath.

No medical responsibility.

No anatomy or physiology background.

No ability to evaluate research.

Just vibes and testimonials.

And somehow… that wins.

And yes — I get it.

To a degree, I’m even a little envious of it.

Because I wear what I jokingly call institutional handcuffs — the ones I signed up for. Paid for. Trained for. Back when people automatically trusted medical providers.

And now those ethics require me to do something that doesn’t always sell well online:

Slow down.

Ask better questions.

Shine a light on the nuance.

Even when nuance is the last thing someone wants to hear.

The irony I can’t ignore

Here’s what’s wild.

The more research we get about pelvic health… the more questions I have.

Because science and working with thousands of women across 2+ decades humbles you.

It shows you complexity.

It shows you gray.

But online?

Everyone sounds more certain than ever.

A quick example of how myths stick around

I read a post recently from researcher Margie Davenport about where the idea came from that exercise causes miscarriage.

For years, women were told to rest. Be careful. Don’t move too much.

Turns out?

That belief came from specifically a 2007 study, that upon analysis, is heavily influenced by recall bias. If you ask someone about their exercise after a miscarriage — instead of when they’re happily pregnant and doing fine — of course their memory is going to skew. (If you’ve been there, you’re probably like, “no, duh.”)

Today…when we analyze the data correctly?

Movement is protective.

Just 10 minutes of walking a day is associated with a 25% reduction in preeclampsia risk. It supports both physical and mental health.

So for decades… women were told to restrict or self restricted movement for no good reason.

Not because anyone meant harm.

But because no one questioned the evidence hard enough.

Because “someone said” became “fact.”

Sound familiar?

So what’s the solution?

Not less community.

We need community.

We need stories.

We need “me too.”

We need the village.

But we also need:

  • More critical thinking.
  • More “this was MY experience, not advice.”
  • More providers explaining the WHY.
  • More nuance.
  • More humility and self reflection.
  • More “it depends.”

Because absolutes are rarely medicine.

They’re usually myths.

One of my favorite quotes

“There comes a point where we need to stop just pulling people out of the river. We need to go upstream and find out why they’re falling in.” — Desmond Tutu

That’s pelvic floor care.

Not random kegels.

Not throwing darts at a dartboard and hoping they stick.

But asking:

Why you?

Why now?

What’s actually driving this?

The hopeful part

And here’s what makes me optimistic.

More women are asking questions.

More women are demanding better care.

More women are finding pelvic floor PT.

More research exists than ever before.

We’re not stuck anymore.

We’re just learning how to pair the village with expertise.

Community for support.

Clinicians for medical decisions.

Both matter.

Both belong.

You don’t have to DIY this.

You don’t have to guess.

And your body isn’t broken — it just needs the right plan.

So next time you’re scrolling at 2am looking for answers… ask yourself:

Am I looking for support, or medical advice?

Because those are not the same thing.

From Pain to Prolapse_ How a Clinical Shift Changed the Way I Treat Pelvic Organ Prolapse Featured Image

From Pain to Prolapse: How a Clinical Shift Changed the Way I Treat Pelvic Organ Prolapse

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“Is this prolapse? Why does it feel like everything is falling out?”
 If you’ve ever asked that question through tears, fear, or total overwhelm—you’re not alone. And you’re not broken.

Funny enough, this story doesn’t actually start with prolapse.
It started with pelvic pain—and a weird, brilliant shift in how we thought about it.

Years ago, we started exploring pelvic pain through the lens of the brain. At the time, this approach had only been studied in conditions like low back pain and complex regional pain syndrome… but pelvic pain? Nope. We were flying blind.

But once we included the brain in the conversation, things started to make sense. When fear entered the picture, the normal rules didn’t apply anymore. Logic took a back seat. A didn’t equal A. Oranges weren’t oranges.

We began to ask:
🧠 What information is your brain interpreting as dangerous?
🧠 What’s being flagged as safe?
Was it…

  • Sensory input? (touch, sound, vision?)
  • Thoughts and beliefs?
  • Movement?
  • Stress and trauma history?
  • Physical symptoms?

If the danger pile was bigger, the brain had a reason to protect you.
But if we could build up the safety pile, the brain could start to back off.

That framework shaped how I treated pelvic pain—and eventually, how I began to approach pelvic organ prolapse (POP).

The Fear Response That Follows a Prolapse Diagnosis

Imagine this: You’ve just delivered your baby. You feel pressure. Heaviness. Something isn’t right “down there.” Maybe you look for the first time (in the worst possible moment—swollen, stitched, and still healing). Then you hear the words:

“Your organs are falling out.”
 Cue panic. Cue Google. Cue Facebook group doom spiral.
Then your OB tells you not to run, not to lift, not to do… much of anything.

You try a Peloton ride out of desperation, only to end up with a 3-day flare so bad you can’t lift the car seat.

By the time you land in my office, your danger pile is sky-high.
Physically? You might be healing.
But neurologically? The alarms are still blaring.

What If the Problem Isn’t Just Physical?

What if your symptoms aren’t only coming from tissue damage or weakness—but from your brain doing its job trying to protect you?

This is especially true if you:

  • Had a history of high-tone pelvic floor (hello dancers and runners 👋)
  • Felt pain or tearing at delivery
  • Don’t have a clear understanding of what prolapse even is (spoiler: most of us don’t)
  • Already carry stress in your breath, shoulders, jaw, or gut

This doesn’t mean it’s “just in your head.”
It means your body is smart.
It’s protecting you.
And it might need a different strategy—not just more reps or more “squeeze your pelvic floor.”

How I Shifted My Approach: Calm > Fix

What I learned treating pelvic pain through graded motor imagery (think: small, safe exposures to build trust and tolerance) completely changed how I treated POP.

We:

  • Calm things down first
  • Stay below the “symptom ceiling”
  • Keep workouts below a 1–2/10 change in symptoms
  • Build tolerance before intensity
  • Stop obsessing over symptoms (yes, this includes Google)

We work with the nervous system—not against it.

This isn’t for every POP patient.
But if I sense a sensitized nervous system, a high-alert brain, or a pelvic floor that’s more clenched than weak?
This method works. And it works well.

What Needs to Change in the Big Picture?

We need better support. Earlier. Smarter.

👶 Can we offer early education before delivery so the prolapse diagnosis doesn’t feel like a bomb dropping?
🩺 Can we use pessaries earlier to deload tissue and calm the brain before symptoms spiral?
📊 Can we stop terrifying moms with Grade 1 prolapse diagnoses that may have existed even before pregnancy?

I don’t have the RCTs yet. I don’t have the flashy study to prove it. But I have a lot of lived experience, and conversations with seasoned clinicians seeing the exact same patterns.

So no, this isn’t just a prolapse post.
It’s a story of how we got here—from pain science, to POP symptoms, to a brain-body understanding that honors the whole person in front of me.

Let’s Talk About You

If you’ve ever been told your prolapse means “no more running,”
If you’ve ever panicked from a Facebook thread or a symptom flare,
If you’ve ever wondered if it’s all in your head (it’s not),

💬 What would’ve changed for you if someone explained this sooner?
Drop a comment or DM me—I’m here for the conversation.

#pelvicfloorPT #prolapseawareness #postpartumhealing #pelvicpain #pelvichealthmatters #runningwithprolapse #highalertnervoussystem #brainbodyconnection #gradedmotorimagery #postpartumtruth #drpagliano #paglianopostpartum #pelvicfloorthoughtleader #womenshealthPT #prolapseisnotanend #nervoussystemregulation #postpartumfitness #pelvichealthstrategy #notjustkegels #paglianorunning #paglianoprolapse

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IG Caption:

You got it. Here’s a sassier, detail-rich version of the Instagram caption—still under 2,000 characters, raw and real with a little edge, and loaded with SEO juice:

“Your organs are falling out. You should probably stop running.”
 Cool cool cool… thanks for the emotional trauma. 😑

If you’ve ever heard that from a well-meaning provider (or Google), I see you—and I was you.
The fear. The pressure. The “tampon falling out” sensation that makes you question everything.

Years ago, I evolved to treating pelvic pain through the lens of pain science: brain + body, not just muscles and joints.

Turns out… that approach works really well for some types of prolapse symptoms, too.

Because sometimes, it’s not just about tissue.
It’s about what your brain thinks is safe.

Prolapse symptoms flare? The alarms go off.
And once your brain tags something as dangerous (hello running, jumping, lifting, sneezing)…

Good luck doing it without a full-body panic.

But here’s what I’ve learned:
➡️ You don’t need to be “fixed” before you move.
➡️ You need to feel safe in your movement.
➡️ Calming the system > chasing perfection.

Yes, prolapse can be a structural thing.
But your brain plays a huge role.
And kegels alone won’t fix nervous system hypervigilance, fear of movement, or the trauma of being told “just stop running.”

We’re done with outdated advice and one-size-fits-all rehab.
We’re treating moms like athletes—because pregnancy, birth, and recovery demand nothing less.

💥 Want to run again? Lift again? Feel strong again?
Then stop accepting “don’t” as an answer.
You deserve a strategy that actually meets you where you are.  And this one might work for some of you.

💬 What’s the worst thing someone told you about prolapse? Join the conversation on Instagram.

#prolapseawareness #pelvicfloorPT #runningwithprolapse #postpartumfitness #pelvichealthmatters #drpagliano #paglianopostpartum #prolapseisnotanend #momrunner #postpartumtruth #youarenotbroken #highalertnervoussystem #pelvicpain #kegelsarenttheanswer #returntorun #strongmoms #paglianorunning #paglianoprolapse

You’re Not Broken. You’re Not the Problem. Featured Image

You’re Not Broken. You’re Not the Problem.

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(And I’m not here to fix you.)

“When we position ourselves as the expert and the patient as the problem, we risk robbing people of their agency in the healing process. That’s not help, it’s hierarchy.” — Chris Johnson, PT

Damn. That one hits hard.

When I first went into PT school, my dream wasn’t women’s health…(wasn’t even on the radar!)


I actually thought I’d be working with spinal cord injuries, stroke patients — “classic rehab stuff.”
I pictured myself diving deep into every little detail, getting my Neuro Clinical Specialty Certification, becoming the expert.
The person at the top of the hierarchy.
The one who knew everything.

Fast forward a couple decades… and life had other plans.
Today, I’m a women’s pelvic health physical therapist, Women’s Health and Orthopedic Clinical Specialist, Certified Running and Weightlifting Coach  — working with moms, runners, lifters, women navigating pregnancy, postpartum, prolapse, perimenopause and menopause.

And if I’m being honest?
The biggest thing that changed wasn’t just my specialty.
It was how I see myself in the healing process.

The best parts of what I do now?
They don’t happen when I rattle off a list of exercises and hand you a perfect little plan.

They happen when we sit down together and say:
“Ok. The kids are sick again. Work is blowing up. The daycare called — again. You’re exhausted. You still want to move your body and feel strong. How do we keep progressing with your symptoms AND make this doable, for real life?”

They happen when we talk about how motherhood feels like walking through a minefield every single day — and instead of pretending we’re “bad moms” for not checking every box, we expect the grenades, plan for them, and still find ways to take care of ourselves alongside the chaos.

They happen when we swap war stories about trying to get family support without losing our minds — and learn how to ask for what we need without guilt.

Those are the sessions that change lives.
Because they’re real. They’re messy. And they actually work.

When we work together, here’s what it looks like:

✅ I teach you to notice what’s happening — not just blindly push through.
(You can’t change what you don’t notice. But once you see it, you can’t unsee it — and that gives you power.)

✅ I explain what’s happening in your body — WHY you might be feeling pain, heaviness, prolapse symptoms — so your brain can stop spiraling into “emergency mode.”
(Fun fact: just understanding why symptoms are happening can turn down the volume of the flare.)

✅ We decide together:

  • Are you in a season where survival mode is the goal?
  • Or do you have a little extra capacity to push and build momentum?

Both are ok.
We meet you exactly where you are.

We build tiny habits, because tiny habits work.

Sometimes that looks like setting your yoga mat down next to the bathroom.
So when you get up to pee in the morning, you walk straight to the mat without thinking about it — and knock out three quick exercises that make your body feel better.

Sometimes it’s scripting the “baby’s awake” plan with your partner:
“If the baby cries in the middle of my second set, you’re on it. I need five minutes to finish.”

(Yes, you can ask for that.
No, you’re not selfish.
You’re building a system that supports everyone.)

We talk about seasons too.

Because sometimes you’re gonna be in a season where the goal is literally:
“How little do I have to do so nobody dies?”

And sometimes you’ll have more in your tank.
Both seasons are real. Both seasons are valid.

I share this story all the time:
When my kids were little, I used to pack my running shoes for every trip.
Not because I was sure I’d get to run.
But because I was practicing hope.
Hope that someday there would be space for me again.

And now?
Now my teenager sleeps late (thank the sleep gods), and I actually get to pack my shoes, plan the route, and go for the run.

It took years to get here.
Years of chaos, missed runs, exhaustion, tiny scraps of self-care.
And because of that, the runs feel that much sweeter now.

The exercises I give you?
They’re not commandments.
They’re experiments.

If they’re too hard, confusing, painful, or just not working — that’s not on you.
That’s on me to adjust, to find a better fit.

You’re not here to guilt trip yourself because you didn’t do your homework.
You’re not a bad patient because an exercise didn’t feel good.

You are the expert of your own body.

I’m here to listen, adjust, collaborate. 
Not lecture.

If you didn’t do your homework or an exercise didn’t help, it’s on ME to find what will make exercise consistent with your lift and find exercises that DO help and DO feel good for YOU!

I was taught to be a gatekeeper.
The keeper of “what’s safe” and “what’s dangerous” for women’s bodies.
If you didn’t do what I said?
You were “at risk.”
(Sound familiar? Because that’s exactly how marketing preys on moms…don’t lift in early postpartum, no planks, sit-ups or squats for your diastasis recti or your prolapse! All untrue BTW.)

But the truth is:
I know A LOT…a TON more than I knew 25 years ago.  But I don’t know everything, because research still doesn’t know everything.
 And the day I finally admitted that out loud to my patients was the day I became a better therapist.

Now?
I lay out everything we know together.
We talk about what can change, what might not.
We prioritize what matters to YOU.

We make a plan.
We stay flexible.
We treat setbacks like information, not failure.  (Did I mention no guilt trips?)

If you miss an exercise?
If a strategy doesn’t work?
If your prolapse symptoms flare again?

You don’t have to apologize.
You didn’t do anything wrong.

It’s just feedback.
It just means we look closer, refine the plan, and move forward.

Healing isn’t about grinding yourself into the ground.
It’s about finding the smallest changes that make the biggest difference — and actually feeling the results, so you want to keep going.

Because when healing feels possible — not like a punishment — that’s when you stay consistent.
That’s when you build something real.

🌟 What if healing your body didn’t mean changing who you are — but finally supporting who you’ve been all along?

#pelvicfloorphysicaltherapy #postpartumrecovery #prolapsehealing #prolapsejourney #pelvicorganprolapse #postpartumfitness #pelvicfloorPT #momstrength #postpartumhealing #womenshealthPT #postpartumrunning #prolapseawareness #reallifehealing #strongasamother