Pelvic Floor Rehab

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.