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Blog
- Fitness
- Pre & Postnatal
- Food
- Fun
- Family
- Self
Services
Contact

Pre & Postnatal

Questions to Ask a Pelvic Floor Physical Therapist

December 25, 2021

Pelvic Floor Physical Therapy changed my life. After my first son was born I felt overwhelmed by how to return to fitness, keep up with my son, and heal my Diastasis Recti. Prior to getting pregnant I had never heard of Pelvic Floor Physical Therapy, nor was it recommended to me. Luckily, I self referred after things felt just a...

Pre & Postnatal

Returning to Running Strength Tests

November 10, 2021

When can I return to running after a baby? Running can be so therapeutic, freeing, and easily accessible after having a baby. But, running can be a very physically demanding form of cardio. Quite honestly, we need strength before we hit the open road. After pregnancy the pelvic floor is still recovering from delivery and being pregnant in general. With...

Pre & Postnatal

Gentle Movement for Early Postpartum

October 13, 2021

“What exercises can I do early postpartum?” I often receive this question from clients eager to return to exercise after baby. But, before we get started, let’s talk about how birth is a HUGE deal. You just grew and birthed a human – that’s amazing <3 Postpartum recovery is incredibly important, not only to support the healing process, but for...

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Empowered Mama Membership 💗
.
San Diego mamas 🏖- I am so excited to team up with the fabulous @empower.physicaltherapy and @getfitwithbritm to offer the Empowered Mama Membership ⭐️ Pelvic Floor Physical Therapy + weekly workouts customized to where you are in your motherhood journey.
.
Truly what I wish I had access to during my postpartum recovery with both boys 👏One session per month with a Pelvic Floor PT + weekly small group training sessions. Full circle comprehensive care as coaches + PTs collaborate to give you the best experience possible.
.
Community, accountability, and movement in a small group with other mamas. Childcare will also be provided 🥳
.
Questions? DM or drop them below ⬇️ Classes begin next month! Link in bio for details (and more coming at you in the next few weeks!)
.
xoxo,
Erica

ericafriedman_wellness

•

Empowered Mama Membership 💗 . San Diego mamas 🏖- I am so excited to team up with the fabulous @empower.physicaltherapy and @getfitwithbritm to offer the Empowered Mama Membership ⭐️ Pelvic Floor Physical Therapy + weekly workouts customized to where you are in your motherhood journey. . Truly what I wish I had access to during my postpartum recovery with both boys 👏One session per month with a Pelvic Floor PT + weekly small group training sessions. Full circle comprehensive care as coaches + PTs collaborate to give you the best experience possible. . Community, accountability, and movement in a small group with other mamas. Childcare will also be provided 🥳 . Questions? DM or drop them below ⬇️ Classes begin next month! Link in bio for details (and more coming at you in the next few weeks!) . xoxo, Erica

2 weeks ago

View on Instagram |

1/6

Hmm False. Hmmm... but WHY? 🤔.
.
I'll preface and say that leaking is a complex topic and there can be many reasons why leaking may be occurring. While childbirth/🤰🏻can be one contributing factor to pelvic floor dysfunction, not all women experience incontinence. AND you can experience leaking not having been pregnant (men and children do too).
.
Some other reasons SUI or pelvic pain may be occuring:
1: Pelvic Floor muscles may need strength following a vaginal delivery and ~9 months of pregnancy. But, they may also be weak due to postural habits and a lack of strength/activity.
2. Muscles may be hypertonic (overactive) and unable to relax, which makes the strength of your contraction weaker. They are overactive, but weak. It's really hard to get a good contraction of a tight muscle.
3. Pressure Management / Timing: Perhaps you have the strength, but the system isn't coordinating or we're having trouble managing pressure. When you cough, jump, etc. you increase pressure in your core and down on your pelvic floor. More pressure relative to strength ➡️increase demand on pelvic floor ➡️increase chance of leaking. I highly recommend a visit to a Pelvic Floor PT here.
4. Pelvic Floor may have been damaged: Intervention during labor, episiotomy, etc. and the scar tissue can affect the muscles ability to contract properly.
5. Need to build strength: The pelvic floor may not be getting enough overload training to handle the demand you're asking of it. Overloading a muscle can help it get stronger. This is where balloons can be helpful.
6. Stress / anxiety around leaking or in general
7. Bladder irritants
8. Hormones: Many notice increased leaking around their cycle and/or during menopause.
9. Max lifting: Typically a sign that the increased intra-abdominal pressure is higher than what your pelvic floor can handle. Holding your breathing ➡️rigid thorax. When you can't contain all of the pressure, it escapes via the weakest link.
.
Now that we know why SUI can occur, I'll next dive into what we can do (in addition to seeing a Pelvic Floor PT)!
.
xoxo,
Erica

ericafriedman_wellness

•

Hmm False. Hmmm... but WHY? 🤔. . I'll preface and say that leaking is a complex topic and there can be many reasons why leaking may be occurring. While childbirth/🤰🏻can be one contributing factor to pelvic floor dysfunction, not all women experience incontinence. AND you can experience leaking not having been pregnant (men and children do too). . Some other reasons SUI or pelvic pain may be occuring: 1: Pelvic Floor muscles may need strength following a vaginal delivery and ~9 months of pregnancy. But, they may also be weak due to postural habits and a lack of strength/activity. 2. Muscles may be hypertonic (overactive) and unable to relax, which makes the strength of your contraction weaker. They are overactive, but weak. It's really hard to get a good contraction of a tight muscle. 3. Pressure Management / Timing: Perhaps you have the strength, but the system isn't coordinating or we're having trouble managing pressure. When you cough, jump, etc. you increase pressure in your core and down on your pelvic floor. More pressure relative to strength ➡️increase demand on pelvic floor ➡️increase chance of leaking. I highly recommend a visit to a Pelvic Floor PT here. 4. Pelvic Floor may have been damaged: Intervention during labor, episiotomy, etc. and the scar tissue can affect the muscles ability to contract properly. 5. Need to build strength: The pelvic floor may not be getting enough overload training to handle the demand you're asking of it. Overloading a muscle can help it get stronger. This is where balloons can be helpful. 6. Stress / anxiety around leaking or in general 7. Bladder irritants 8. Hormones: Many notice increased leaking around their cycle and/or during menopause. 9. Max lifting: Typically a sign that the increased intra-abdominal pressure is higher than what your pelvic floor can handle. Holding your breathing ➡️rigid thorax. When you can't contain all of the pressure, it escapes via the weakest link. . Now that we know why SUI can occur, I'll next dive into what we can do (in addition to seeing a Pelvic Floor PT)! . xoxo, Erica

3 weeks ago

View on Instagram |

2/6

Do you experience pelvic floor symptoms while training? After having my second son I navigated leaking and a hypertonic pelvic floor. I find that flare ups for me are often brought on by stress, injury / compensations, and 💩habits.
.
When symptoms flare up I get frustrated. But, these can also be opportunities to tune in, slow down, reach out to a Pelvic Floor PT, drink more 💦 add in more mobility & release work. Through all of my education I have developed more body awareness + build up my resources, which has made a HUGE difference.
.
Here are 10 strategies I use that you can experiment with when new or old symptoms appear.
.
𝘘𝘶𝘪𝘤𝘬 𝘯𝘰𝘵𝘦: 𝘚𝘺𝘮𝘱𝘵𝘰𝘮𝘴 --> 𝘱𝘢𝘪𝘯 𝘰𝘳 𝘱𝘳𝘦𝘴𝘴𝘶𝘳𝘦 𝘪𝘯 𝘵𝘩𝘦 𝘱𝘦𝘭𝘷𝘪𝘴, 𝘭𝘦𝘢𝘬𝘪𝘯𝘨, 𝘰𝘳 𝘥𝘰𝘮𝘪𝘯𝘨. 𝘐𝘧 𝘺𝘰𝘶 𝘩𝘢𝘷𝘦 𝘦𝘹𝘵𝘳𝘦𝘮𝘦 𝘥𝘪𝘴𝘤𝘰𝘮𝘧𝘰𝘳𝘵 𝘐 𝘦𝘯𝘤𝘰𝘶𝘳𝘢𝘨𝘦 𝘺𝘰𝘶 𝘵𝘰 𝘳𝘦𝘢𝘤𝘩 𝘰𝘶𝘵 𝘵𝘰 𝘢 𝘮𝘦𝘥𝘪𝘤𝘢𝘭 𝘱𝘳𝘰𝘧𝘦𝘴𝘴𝘪𝘰𝘯𝘢𝘭.
.
1. Are you breathing? - This may seem like an obvious one, but worth mentioning. If you aren't breathing, you aren't able to manage IAP. Good intra-abdominal pressure management is key to navigating symptoms.
2. Experiment with different breath strategies: While "exhale on exertion" is the go-to strategy taught, you can experiment. For many I like an "exhale through full range of motion."
3. Alignment: can you achieve a stacked body position (ribcage over pelvis)? While neutral is a range, achieving a stacked body position while under load is optimal.
4. Switch up the time of day: when do you feel symptoms occur? Perhaps training at a different time may make a difference.
5. Adjust range of motion / add support: pay attention to where and when you feel symptoms during a lift.
6. Change tempo: I often find moving slower allows me to better own a position and tune in to my breathing.
7. Get off your feet / change the set up position
8. Increase Rest time between sets
9. Modify overall volume: reps + sets
10. Dial back intensity / swap out movements: If some of the above strategies don't help, it's totally OK to sub a movement out if it's not working in your body...right now. Also recommend working with a coach or PT.
.
Xoxo,
Erica

ericafriedman_wellness

•

Do you experience pelvic floor symptoms while training? After having my second son I navigated leaking and a hypertonic pelvic floor. I find that flare ups for me are often brought on by stress, injury / compensations, and 💩habits. . When symptoms flare up I get frustrated. But, these can also be opportunities to tune in, slow down, reach out to a Pelvic Floor PT, drink more 💦 add in more mobility & release work. Through all of my education I have developed more body awareness + build up my resources, which has made a HUGE difference. . Here are 10 strategies I use that you can experiment with when new or old symptoms appear. . 𝘘𝘶𝘪𝘤𝘬 𝘯𝘰𝘵𝘦: 𝘚𝘺𝘮𝘱𝘵𝘰𝘮𝘴 --> 𝘱𝘢𝘪𝘯 𝘰𝘳 𝘱𝘳𝘦𝘴𝘴𝘶𝘳𝘦 𝘪𝘯 𝘵𝘩𝘦 𝘱𝘦𝘭𝘷𝘪𝘴, 𝘭𝘦𝘢𝘬𝘪𝘯𝘨, 𝘰𝘳 𝘥𝘰𝘮𝘪𝘯𝘨. 𝘐𝘧 𝘺𝘰𝘶 𝘩𝘢𝘷𝘦 𝘦𝘹𝘵𝘳𝘦𝘮𝘦 𝘥𝘪𝘴𝘤𝘰𝘮𝘧𝘰𝘳𝘵 𝘐 𝘦𝘯𝘤𝘰𝘶𝘳𝘢𝘨𝘦 𝘺𝘰𝘶 𝘵𝘰 𝘳𝘦𝘢𝘤𝘩 𝘰𝘶𝘵 𝘵𝘰 𝘢 𝘮𝘦𝘥𝘪𝘤𝘢𝘭 𝘱𝘳𝘰𝘧𝘦𝘴𝘴𝘪𝘰𝘯𝘢𝘭. . 1. Are you breathing? - This may seem like an obvious one, but worth mentioning. If you aren't breathing, you aren't able to manage IAP. Good intra-abdominal pressure management is key to navigating symptoms. 2. Experiment with different breath strategies: While "exhale on exertion" is the go-to strategy taught, you can experiment. For many I like an "exhale through full range of motion." 3. Alignment: can you achieve a stacked body position (ribcage over pelvis)? While neutral is a range, achieving a stacked body position while under load is optimal. 4. Switch up the time of day: when do you feel symptoms occur? Perhaps training at a different time may make a difference. 5. Adjust range of motion / add support: pay attention to where and when you feel symptoms during a lift. 6. Change tempo: I often find moving slower allows me to better own a position and tune in to my breathing. 7. Get off your feet / change the set up position 8. Increase Rest time between sets 9. Modify overall volume: reps + sets 10. Dial back intensity / swap out movements: If some of the above strategies don't help, it's totally OK to sub a movement out if it's not working in your body...right now. Also recommend working with a coach or PT. . Xoxo, Erica

4 weeks ago

View on Instagram |

3/6

Breath with movement. In Part 1 we chatted about the importance of getting a good inhale, and mastering the breath in various positions. Once you've got the hang of it, we can start adding a bit more 🔥
.
Progressing too quickly without establishing a more optimal breathing pattern / diaphragm function can often lead to bearing ⬇️when an exercise is too difficult, something we want to try to avoid with POP. As a coach I monitor pressure regulation and control as we progress through movements. Outside of our sessions I know mamas need to pick up kiddos, push strollers, etc., so mastering this coordination and control can be applied to ALL the things.
.
When starting to add more challenge I encourage you to play around with different exercises and tune in to how your body responds. There is no one right way to breathe, load, or align the body that works for everyone. Below are a few breathing options for you as you start to progress strength movements.
.
1. Just Breathe 😄Sometimes this is the biggest piece of advice I can offer. When things become difficult often our go-to strategy can be to hold our breath.
2. Exhale on Exertion (hard part of the movement): exhale, and do all the things. A go-to strategy to avoid bearing down under load is to exhale on the harder part of the movement. BUT, you also need to get a good inhale 😉If you are unsure I recommend seeing a PT.
3. Exhale through Exertion: Exhale breath lasts through full range of motion. Begin exhaling before you start moving, otherwise referred to as "blow before you go" (Julie Wiebe).
4. Inhale on exertion: for some it may be appropriate to inhale on the exertion portion (defer to PT).
5. Breath hold: While a breath holding strategy is possible (typically with max lifts), this would be more advanced. You hold your breath, maximizing IAP. When done correctly this does not lead to excessive pressure ⬇️
.
Know that different strategies work for different people. Once you've mastered the breath in different positions and experimented with a strategy that works for you as you add challenge, we can then move on to building strength!
.
POP questions? Drop them ⬇️
.
xoxo,
Erica

ericafriedman_wellness

•

Breath with movement. In Part 1 we chatted about the importance of getting a good inhale, and mastering the breath in various positions. Once you've got the hang of it, we can start adding a bit more 🔥 . Progressing too quickly without establishing a more optimal breathing pattern / diaphragm function can often lead to bearing ⬇️when an exercise is too difficult, something we want to try to avoid with POP. As a coach I monitor pressure regulation and control as we progress through movements. Outside of our sessions I know mamas need to pick up kiddos, push strollers, etc., so mastering this coordination and control can be applied to ALL the things. . When starting to add more challenge I encourage you to play around with different exercises and tune in to how your body responds. There is no one right way to breathe, load, or align the body that works for everyone. Below are a few breathing options for you as you start to progress strength movements. . 1. Just Breathe 😄Sometimes this is the biggest piece of advice I can offer. When things become difficult often our go-to strategy can be to hold our breath. 2. Exhale on Exertion (hard part of the movement): exhale, and do all the things. A go-to strategy to avoid bearing down under load is to exhale on the harder part of the movement. BUT, you also need to get a good inhale 😉If you are unsure I recommend seeing a PT. 3. Exhale through Exertion: Exhale breath lasts through full range of motion. Begin exhaling before you start moving, otherwise referred to as "blow before you go" (Julie Wiebe). 4. Inhale on exertion: for some it may be appropriate to inhale on the exertion portion (defer to PT). 5. Breath hold: While a breath holding strategy is possible (typically with max lifts), this would be more advanced. You hold your breath, maximizing IAP. When done correctly this does not lead to excessive pressure ⬇️ . Know that different strategies work for different people. Once you've mastered the breath in different positions and experimented with a strategy that works for you as you add challenge, we can then move on to building strength! . POP questions? Drop them ⬇️ . xoxo, Erica

1 month ago

View on Instagram |

4/6

$Hi mama 👋 Saying hi and checking in ❤️ . When life gives you 🍋 ..... I decided to take an unplanned break last week from social media to spend time with my kiddos and navigate a few unexpected life events. I LOVE this platform for the community, education, and fun it brings, but sometimes I need a short disconnect to send my energy to other parts of my life. I know many of you can relate! . A few things I’m excited about 💥 - Kicking off EP with @katie.stclair.fitness in a few weeks! - Finishing up the @mamastefit Fitness Trainer Course 👏 - Some in person fun projects coming soon this summer / fall in San Diego 🥳 - Keeping two humans alive, entertained, and fed. My most important job ❤️ . This summer I will likely be having MPFL reconstruction. Prior to this I had honestly never heard of it (go figure!). The medial patellofemoral ligament has the important job of keeping the patella (kneecap) centered so it glides properly during movement. I have a history of patella dislocations, which I've now realized has led to a lot of asymmetries as my body has searched for stability - calf strains, stress fractures, pelvic floor dysfunction, etc. I am a firm believer that the body is all connected. After surgery + lots of PT my knee should be "solid!" and ready for action. . I'll be documenting my rehab process here on IG. While knee surgery / rehab isn't postpartum specific it will be a huge part of my life for ~6+ months. There are also huge parallels between knee rehab and postpartum recovery. Knee pain / discomfort is also a HUGE topic, and while there are many reasons knee pain may be present, it can also be a structural issue with the knee itself! If you are in pain I recommend seeking support from a medical professional. . I'll be honest and say I spent a few days feeling like 💩 , but then also realized what a big learning this will be for me. Also an opportunity to finally feel stable in my knee and gain some strength on my left side. I'll be in PT leading up to surgery in the hopes of getting as strong as possible prior, which should help with recovery. . Thank you for joining me in this journey <3 I'll finish up my POP series next 😉 . xoxo, Erica$

ericafriedman_wellness

•

Hi mama 👋 Saying hi and checking in ❤️ . When life gives you 🍋 ..... I decided to take an unplanned break last week from social media to spend time with my kiddos and navigate a few unexpected life events. I LOVE this platform for the community, education, and fun it brings, but sometimes I need a short disconnect to send my energy to other parts of my life. I know many of you can relate! . A few things I’m excited about 💥 - Kicking off EP with @katie.stclair.fitness in a few weeks! - Finishing up the @mamastefit Fitness Trainer Course 👏 - Some in person fun projects coming soon this summer / fall in San Diego 🥳 - Keeping two humans alive, entertained, and fed. My most important job ❤️ . This summer I will likely be having MPFL reconstruction. Prior to this I had honestly never heard of it (go figure!). The medial patellofemoral ligament has the important job of keeping the patella (kneecap) centered so it glides properly during movement. I have a history of patella dislocations, which I've now realized has led to a lot of asymmetries as my body has searched for stability - calf strains, stress fractures, pelvic floor dysfunction, etc. I am a firm believer that the body is all connected. After surgery + lots of PT my knee should be "solid!" and ready for action. . I'll be documenting my rehab process here on IG. While knee surgery / rehab isn't postpartum specific it will be a huge part of my life for ~6+ months. There are also huge parallels between knee rehab and postpartum recovery. Knee pain / discomfort is also a HUGE topic, and while there are many reasons knee pain may be present, it can also be a structural issue with the knee itself! If you are in pain I recommend seeking support from a medical professional. . I'll be honest and say I spent a few days feeling like 💩 , but then also realized what a big learning this will be for me. Also an opportunity to finally feel stable in my knee and gain some strength on my left side. I'll be in PT leading up to surgery in the hopes of getting as strong as possible prior, which should help with recovery. . Thank you for joining me in this journey <3 I'll finish up my POP series next 😉 . xoxo, Erica

1 month ago

View on Instagram |

5/6

Lifting with Prolapse - an opportunity to get STRONGER. Part 1.
.
Total body strength is critical for optimal pelvic floor function. And while many recommendations on the internet talk about why lifting heavy is ❌, I'm here to tell you that's not the case. There is no inherently unsafe exercise. It's about how the exercise is performed. We need to be able to squat, hinge, carry, etc. for all things #momlife.
.
Treating POP often takes a multifactorial approach. I love collaborating with a team (it takes a village) when working with POP mamas. A Pelvic Floor Physical Therapist is so helpful. They can:
- Evaluate pelvic floor muscle firing
- Provide manual therapy for tissue release
- Check for imbalances, muscle firing, and total body strength and function that impacts the pelvic floor (Ortho PT can do this as well).
.
As a coach one of the biggest things I can do is instill confidence, provide education, and progress you in a way that supports your pelvic floor and healing. So, let's start moving.
.
Step One: Breathing + Rib Cage Movement 🫁
- Optimal breathing = foundation for core + pelvic floor function. The pelvic floor must learn how to relax. When the pelvic floor is too tight we cannot take the muscle through its full range of motion / get a great contraction, which limits its ability to build strength.
- Inhale breath: diaphragm expands ⬇️, the pelvic floor responds by lengthening downward. If we carry a lot of tension in the PF it's challenging to get a great inhale ⬇️ into the body.
- Experiment with breath in different positions: supine / side lying ➡️quadruped ➡️sitting ➡️standing. Being able to establish breathing patterns in all positions helps prepare us to exercise in these positions.
- Vary your breathing strategies: Exhale on exertion is a great place to start, but may not work for everyone. Another example? Exhale through the entire movement.
.
We spend a lot of time on deep breathing + the inhale breath. Why? A good inhale sets our pelvic floor up for a natural recoil on exhale. A win win for the pelvic floor and pressure regulation 👏
.
More on step 2 coming at ya 🎉

ericafriedman_wellness

•

Lifting with Prolapse - an opportunity to get STRONGER. Part 1. . Total body strength is critical for optimal pelvic floor function. And while many recommendations on the internet talk about why lifting heavy is ❌, I'm here to tell you that's not the case. There is no inherently unsafe exercise. It's about how the exercise is performed. We need to be able to squat, hinge, carry, etc. for all things #momlife. . Treating POP often takes a multifactorial approach. I love collaborating with a team (it takes a village) when working with POP mamas. A Pelvic Floor Physical Therapist is so helpful. They can: - Evaluate pelvic floor muscle firing - Provide manual therapy for tissue release - Check for imbalances, muscle firing, and total body strength and function that impacts the pelvic floor (Ortho PT can do this as well). . As a coach one of the biggest things I can do is instill confidence, provide education, and progress you in a way that supports your pelvic floor and healing. So, let's start moving. . Step One: Breathing + Rib Cage Movement 🫁 - Optimal breathing = foundation for core + pelvic floor function. The pelvic floor must learn how to relax. When the pelvic floor is too tight we cannot take the muscle through its full range of motion / get a great contraction, which limits its ability to build strength. - Inhale breath: diaphragm expands ⬇️, the pelvic floor responds by lengthening downward. If we carry a lot of tension in the PF it's challenging to get a great inhale ⬇️ into the body. - Experiment with breath in different positions: supine / side lying ➡️quadruped ➡️sitting ➡️standing. Being able to establish breathing patterns in all positions helps prepare us to exercise in these positions. - Vary your breathing strategies: Exhale on exertion is a great place to start, but may not work for everyone. Another example? Exhale through the entire movement. . We spend a lot of time on deep breathing + the inhale breath. Why? A good inhale sets our pelvic floor up for a natural recoil on exhale. A win win for the pelvic floor and pressure regulation 👏 . More on step 2 coming at ya 🎉

2 months ago

View on Instagram |

6/6

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