Questions for Women's Health/Pelvic Floor PT, Dr. Michelle Little

We had a wonderful discussion with Pelvic Floor PT, Dr. Michelle Little [@MLittle ]. If you have any follow up questions for her please hit the REPLY button on this topic and she will hop on to answer over the next few days!

To learn more about Michelle and what she has to offer click here

If you missed it on our :instagram: / :facebook: stories you can see it here:

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Happy to answer all questions

@MLittle I loved watching the story tag!

Ok, during my last pregnancy I felt a lot of pressure down below and had a hard time walking. Hearing you talk made me realize that something obviously went wrong with my pelvic muscles. Firstly, is there anything I could have done during my pregnancy to prevent/help that? And if I want to get pregnant again, are there exercises I should do ahead of time to prepare my body?

My youngest baby is now 3 and I still feel pressure in my vaginal area at times and some pee comes out out when I exercise. I try to do kegels based off what I read on the internet, but I’m not sure I’m getting all the right muscles. Also, when I contract those muscles, should I hold them for a few seconds before relaxing?

I had several stitches after childbirth and after a few months I noticed like an extra flap of skin near the area that was stitched. Do you know if that will ever go away? It just feels a little weird.

Pelvic Pressure and heaviness is common the first 6 weeks as the organs are readjusting, there are also a lot of hormonal changes. If heaviness or pressure persist beyond the 6 week mark is recommended to get it checked out. One of many things to rule out is pelvic organ prolapse. Pelvic PT is a great conservative treatment to manage symptoms and help women stay active. Being active is the best thing we can do to prepare our bodies for birth. ACOG recommends 30 minutes of moderate intensity activity 5 days per week. This can greatly be affected if there is pain or heaviness. I always say birth is a marathon and we need to prepare for it, not just show up. Soooo many thoughts on this, check out my Instagram feed for lots of pregnancy content I also offer a pregnancy and postpartum class and virtual sessions XO

Hey mama,
Beyond the early postpartum phase kegels need to be done “upright” and as part of your exercise routine to be functional. I find that many women do kegels sitting or laying down but that doesn’t translate over into jumping on a trampoline, sneezing, laughing or running. They are muscles so we have to load them appropriately. Learning how to properly contract is step 1 ( most ppl have a hard time with this). If you have a pelvic PT in your area that can be so helpful to confirm proper engagement. There is also an internal and external DIY screen you can do that I talked about in stories XO

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@MLittle Hi Dr. Little. This is so helpful, thank you! I have a question regarding a feeling of “heaviness.” I definitely felt that pressure that you’re describing when I was pregnant with my son. But since he was born, I continue to feel heaviness during that “time of the month” :grimacing: Is it normal to continue to feel that pressure during menstruation?

It is common to feel that heaviness during your cycle, it is usually just from your Uterus contracting, If the support system is weakened it may increase the heaviness/pressure symptoms. To find out the current status of the pelvic floor muscles post baby seeing a Pelvic PT would be the best way. They should be able to give you functional strengthening exercises that include abdominal muscles, pelvic floor, back stability with reps to target endurance to help with these symptoms. allows you to search by zip code and specialty. If there isn’t any one in your area check out my virtual wellness options.

Check with your OB to make sure its just a skin tag. Generally, if the skin isn’t painful, irritable or hypersensitive they recommend just leaving it alone. But if it bothers you (even for cosmetic reasons), they can remove it

So helpful, thank you!

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Ok, glad to hear that it is somewhat normal around that time in the cycle. I’ll also check out the APTA website like you suggested. Thanks!!

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you are 100% correct! I always do them lying down in bed. Sorry, one more question-do I have to be standing or can I do them while sitting in a chair?

Thank you!