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Normalize This: Pelvic Floor Physical Therapy

Grace Physical Therapy

Here we are, ladies — our final installment of our year-long Normalize This series! What an incredible journey it has been. We are so grateful to the many experts and community members that have contributed to this rich, thought-provoking content series. From discussing new wellness ingredients like CBD, to exploring sexual pleasure as we age, to sharpening our eco-literacy skills, and speaking openly about mental health, it has sparked so much conversation. Thank you for following along, and if there were topics you wish we would have covered, please do send us a note.

For this final installment, we are diving into a growing movement that hits very close to home for us — pelvic floor physical therapy. Though it is a hot topic within women’s health, and a growing profession within healthcare, it is still often misunderstood and far from commonplace. In effort to further demystify what pelvic floor physical therapy is, we reached out to Carine Carmy, Co-founder of Origin PT, a fast-growing women’s physical therapy platform that aims to make pelvic floor physical therapy essential care that’s accessible to women across the country.

Carine, we are so incredibly excited about the pelvic floor therapy movement. Honestly, it feels like it has the potential to be one of the more empowering movements within women’s health (if you think about it, our pelvic floor is such an invisible “main character” of our bodies, especially as we age as women). How did this “movement” come to be?

I share your enthusiasm! It feels like the world is waking up to the fact that women have bodies, and shockingly, those bodies do indeed have unique needs! 

We’re still in the early stages of the pelvic floor movement, and it’s emerging from a groundswell of change — in the medical community, in business, and in culture. 

One massive shift happened in the 90s, when it became required to include women in clinical trials. At that time, you also saw the founding of specialized medical societies to focus on pelvic health in women, like the Academy of Pelvic Health Physical Therapy (formerly called Section on Women’s Health). 

The next big shift happened in business, when venture dollars started going toward fertility. The success of these companies validated the investment opportunity in the  “women’s health” and “femtech” sectors, which has enabled dozens of startups to tackle issues that were historically perceived as “niche,” from endometriosis to menopause. It also helps that you have far more female investors in positions of power. 

Finally, and perhaps most powerfully, there’s the cultural shift that’s happening in our post #metoo + pandemic at-home world, in which formerly taboo conversations are now mainstream on social media. People are having far more real talk in open forums about miscarraige, painful sex, postpartum depression, and other challenges that are incredibly common but historically stigamtized. These conversations are empowering, helping women and people with vaginas connect with their bodies and challenge the assumption that pain is normal.

It’s absurd that it’s taken this long to shine a light on conditions that impact one-in-three adult women (!), but now that we’re here, let’s freakin’ go! 

What is it that inspired you to co-found Origin PT? 

My path to Origin started in my early 20s. I began my career working in healthcare and technology and I quickly learned two things: 1. Changing healthcare is really hard. 2. If you’re going to do it, work from within the system. 

Flash forward to 2018, I was sitting with my now Co-founder Nona Farahnik Yadegar, and she was telling me about her postpartum experience: full body pains, incontinence, separated abs, the list goes on. No one prepared her for what she would physically experience, and it reminded me of my experience with painful sex. I saw nearly a dozen different doctors, had two biopsies, and the best answer was, “Maybe it will just go away over time?”

We learned that physical therapy is the first-line treatment for pelvic floor dysfunction and for many of the physical challenges women experience during pregnancy, postpartum, and menopause. But it’s not yet the “go-to” for women. Instead, we are given surgeries or question marks. 

So we set out to build a business that would make this essential care accessible to women across the country.

What does Origin uniquely bring to the pelvic floor therapy community/space/movement?

We’re very focused on increasing access to pelvic floor therapy across the country. This means offering in-network, affordable care in an industry that is historically cash-based (i.e., $200+ per visit). This means innovating on how we deliver care, with a heavy focus on virtual services and digital interventions, so you can get support wherever, whenever. It also means taking a brand-centric approach to help normalize pelvic health, creating spaces that are beautiful, open, and welcome, that destigmatize the shame that quietly exists around the biggest milestones in women’s lives.

How would you recommend that women think about pelvic floor PT? How do they know it’s right for them?

Pelvic floor PT is something to consider at every stage of life. It’s truly self care, a way to connect more deeply to the center of your body’s universe. 

I always recommend folks start pelvic floor therapy before issues come up so you can understand your body’s normal. And it can be helpful through every stage of life: in your teens and 20s; throughout pregnancy and postpartum; when you’re going through menopause, and beyond. 

If you’re noticing any of the following, these could be signs of pelvic floor dysfunction:

- Heaviness caused by poorly supported pelvic organs pressing on your vagina (you might notice a bulge inside your vagina) is a sign of prolapse

- Leaking urine (even just a little, when you sneeze) or not being able to hold in gas/poop is a symptom of incontinence

- Feeling like you have to pee unreasonably often is another type of incontinence

- Pain during intercourse or when inserting a tampon occurs with vaginismus

- Pain in any part of your pelvis, including your vulva, vagina, or bladder

What are some of the issues that you help women with at Origin PT?

We work with patients through every stage of life, with a focus on the pelvic floor and taking a full body approach. This includes, pregnancy and birth prep, birth recoveryrelief from painful sex, bladder and bowel control, menopause symptoms, and pelvic organ prolapse.

How can pelvic floor PT help women who experience bladder leaks / urinary incontinence?

Your pelvic floor muscles are responsible for supporting your bowels and bladder and controlling the sphincters that hold in poop and pee. Incontinence is a signal that these muscles need support restoring function. (Also important to note: there are three types of incontinence!)

Pelvic floor therapy can help you restore function to your pelvic floor, so leaks happen less often (or stop altogether). Treatment may include:

- Techniques for connecting with your pelvic floor

- Working through daily habits that may be triggering symptoms

- Manual pelvic floor therapy

- Strength & coordination exercises

- Vaginal weights — yes, your vagina can lift weights

What would you say to any women who wonder if they are “too old” to reap the benefits of pelvic floor PT?

No such thing!!! There’s never too old or too late. The pelvic floor is like any other muscle group, so if it’s not too late to go for a walk or pick up a pair of light arm weights, it’s not too late to build strength and improve pelvic floor function. The sooner you start, the lower risk for needing surgeries or more invasive procedures.

When it comes to normalizing pelvic floor physical therapy, where is there the most work to be done?

The main barriers right now are education and awareness. I didn’t even know I had a pelvic floor until my 20s! The more we understand our bodies, the more we can advocate for ourselves and seek out expert care. 

Education can also help reduce shame and stigma. One-in-three women avoid going to the doctor for gynecological concerns altogether because of embarrassment. We need to talk about pelvic health openly and in public, not in hushed voices behind closed doors.

To women out there who have never gone to pelvic floor physical therapy, what advice or encouragement do you have for them?

I often hear that folks are afraid of having internal pelvic floor please know that in pelvic floor therapy, you never ever have to do anything you’re uncomfortable with. If you’ve had negative experiences with other providers or your annual OB exam, it can feel scary to think about doing internal pelvic floor work with a provider. 

There’s actually a lot of progress you can make without ever doing internal work, including therapeutic exercise, diaphragmatic breathing, and even body education. You can start with virtual care too, which is a great way to learn more so you can gain confidence and comfort.


More from our Normalize This Series

Normalize This: Urinary Incontinence

Normalize This: Sexual Wellness

Normalize This: Holistic Medicine

Normalize This: Eco-Literacy

Normalize This: Mental Health

Normalize This: Women Centered Health

Normalize This: Holistic Fitness

Normalize This: Menopause

Normalize This: Women's Entrepreneurship