"There will be zero growth, without failure."

“We get caught in this idea that it’s going to pass…..and it doesn’t necessarily just pass.”

-Renee Groenemann

Big T and little t traumas affect our mental health AND our physical health. Our body remembers these traumatic events and often holds onto a trigger that will stimulate our sympathetic nervous system into the fight, flight, or freeze cascade. In other words, these triggers can cause not only nervousness and anxiety, but also muscular tightness and pain.

Much like as we go throughout our days and the stress builds we often tense our shoulders, as we experience any type of trauma our bodies respond by tensing our muscles. Later in life, our triggers then bring back this muscular memory and tense those same muscles.

Think back to your own personal birth experience. As you go through the events in detail do you notice anything about your body? Do you feel….

…the pain in your back from contractions?

…your incision from the c-section you needed?

or maybe you can feel your pelvic floor tighten thinking about the pain from tearing?

These are just a few examples of things you may feel physically alongside your emotions when remembering your birth story.

So often, women who are in pelvic floor PT will need to see a mental health practitioner to help work through the emotions that are associated with their specific pain or problems and vice versa. That’s why it’s so important to find an integrative professional who works cohesively with other professionals to fully address all their patients/clients needs.

EMDR

Again, this is also where EMDR can be so effective. *If you missed Part 1 with Renee, go back and listen to it first.

When you have a trigger point, one of the most common treatments to start is to first apply a consistent pressure to it to fatigue the muscle until it releases. This is sort of how EMDR works, by fatiguing out the memory of something traumatic to lessen the bodies response to it.

Pelvic floor issues are a prime example of how physical therapy and mental health can work closely together. Pelvic floor issues can sometimes arise from a traumatic birth and until you fully process your birth story, it’s difficult if not impossible to physically recover.

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“I had this belief that is I went to sleep, my baby would die.” 

-Renee Groenemann

Pregnancy, Birth, and Postpartum can be a whirlwind of events that can fly by in the blink of an eye. Some of these events can be more traumatic than we initially realize. Trauma comes in 2 main forms: 

Big T- things like rape, assault, war, near death experiences.

little t- things that are more emotionally charged, but are not life threatening. 

These little t’s can add up over time and are unfortunately very common surrounding our birth experiences. Things like:

• Deviating from your birth plan- especially emergent c-sections
• NICU experience
• Extreme nausea while pregnant
• Lack of support
• Issues with breastfeeding
• Lack of sleep

Honestly, I had no idea that there were different types of trauma and it felt extremely validating to know that things like this can truly be traumatic and cause lasting stress, anxiety, etc. 

RENEE GROENEMANN

Renee is a mental health counselor, certified EMDR practitioner, certified yoga therapist and yoga teacher, certified hypnotherapist.

She specializes in perinatal mood and trauma to help prepare women for birth and recover from challenging pregnancies, births and postpartum periods using body-based approaches and mindfulness. https://www.spiritedgrowth.com/childbirth/

Renee has experience trauma surrounding her birth story, however even as a trained counselor it took her 3 years to realize what was really happening. That’s how sneaky this trauma can actually be.

SYMPATHETIC NERVOUS SYSTEM

When a threat appears we have 3 options- fight, flight, or freeze. All of these options are given by our sympathetic nervous system being activated by something our body perceives as a danger.

A flood of hormones are released, our heart rate increases, blood pressure rises, your muscles tense, and our other body functions come to a halt. Why do we respond this way? Well, it’s based on our past experiences. 

Ever been pulled over by a cop? I’m guessing yes… So, it’s possible that everytime you see a cop car you have a bit of anxiety as you anticipate him pulling out behind you. However, often we have these responses as our body remembers past traumatic events.

TRAUMA

All forms of trauma are held within our body and may manifest in many different ways. Some of the most common manifestations are stress, anxiety, and depression. These trauma’s also come with triggers. 

Triggers are often the tricky part. We often don’t realize what is triggering us until we really dig deep into our past experiences. 

For instance, Renee had a client who would often experience anxiety attacks when in public places. It took a very deep dive into this woman’s life to figure out that double doors were actually her trigger. 

She had experienced an emergency c-section and banging through the double doors into the OR got...

Hi! And welcome to episode 6 of the All out motherhood podcast- I’m so glad you’re here! I wanted to change it up a bit and take a minute to just introduce myself finally. 

So, Hi I’m Allyson. I have a doctorate in physical therapy and specialize in women’s health. I’m also a medical yoga therapist, women’s health and nutrition coach, and entrepreneur. 

I’ve actually worked in health care for 20 years now since I was 16 working as a pharmacy tech and have always had a strong interest in women’s health. 

I’ve seen a lot of changes in healthcare during this time period, however the one area that I’ve only recently noticed changes taking place in is women’s health. This bothers me…. A lot.

Now, it’s important to note that I’m in the US, so our healthcare system is very different from many other countries. 

We live in a country that prides itself on being innovative, cutting edge, and strives to be ahead of the curve in every subject possible. But, also a country where it is illegal to take newborn puppies away from their mother until they are 8 weeks old, yet many women have to go back to work at 2 weeks postpartum- unless of course you take short term disability, then you get 6 weeks. Let that sink in for a second.

What does that say about the value we place on mothers as a society? What msg does that send out regarding breast feeding, postpartum recovery, and the care of our newborns? 

Don’t get me wrong, there are absolutely some companies that have recently began offering maternity leave and even a very few that offer paternity leave for dad. But how did we get so far behind here?

And if you really want to get me up on a soap box, let’s talk about some of the crazy and completely ridiculous things women go through after having a baby.

Thank god the husbands stitch is not really a thing anymore- although i have heard women still being offered it. If you don’t know what the husbands stitch is, it is an extra suture that a doctor used to do in order to “tighten your vaginal opening” after an episiotomy or tearing during childbirth in order to make sex more pleasurable for your husband later. Um, seriously? 

The first time I heard about this cringe worthy procedure I thought it was a bad joke…... and when I learned it was a real thing that was CURRENTLY happening, not like 500 years ago- I'm pretty sure some four letter words came flying out of my unpolished mouth. I may be introverted, but I am forever incapable of hold my tongue or hiding my facial expressions. Sorry mom.

Working with women who are dealing with pelvic pain you hear some just awful things, and maybe you yourself have unfortunately heard something like “if sex hurts, just have a drink and relax”- I know when pts have said this, there’s really no need for me to respond verbally because my face says everything I’m thinking.

We also hear things like “peeing when you sneeze is just part of life after babies and as we get older”- well, I can assure you it’s not. As my friend and colleague Dr. Libby Trausch said on our first episode “You have to rehab your body to your new self and accept the changes that come with having a baby. But, acceptance doesn’t mean you have to settle.” 

Also, I can’t tell you the number of women that I’ve known- myself included, who have had their back plain blown off as “just menstrual pain” and on the flip side had their dysmenorrhea, or painful periods, ignored as normal or simply put on birth control without actually looking into the cause and what’s going on. 

I’m tellin ya- I could literally go on for days, but then we’d all be feeling even more ticked off than I’ve made us at this point. 

So, let’s move on to something a little bit lighter… because out of all this frustration- a podcast was born. 

My main goal with each episode is to bring information to you that can help you prepare,...

"Stress stays with you and sleep is a good time to heal the body. Our body can only take so much until it's like "I'm out!" and you start to have health issues."

-Dr. Amisha Klawonn

Sleep. Just saying the word makes me imagine myself snuggled up in my comfy, cozy bed just about to fell asleep. But, then I realize it's 3p on a Monday and I only have 2 hours of work time left before I have to get the kids.

So often we are trying to be productive right up until our eyes close and then we start again as soon as they open. Laying in bed scrolling our phones, checking email as soon as the alarm goes off. That's just about the worst way you can start and end your day and I am 100% guilty of doing it.

MEET AMISHA

Dr. Amisha Klawonn is an integrative physical therapist, women's wellness + sleep coach, yoga therapist, and mother. She is all too familiar with the difficulties surrounding sleep that come with being a mom. Her personal experience with sleep led her to dive deep into the topic and she now coaches women on how to optimize their sleep.

SLEEP

Sleep is not an option. It's a requirement. There are so many processes within our bodies that require us to sleep. Have you ever gone several night on very little sleep (ahem, maybe with a new baby)? What did you notice?

When I don't get enough sleep I don't feel good and I'm just not a nice person to be honest. I can't focus, my brain is mush, my stomach is usually upset, and my body just says 'no' to everything.

Sleep is the time our body uses to process the information from that day, heal + restore tissues, and just overall rejuvenate in order to do it all over again the next day.

The problem is as we get older things like stress, anxiety, alcohol, caffeine, blue light, children, and many other things can interrupt our sleep and make us miss out on it's much needed benefits. We turn into cranky walking mombies.

Sleep affects everything from our mood, hormones, productivity, digestion, and everything in between. That's why it's so important to make sleep a priority.

Now, there are absolutely times when it is just unavoidable to miss out on a good night's sleep and that's ok. The key is not making it a habit.

MINDFULNESS

One of the absolute biggest factors affecting our sleep as moms is stress.

Stress is often a factor in most bad things that happen to our body, to be honest. It keeps us up at night, raises our blood pressure, causes anxiety, upsets our digestion, and so much more.

What's one of the easiest (yep, I promise it is) ways that you can decrease your stress? Mindfulness.

Mindfulness is "a mental state achieved by focusing one's awareness on the present moment, while calmly acknowledging and accepting one's feelings, thoughts, and bodily sensations, used as a therapeutic technique." according to the Oxford Dictionary.

I used to think you could only be mindful if you meditated for 2 hours a day, but that's just not the case.

Sometimes mindfulness looks like a guided meditation for 3 minutes while you just breathe. Other times it is taking a second to acknowledge your anger when your kid draws on the couch with a sharpie (true story- happened last week). Then, instead of losing your mind- you talk to your kid, explain what they did, why it's not ok, and why they are in trouble.

Sometimes it's so easy to just lose your cool, yell, and let it all out. But, most of the time that leaves you feeling guilty and your child wondering what in the world just happened while sobbing and creating a whole other stressful situation. Been there, done that way too many times.

Meditation also doesn't have to be so boring. The are guided meditations, walking meditations, sound bath meditations, and so much more. It may take trying a few to see what fits you, but I'm telling ya it's worth it.

Check out these apps for some meditation options:

Did you know that physical therapists can help with things like pain with sex, bladder leaking, IBS, recovery after pelvic cancer, and lymphedema? Well, you do now. 

MEET MELANIE

Dr. Melanie Struzzi Sutton is a PT with certifications in women’s health pelvic floor, lymphedema, and oncology. Melanie shared her wealth of knowledge in this episode of the All Out Motherhood podcast as we chatted about her experiences with treating women’s health patients.

PAIN WITH SEX

Have you ever had pain or discomfort with sex? I’ll be the first to admit it- yes, I have. Sometimes it’s a one time occurance that is quickly remedied with a position change or some lubrication. Other times….it doesn’t go away. 

Pain during sex can occur at any time during a women's life, even from the start. However, it is frequently begins after giving birth (yes, even after a c-section).

There’s a stigma society has created around this topic even though 9/10 women experience pain with sex after having a baby and it persists in a quarter of those women after 18 months. This is not ok.

Women should not feel ashamed or embarrassed that something hurts them, especially sex. For decades, women have suffered in silence for fear of being judged. When you talk to some women who have experienced pain for years they will say things like:

“It’s just not something you talk about.” 

“I must be broken.”

“I was too embarrassed to ever tell anyone.”

“I should be able to deal with it for my partners sake.”

OR

“No one ever asked me” 

Screening for these issues is something that should be routine during our health checkups and we should feel comfortable talking with our providers about these topics. Especially, for postpartum women- whether you had a vaginal birth or c-section.

It’s not ok that we still have women that hear things like “just relax, sex always hurts after baby” or “take a shot of alcohol, it’ll help” from their providers. Some women end up ‘just dealing’ with the pain for decades because they think it is normal and just a part of life now. 

Yes, some pain after baby may be normal, especially if you are still healing. It takes time, especially depending on how your birth went. Just because you got the all clear at your 6 week check up doesn’t mean you are completely healed and ready to jump back in the sack like before. 

*It’s important to note that as we get older, our hormones do shift and dryness may become an issue that contributes to or causes pain. Something as simple as finding a quality, non-toxic lubricant may be the solution, but if that doesn’t fix it- talk to your provider. 

It’s always good to see a pelvic physical therapist after giving birth even if you had no complications, tearing, trauma, etc. Pelvic PTs can give you individualized recommendations based on your specific needs and check for things that might cause problems in the future. This doesn’t mean you necessarily have to have a full internal exam. There are plenty of things to still talk about and address externally. 

There’s a mental, emotional, and obvious physical toll that this can have on women as well. It can affect our marriage, our self-esteem, our mood, and in turn our children. 

If you are experiencing pain, please talk to your provider. If you happen to have one that just doesn’t want to listen, then feel free to message me and I’ll help you locate one in your area who will!

Looking for a pelvic health professional? Try here first.

Directory of Pelvic Health Professionals by the Pelvic Guru

HOW TO CONTACT MELANIE