When we were still allowed to be in public with other people, we had the chance to meet Mary Yoffe of Back in Action Physical Therapy. We were so excited to connect as we did not have a pelvic floor referral in the Cary/Apex area, and we definitely found one now!
We talked for a long time as she was curious to learn so much about the birth community and were so happy to hear her gentle but therapeutic approach when working with her pelvic floor patients! She definitely has a strong passion for the work which can be immediately felt as she describes how she cares for her patients! We are so excited to feature her this month!
How did you first become interested in working as a pelvic floor therapist?
I started working as a Physical Therapy Aide to get a little experience prior to going to graduate school for Physical Therapy and stumbled upon a clinic in the Triangle that specialized in Pelvic Health. After a few months of learning all about Pelvic Health Physical Therapy and how many issues I had just assumed was a normal part of life (ie incontinence during/following child-birth, pain with intercourse, etc.), I found out that I actually had some pelvic floor dysfunctions that had been causing me pain, and decided to try a few sessions of Physical Therapy to see if it would help me. Within 3-4 sessions I felt significantly better and in much more control of my body, and immediately knew that was the field of Physical Therapy I wanted to go into. I think the fact that I have personally gone through Pelvic Health Physical Therapy and know how much of an impact it made in my relationship and personal confidence, makes me that more passionate about helping other women (and men) who may have similar issues.
What does a typical session with you look like?
A typical Physical Therapy session with me can honestly look like however you want it too. One thing that people tend to focus on too much is how we assess the pelvic floor, but that is only a small part of the initial assessment. As a Pelvic Health Physical Therapist, I am looking at a multitude of things from the ribs down to the ankles, including strength, posture, breathing mechanics, and functional movement, because those can be important factors that can play into the pelvic floors ability to perform. The gold standard of care to assess the pelvic floor muscles is with an internal muscle assessment (1 finger palpation, no tools or speculum), however this is always optional for patients, and there are a number of other things externally that we can do to evaluate the pelvic floor if they are not comfortable.
What are some common red flags that you hear in a consultation that someone may or may not associate with pelvic floor issues?
Common things that people think are no big deal or believe are “normal” and can actually be a pelvic floor issue include: painful gynecological visits, painful intercourse (at any point in life), painful urination or bowel movements, constipation or difficulty emptying bowels, urinary incontinence with low or high impact exercise, urinary incontinence with laughing/sneezing/coughing, hip or low back pain, abdominal pain, urinary urgency or frequency, c-section scar pain, diastasis recti (abdominal separation), and heaviness or bulging in abdomen or pelvic floor (vaginal or rectal opening).
Why do we need to know how to contract AND relax our pelvic floor muscles?
There are a multitude of reasons that we need to be able to contract and relax our pelvic floors. Some women try to perform a kegel during urination to see if they are strong enough to stop the flow (PLEASE DON’T DO THAT!), however that can affect the nerve pathway between your brain, bladder, and pelvic floor muscles from running smoothly. The bladder and pelvic floor muscles have a reciprocal relationship, which means that when one contracts the other relaxes. Therefore, if you have a strong urge to use the restroom, you need strong pelvic floor muscles to be able to contract and suppress the signal and contraction from the bladder until you can make it to the restroom. On the other hand, when you are urinating you need to be able to fully relax the pelvic floor muscles to allow the bladder to contract and empty out all the urine. In some cases, the pelvic floor muscles can actually be too tight and limiting your ability to relax the pelvic floor or perform a strong pelvic floor contraction, which in turn can cause increased urinary urgency.
When you are not with clients, where can we find you?
The top two places you will find me are 1) at the farm riding my horse through the beautiful woods around Jordan Lake or 2) lying on the boat down at Wrightsville Beach with my husband and black lab!
