How can pelvic floor health impact your time spent on the trail? It turns out there are several ways. Thanks to pelvic floor physical therapist Dr. Lauren Trosch, PT, DPT, we learned last month how you can be mindful of your pelvic floor to prepare for smoother pooping in the woods

This month, we’re continuing our “Pelvic Floor Health for the Trail” mini-series with a focus on all the mothers out there who may encounter new challenges hiking postpartum.

As Dr. Trosch shared in the first blog of this series, “Pelvic pain and problems with peeing, pooping, and sexual function can have a huge impact on some really important aspects of your life—like your relationships, your ability to exercise and stay healthy, and even really basic activities like sitting and standing. These issues can feel embarrassing or shameful, and so many people just suffer with them in silence rather than finding someone to talk to and get help. It’s so rewarding to help people feel more comfortable in their bodies and help them get back to doing the things they love.”

We hope that this blog series encourages us all to get the support we need in the various aspects of our lives where we might feel too embarrassed to ask for help. And this month in particular, we hope that whether you’re a new mama, been a mother for a while now but are still adjusting, or know someone in your life who may be struggling postpartum, that you feel seen. You deserve to keep doing what you love—both in the backcountry and the frontcountry—and we hope you find the support that lets you do so.

Disclaimer: This interview is provided for informational purposes only and does not constitute professional medical advice, diagnosis, or treatment.

Interview With Dr. Lauren Trosch, PT, DPT, on Pelvic Floor Health for Postpartum Hiking

Many outdoor moms aspire to share their love of the wilderness with their children. But what’s also true is that hiking or backpacking as a new mom can come with some unique challenges.

Below, we chatted with Dr. Trosch to normalize the experiences pregnancy can have on women’s outdoor pursuits and some tips for how mothers can be kind to themselves and improve their pelvic floor strength to feel more comfortable on the trail again.

Gossamer Gear: As you’ve mentioned, pelvic pain and related problems can make people feel embarrassed, which leads to us not talking about these topics—which leads to a lot of us feeling more alone than we need to. What are some of the things a woman might experience postpartum on the trail that are totally common and we should be talking about more?

Dr. Trosch: One thing that we should be talking about more often is our bladders! So many people start leaking during pregnancy or after childbirth and feel embarrassed and uncomfortable. Maybe you’ve noticed you leak when you laugh, sneeze, cough, walk fast, or jog on the trail. Or maybe you used to be able to make it to the bathroom without issue, but now there are times where you’re trying to make it to the bathroom and are leaking on the way. 

Unfortunately, to solve this problem some people start exercising less or stop drinking as much water to avoid leaking—which isn’t great for your overall health and wellness. And like we talked about before, hydration and exercise are also key for good bowel movements. 

With physical therapy, I think we tend to imagine receiving very tangible, hands-on strategies for solving our situation. But your work seems to also utilize things like mindfulness and self-compassion. Can you talk a little more about why that is and some examples in action?

So, there is definitely a time and place for tangible, hands-on strategies for rehabbing your core and pelvic floor. 100%. But, during pregnancy and after childbirth, your body and life changes quite a lot in a short period of time. 

Maybe you don’t have the time to exercise and eat like you used to. Maybe you’re completely sleep deprived and stressed and you would rather sleep and recover than exercise. Maybe you’re recovering from a cesarean delivery (a major abdominal surgery) or a vaginal delivery—and your delivery didn’t go as you had planned. Maybe breastfeeding/chestfeeding didn’t work the way you would have liked. Maybe you’ve noticed changes in the way your tummy looks, you haven’t returned to your pre-pregnancy weight, or you may have discomfort or difficulty with activities that were very easy pre-pregnancy. Maybe you’re dealing with the challenges of postpartum depression.

You may have thought by two months postpartum you’d be sexually active, feeling great about your body, walking the trails, and managing work or home life like a pro—and maybe you aren’t. I see so many people who feel really disappointed in themselves because they aren’t where they thought they would be or they’re not recovering like their friends. 

Instead of pushing through potential discomfort, fatigue, and depression, it can be really helpful to be mindful of how your body feels and listen to it. For example, if you are uncomfortable with wearing a backpack on the trail due to an abdominal incision or feelings of discomfort in your pelvis—listen to your body. It may be that you need some more time to heal, or you need help from a medical professional. You likely would do that to any other part of your body if it went through all those changes and stresses that occur with pregnancy and childbirth!

Pregnancy, childbirth, caring for a baby (and potentially other children), hormonal changes—it’s all a lot and it’s so important to have some self-compassion for all that you’ve been through. Most people struggle at some point during pregnancy/childbirth/postpartum life and you may feel like a failure or broken along the way. But, you are not.  

If there is one thing I could share with everyone it’s that you deserve self-compassion, you’re not alone, and if you’re struggling, please get the help you need. 

So, in addition to that, what are some of the tangible techniques moms can try out for strengthening their pelvic floor, and what kind of results might they expect over time?

Great question! So, first thing is that you want to make sure strengthening is the appropriate activity for you. Sometimes, people’s muscles are overactive (or tight) and that might be contributing to pain, as well as urinary, bowel, or sexual problems. Some hints that you might have an overactive pelvic floor would be constipation, difficulty peeing, and pain.

If strengthening is appropriate, you want to make sure you are doing a kegel (pelvic floor muscle contraction) correctly. When you do a correct kegel you may notice a closure and lift of the vaginal or anal region. You may have heard you are doing a kegel correctly if you can stop or slow the flow of urine—which is true. But, we really don’t want you practicing kegels while you’re peeing! So you can pretend like you’re stopping the flow of urine or like you’re stopping gas. 

You can see a pelvic floor physical therapist to make sure your pelvic floor muscles are not overactive and they can also check to make sure you are contracting and relaxing your pelvic floor correctly. There are also devices out there that may help you to see if you are performing kegels correctly, like the Flyte or the Elvie. 

If strengthening is needed, we often encourage our patients to really challenge their pelvic floors—and that means not just doing kegels while sitting or lying down. Doing kegels while standing and during other exercises may be important for making sure your exercise program is challenging enough. It’s also important to work on the endurance of your pelvic floor, and you need to make sure you can contract and relax your pelvic floor rapidly. And just like when you are working other muscles, you need to make sure you give your muscles rest. 

If you do have problems like urinary leaking due to pelvic floor weakness, it might take three months or so for improvement—so hang in there. And it’s always good to get checked by a pelvic floor physical therapist before starting a program, if possible. If your problems are not resolving, your pelvic floor physical therapist can help you find a physician for further help!

What are some specific resources you’d recommend that could provide support for outdoor mothers?

To find a local pelvic floor physical therapist, you can check out any of these organizations:

  • American Physical Therapy Association’s Academy of Pelvic Health
  • Herman and Wallace
  • Pelvic Guru

These all have a feature to search for local providers in your area!

If there’s one message you can leave women with who are facing challenges on or off trail following a pregnancy, what would it be?

Even though people may not be talking about their physical/mental challenges, struggling in some capacity during pregnancy and after childbirth is common. You may be busy and stressed taking care of everyone in your life and talking about your pelvic floor or mental health struggles might feel difficult. But, if your struggles are limiting you from doing the activities you enjoy, I really recommend seeking the help.

Connect With Your Pelvic Floor to Reconnect With the Trail Postpartum

For more tips on postpartum health and other pelvic floor information, you can follow Dr. Trosch on Instagram and Facebook and learn more about her work on her website.

Looking for some more outdoor mama trail magic? Check out some of our favorite guest posts on the Light Feet blog about the connection between motherhood and wilderness:

Stay tuned to the Light Feet blog next month for more pelvic floor tips for the trail from Dr. Trosch. And remember to read the first post in the series on pelvic floor health for good trail poops!


Header Photo by Josh Willink on StockSnap

March 15, 2022 — Korrin Bishop