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Pelvic Floor Physical Therapy and Rehabilitation vs. Personal Training, and the Sessions In Between

What is pelvic floor physical therapy? And what is personal training? You may understand that physical therapy gives you exercises, and if you’re aware that pelvic floor physical therapy still focuses on the total body (and you may not know this! Many don’t!), you may not understand how physical therapy and personal training are different.


Along the same lines, if you’ve tried one or the other, you might be curious if there’s anything in between. For example, maybe you’ve seen a pelvic floor physical therapist, gotten a diagnosis, and made some progress on some exercises. Yet, you may not feel quite strong enough to embark into personal training for general fitness. Or maybe physical therapy costs more than you’re able to pay at the moment, but still personal training isn’t specific enough to your goals for fitness as a mom, healing diastasis recti and pelvic floor issues, and learning how to exercise in a variety of formats safely.


Postpartum recovery is so important, learning how to heal after having a baby and learning how to safely resume exercise and meet your fitness goals. Pregnancy changes your body, and you’re not alone if you’re experiencing some unpleasant changes! One in three women who have had a baby experience urinary incontinence (source: pregnancybirthbaby.org.au), all pregnant women have diastasis recti at 9 months of pregnancy, and 40% of women have diastasis at 6 months postpartum (source: Core Exercise Solutions). You may also have significant back pain after having a baby and not really be sure why…but it’s, at best, a distraction, and worse, may be inhibiting your everyday activities.


In this post, you’ll find a guide for your options for healing, recovery, and fitness after having a baby. We’ll cover what pelvic floor physical therapy is, what personal training is, and what’s in between the two, and help you figure out when you might want to choose each of these options for your personal needs.


What is Pelvic Floor Physical Therapy?

Pelvic floor physical therapy is a specialized practice of physical therapy that is focused on the pelvis and its surrounding muscles. That said, because your whole body is connected, treatment is not limited to the pelvic floor muscles. Pelvic floor physical therapists (PTs) will assess issues related to pelvic floor dysfunction by asking you questions about your symptoms, evaluating your range of movement throughout the body, performing an internal and external exam of the pelvic floor muscles, and connecting you to specialized machines for biofeedback that help determine weakness and strength. All of these pieces of their assessment can help them form a diagnosis. Based on their assessment and diagnosis, they can treat you through exercises (which you’ll then want to do at home in between sessions), manual therapy (somewhat like massage or stretching of these muscles), and biofeedback therapy.


What is Personal Training?

Personal training is a customized fitness program designed for you by a certified trainer. A personal trainer will work with you to understand your goals and may also assess your areas of weakness and strength so they can design your fitness regimen to meet your needs. They’ll teach you what exercises to do, how to do them, how many reps to do, and be with you to watch you do them correctly. Sometimes they’ll also offer nutritional guidance. Personal training can be a great way to ensure you’re making progress towards your fitness goals. While customized to meet your fitness needs, it is usually focused on general or overall fitness (vs. healing pelvic floor), unless your trainer has additional certifications.


How are Pelvic Floor Physical Therapy and Personal Training Different?

These two professions overlap in helping your body, but they do have differences beyond assessment and treatment – differences in training, scope, client base, and benefits.


Training and Education

Pelvic floor PTs have specialized training in the pelvic floor, how to assess and treat it, as well as the rest of your anatomy and how your whole body works together. They typically have degrees or doctorates in PT. Personal trainers are certified in exercise and fitness, and while they may have additional certifications, they do not typically have in-depth knowledge of the pelvic floor anatomy and function.


Scope of Work

Pelvic floor PTs work to diagnose and treat dysfunction, such as incontinence, pelvic pain, diastasis recti, and pain elsewhere in the body that may be due to changes that occurred during or after pregnancy. Pelvic floor PTs work with healthcare providers to address health issues and may also help with postpartum rehabilitation. Personal trainers are not diagnosing problems, but rather are looking for ways to help their clients meet fitness goals such as improved cardiovascular fitness, weight loss, strength training, etc. Personal trainers do not treat medical conditions.


Clients They Serve

Pelvic floor PTs work with people who have pelvic floor concerns (and these people could be men or women). Personal trainers often have a more broad range of clients with a variety of fitness goals.


Benefits

Because the goals of working with a trainer vs. PT are different, the benefits are different too. As pelvic floor PTs can diagnose what specifically is contributing to your symptoms, their clients benefit from knowing exactly what to work on and can track towards that goal. Their specialized area of focus will help their clients resolve the issues they’re experiencing.


Clients who work with personal trainers can track towards their fitness goals with the help of their trainer, and they’ll benefit from on-the-fly adjustments to the fitness program as they advance in mobility and strength.


The In-Between: Postpartum Exercise Specialists

As you may be thinking, PTs and personal trainers can seem pretty different. There is a bucket of professionals who work in the space between pelvic floor PTs and personal trainers: Postpartum Exercise Specialists (spoiler: this is the work I do). These professionals can work across different segments of the wellness space, from yoga and pilates teachers to specialized personal trainers to general PTs. It is, however, a bit different from a postpartum fitness instructor (e.g., a postpartum yoga teacher). Using that example, a postpartum yoga teacher would know how to help you do yoga safely as you’re healing and strengthening your body after having a baby. That is different from a postpartum exercise specialist who is trained to teach you exercises to help with issues like diastasis recti, incontinence, and back pain.


Let’s see how the training, scope, etc. looks for postpartum exercise specialists as compared to pelvic floor PTs and personal trainers.


Treatment

Postpartum exercise specialists should help you by assessing your needs and teaching you exercises to help meet your needs and goals. Similar to a pelvic floor PT, they will ask you questions, assess your movement and breathing, and offer you exercises to improve your symptoms. Similar to a personal trainer, they will be able to give you an exercise program to follow that is inline with your pelvic floor, diastasis, or pain relief goals.


Training and Education

Like personal trainers, most often postpartum exercise specialists will have a certification to train them on their area of expertise. More like PTs, this certification for postpartum specialists covers knowledge of the pelvic floor anatomy and how the rest of the body works to support it (or inhibit it). Unlike PTs, they do not always have advanced degrees in the area.


Scope of Work

Like pelvic floor PTs, postpartum exercise specialists can help with dysfunction, such as incontinence, pelvic pain, diastasis recti, and pain elsewhere in the body. They do it through your feedback on what’s improving vs. treatment that requires diagnosis or manual or biofeedback therapy. Like personal trainers, these specialists do not diagnose conditions.


Clients They Serve

Postpartum exercise specialists work with women specifically on issues like pelvic floor dysfunction, diastasis recti, back pain, and safe return to exercise.


Benefits

With postpartum exercise specialists, clients benefit from learning how to safely return to any exercise program. They benefit from working with someone with specific knowledge of the pelvic floor and how the body can change after pregnancy, and knowing that they’re working to heal and strengthen the areas where they need it most after having a baby. These are different from the benefits of a PT and personal trainer because the goals are different.


Comparison of All Three Specialties

I created the Venn diagram below to help you understand the key differences among the three specialties because I’m a visual person and you may be too.



Choosing the Right Approach for Your Postpartum Journey

Depending on what your goals and needs are, you may find that any one (or multiple) of these professionals are the right fit for you. In the most clear cut of examples, if your goals are general fitness-related, see a personal trainer. If you have severe or many physical challenges after having a baby, see both your doctor and a pelvic floor physical therapist. I’m a big believer in having a team of professionals helping you, so I think it can be a good thing to see all kinds of professionals to help you until you find what works best for you. That said, sometimes it’s nice to know where to start. So if you’re somewhere in between, in that you care about general fitness and also have pelvic floor or postpartum-related issues, you’ll likely want to start with either a PT or a postpartum exercise specialist. Here are a few examples of what I think makes sense; you may feel differently, and that’s ok too!


Example: Client struggles with incontinence, but it’s mostly manageable with a pad and frequent bathroom stops. But, she realizes that urinary leaking doesn’t have to be her life, so she’s looking for someone to help her resolve her incontinence issues.

  • She might choose a pelvic floor PT if: she wants to confirm a diagnosis, she wants to be able to track via biofeedback, she has insurance that will cover PT, or she wants to know if manual therapy is needed.

  • She might choose a postpartum exercise specialist if: she wants to see how exercise can improve her condition, she is more cost-conscious (either due to insurance not covering PT or not covering enough of the cost), she is comfortable with measuring progress in terms of increased strength or hours/days without leaking.

  • She might choose a hybrid approach, in which she sees a PT to confirm diagnosis and whether or not there’s a need for manual or biofeedback therapy, then move to a postpartum exercise specialist for ongoing work on exercises designed to meet her needs.

  • When she’s ready to focus on general fitness or advance beyond what a PT or postpartum exercise specialist might typically offer, she’ll reach out to a personal trainer, ideally one also specialized in working with women.

As I hope you can see, all three professionals have a lot to offer! It really depends on what your needs and personal preferences are for how you work with someone and measure progress.


Success Stories

As you may know, I work with moms 1:1 and in small groups and love helping other mamas find what works to heal and strengthen their bodies! Some of my clients have been new to postpartum (just a few months after having a baby) and some have been YEARS postpartum!


From one client who is 20+ years postpartum:


“The breathing and exercise skills you taught me are working! I am feeling much stronger in my core and not leaking as much since our session. I do the breathing exercises throughout the day to maintain my progress. Thank you so much! It really has made a big difference in my life.”


From another client:


“Katy is warm, kind, and makes you feel supported and seen no matter where you are in your postpartum healing journey. When I was feeling bad about my weak pelvic floor and core, Katy not only gave me the tools to address my issues but also encouraged me and renewed my confidence in myself. She’s a great teacher AND cheerleader!”


Without working with someone (and that doesn’t have to be me!), these women would not have seen improvement or believed in themselves enough to hope for things to be different for their physical experience. I want all moms to know they are not alone, they can see progress, and there are many types of professionals who can help them. If you’re reading this and still not sure where to start, send me a message and I’d be happy to weigh in. In the meantime, I have a few resources and services I can share (below) for you to peruse. As always, let me know what else to add, especially if you’re local to Dallas. You can do this, mama!


Resources

  • Special Partnership with Babies Love Barbells: If you’re reading this post close to its publish date (October 2023), I’m running a special package in partnership with Babies Love Barbells (personal training with a focus on exercising after having a baby). It’s for 3 sessions with me, 3 with them, and the first TWO people to purchase the 6-session package receive an additional session with each of us for FREE! Email me to sign up.

  • Healing & Strength Private Sessions: Work with me 1:1 to help resolve any issues and meet your goals.

  • Heal Together: Small Group Movement: Work with me in a small group of moms to learn exercises to heal your bodies, plus have community and accountability.

  • Genesis PT: A pelvic floor physical therapy practice local to DFW that I hear great things about from other moms.

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