Interview with Dr. Sarah Miller from Revive Rehab in Columbia, MO

Pelvic floor physical therapy is not only helpful for easing various pains in pregnancy and helping ensure baby is in an optimal position for birth, but it can also provide vital support for your body in all stages of life, including pre-conception and postpartum. Too often, many women are told that the pain and discomforts that they are experiencing are normal, but they’re not! I interviewed Dr. Sarah Miller, a pelvic health and orthopedic physical therapist from Revive Rehab in Columbia, MO, and she provided some great insight into how important it is to get to the root cause of your symptoms. Check it out! Here is the link to Revive Rehab’s website.

Me: What can a client expect during their first visit with you? 

Dr. Sarah: An initial visit includes a detailed health history where we discuss symptoms, when they began, and what may be contributing to them. Lots of patient education is provided at the first visit so you are educated on what your body and pelvic floor are doing to contribute to your concerns. Then a thorough full-body movement assessment is performed with an internal pelvic floor assessment if appropriate. Nerves, muscles, connective tissue and how it all coordinates together is what we’re looking at. This is to get a full-picture of what is contributing to your concerns. I like to say I’m really looking outside of the box! 

Me: What are the most common symptoms that women in the perinatal period have been told to "just live with" that are actually very treatable? 

Dr. Sarah: Common symptoms include: urinary or bowel leakage, chronic constipation, pain with intimacy, pelvic pressure and/or heaviness, pubic bone pain, tailbone pain, hip and/or low back pain. 

Me: How can pelvic floor physical therapy help support a woman's body through pregnancy and labor/birth? 

Dr. Sarah: Pelvic floor physical therapy during pregnancy is to help maintain pelvic floor mobility and optimize comfort. We address movements during pregnancy that optimize baby’s position in the pelvis and reduce any aches and pains that come with pregnancy. In sessions, we go over perineal massage to help reduce vaginal tears, practice labor and delivery positions, practice pushing, and even have your partner come in to review pain-relief techniques and position support! 

Me: How does the pelvic floor interact with the rest of the body? 

Dr. Sarah: The pelvic floor is part of the deep core system that includes the deep abdominals, low back, diaphragm, and pelvic floor. They work as an interconnected system. When one is slacking, the other parts of the system have to pick up the slack. This can result in over activity in certain areas and under activity in others. This can then affect how these systems interact with the ribs, shoulders, hips, knees, and everywhere else. We are a whole system! 

Me: How has physical therapy impacted your own motherhood journey? 

Dr. Sarah: It gave me a unique perspective on the psychological aspects of motherhood. Like how to give myself grace while healing, how pelvic health can impact mental well-being, and the importance of self-care. Being apart of the pregnant and postpartum journey made me realize everyone’s journey through motherhood is so unique. There is no “timeline” to postpartum recovery. 

Being a pelvic health physical therapist while navigating my own motherhood journey strengthened my empathy and deepened my passion for empowering other women to take control of their pelvic health, while still finding balance with it all.