November 8, 2013

My Vagina has a Personal Trainer: Tales from Pelvic Floor Rehab.

For the rest of this story: 

Read Part 2 here. 

Part 3 is found here.

The last in the series, part 4, is here.

I lie on the table with my heels touching each other, my knees splayed to the side, and naked from my waist down.

“Okay, now do a Kegel,” Ally says.

I look at Ally.

“Like you’re stopping the flow of urine but also trying not to pass gas at the same time,” she explains. I laugh a little, because I always laugh when someone talks about farting or peeing and she just mentioned both. And also because Ally, the physical therapist who I just met, is staring at my lady parts.

I tense my pelvic floor muscles while she watches. I feel like I am winking at a stranger.

With my vagina.

Looking back, pee problems have been sprinkled throughout my life.

There was the humiliating time I peed my Bluebird tights in first grade. The teacher, Mr. Opitz, had said it was quiet time. I was very quiet, except for the faint trickle of piss pooling around the legs of my tiny chair and blackening my tights. I’ve been weak-bladdered as long as I can remember. When travelling by car, I stop at every rest stop.

Giving birth to two babies did not help the cause.

My son’s birth, in particular, was traumatic. I pushed for four hours to bring him into the world. He was posterior, with the widest part of his generous head pressing on my tailbone. Towards the end of the pushing phase, I was exhausted and pretty sure I was going to die. For a brief, terrible time, the contractions were pushing him in and out of my vagina like a prairie dog, because I was too tired to push with the contractions.

My daughter’s birth was a breeze by comparison, but I still pushed for an hour and a half. Her little grey head, which I watched emerging from my body via a small mirror, was attempting to come out temple-first, so she, too, was stuck for a time. I sometimes speculate that I have a u-turn somewhere in my vagina, explaining my birthing trials.

I complained of my constant peeing to a midwife I saw during my pregnancy with my daughter.

“Since my son was born, I cannot stop peeing,” I told her.

“They do actually have physical therapy for that, you know,” she said.

I imagined a strange, sterile room filled with tiny vagina barbells.

I tucked the piece of information in the back of my pregnancy-addled mind, where it stayed until recently.

I recently weaned my daughter, marking the end of five continuous years of breastfeeding and/or pregnancy. I was tired of needing to pee all the time. Tired of having to plan playground visits around which ones had clean, nearby bathrooms that were big enough to drag my two children in with me. I was tired of sex being so different than it used to be. Not bad, but not as good, either.

Now that I had my body back to myself, I wanted to make the most of it.

And so it is that I find myself at pelvic floor rehab.

Week One

After Ally is finished inspecting my ladytown, I get dressed. Grateful for my jeans, I perch in a chair next to her desk while she talks.

She informs me that my muscle tone rates a low two on a scale of 1-5. As far as I can tell, my vulva just got a D-.

Ally explains that the weakness is probably due to the trauma of my son’s birth, but that sometimes people just “lose it from not usin’ it.” Ally speaks in a soft, sing-song voice. She has two kids who are just a pinch older than mine.

I learn that the pelvic floor is a hammock of muscles stretching between the pubic bone at the front of the body, and the tailbone at the back. The muscles support the reproductive organs. When this rope of muscles becomes weakened, risks are incontinence, decrease in sexual satisfaction, and in severe cases, organ prolapse.

She sends me home with a “Voiding Log,” so I can track my urinary habits for 48 hours. She tells me to count how many seconds I pee each time and record it the log.

Fun fact: the number of seconds you pee corresponds with how many ounces of liquid waste you’re eliminating! Pee for twelve seconds, and you just voided that tall latte.

I groan when Ally explains that I’ll need to come back weekly for at least 12 weeks. Squeezing anything else into my schedule seems unlikely. But the reason I started therapy is because my bladder weakness was starting to interfere with my life. I reluctantly agree to commit to the treatment schedule.

Speaking of squeezing, Ally assigns me two different types of Kegels to practice several times a day. One thing Ally teaches me is that when performing Kegels, you’re not just supposed to tighten your vagina, but also your bum. So if you see me out and about and I look focused or distracted, don’t worry. I am probably just squeezing my junk.


Week Two

“Did you do your homework?” Ally asks.

“Yep!” I hand her my pee log like a proud student.

She looks over them and nods her head. In the mornings, I often peed every 45 minutes or so. “Yeah, it’s really good that you’re here!” she concludes, analyzing the data.

“So what I’m going to start having you do now is called ‘urge suppression.’ So, the next time you have to pee, and it’s been less than an hour, you’re going to do five quick Kegels, like this.”

She makes five quick fists with her hand, since I guess she doesn’t want to show me her vagina.

“We’re going to do some biofeedback work today,” Ally tells me next.

I freeze. The paperwork I received prior to my appointment included a terrifying warning about ‘biofeedback equipment being hooked up to genitals and/or rectal area.’ I had glossed over it out of necessity; surely this was something other patients needed to do, but it would not be necessary for me.

“I read about this,” I stutter.

“Yeah, you were probably like, ‘what am I getting myself into?’”

I nod and let out a nervous laugh.

“I’m not going to give you electric shocks or anything,” she says. This is a thought my anxious mind hadn’t even dreamt of.

Ally points to her table, which has a big pad spread out right in the middle of it. The same kind of pad they place under you after you’ve just given birth. I feel a flash of shame; just because I have a bladder issue doesn’t mean I’m going to spray all over Ally’s office like a tomcat.

“So what you’re going to do is lie down on your side and pull your pants and underwear down,” she explains.


She holds up a few wires that look like earbud headphones. “And then I’m going to place one of these on your hip.” I relax a bit. Hips I can deal with.

“And the other two, I’m going to place on either side of your anus.”

“Oh, Ally. What are we doing here?” I laugh. “I’m glad I at least get to face the wall, away from you, in quiet shame.” I hold my breath. My butt has, historically, been my least favorite body part.

By nature, having children makes us more vulnerable. We vibrate with the urge to keep them safe, while constantly being reminded that we cannot. With birth, we’re reminded just how animal we are: the howls and moans, the way at a certain point we fall deep inside of ourselves and our own pain, partners and medical staff dropping away. And with babies and small children, who begin so helplessly, always shitting and puking and drooling and screaming, it is hard to not soften into our humanness, our own messy animal bodies.

Modesty also goes out the window with the arrival of young children. Every time my bottom hits the cool toilet seat at home, my kids both come running towards me as if I had fistfuls of candy and balloons. When I dare to close the bathroom door, I can hear their hot animal breath just beyond the door.

And yet, even with the humiliation and humbling of parenting, I lie on the table like a victim of an alien abduction, mortified and dripping with vulnerability.

Ally lifts my fleshy cheeks away from each other and places the two sensors right where she promised she would. Thoughts dart through my head: you really should have taken a shower. You have earbuds on your anus.

The humiliation is too much and I start laughing. “Sorry, I have the sense of humor of a nine-year-old,” I tell Ally, who smiles in a comforting way. I am so far out of my comfort zone, so exposed, that laughing about it is the only relief.

“Oh, me too,” she says. “And just so you know, all the stuff that I’m doing to you, I’ve had done to me, too.” Enough about your weekend, Ally, I want to say.

“In school,” she adds.

She pulls the end of the wires and hooks them up to your laptop on a small rolling table table next to the bed.

“So… is my ass really hooked up to your computer?” I ask. Ally nods, smiling.

She leads me through a series of timed Kegels, and yellow peaks and valleys rise and fall across her computer screen. It feels a little bit like I have an Etch-A-Sketch attached to my privates.

“Good,” she says, encouragingly. The numbers by the peaks measure my muscle tone. The highest I go is a 10. At the top of the screen is the number “100.”

“So how high would a really strong pelvic floor go?” I ask Ally.

“Our goal is to get to 20,” she says.

“Then I want to go to 30.”

“Alright! Awesome,” she says.

“I want to be able to lift stuff with my vagina,” I vow. Ally and I both giggle.

After she unhooks my butt from her computer, she sends me to the physical therapy area down the hall. There are a few Pilates machines that look suspiciously like torture devices, a couple of tables, and a bike and treadmill in the area. Two other women are working with clients in corners of the room. Ally introduces me to a woman named Rachel, who has me lie on a small table and breathe. She tells me we’re going to do some work with body awareness and posture.

Rachel says something about knitting my rib cages towards each other, and breathing without moving my spine. I try what she is telling me, but it makes no sense to me, and the harder I try to understand, the more lost I am. Rachel looks down at me, her face faintly impatient.

I still have the earbuds on my butt, the ends of wire slinking out of the top of my jeans. Rachel hooks them up to a handheld screen and tries to turn the volume up, an attempt to help me ‘listen to my body.’ She wants me to slide my heels up and down the table while tensing my abdomen and pelvic floor. The machine is silent.

“My pelvic floor is feeling shy,” I say. Rachel says nothing. She apparently does not possess the same sense of humor as Ally.

“I think I got a bum machine,” she says.

“So to speak,” I quip. She says nothing.

I lie on the table for a few more minutes, as Rachel instructs me to slide my heels up and down the table using my pelvic floor muscles. My brain hurts. I feel as if I’m trying to sing one song while listening to another at the same time.

Rachel gives up and directs me to a changing room specially designed for people who need to remove biofeedback wires from their rectums. “There are directions right there on the wall,” she points out. She shows me a box where I am to place the used wires. “And there’s hand sanitizer there, and air freshener.” She points to a bottle of Oust. I want to ask her if the air freshener is to keep the small room from smelling like ass, but we’ve already established she wouldn’t be amused.


Relephant reads:

A Vagina Manifesto For Males & Females.

The One Thing Women Really Want in Their Vagina. {NSFW Video}

Yoga with the Vagina, Hoo-ha, Coochie?


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Editor: Catherine Monkman

{Photo: Flickr.}

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Melina Sep 17, 2015 7:22pm

I had incontinence in my late 20's for a while when I had a group of other autoimmune like symptoms too. I went to a urologist during that time period and they recommended using their pelvic floor tens unit contraction machine (I don't know if this is the exact name for it), but I do not recommend it unless you bought it for only yourself and no one else has used it based on my experience. I am sure some will doubt that this could happen as the technician did. However, I know my body well enough now to honor what it tells me over what others say even if they are supposed to be experts. Basically, you place a probe inside your vagina and it electrically contracts those muscles for you to help strengthen them. I went in once and two days later I got a horrible vaginal infection. I had never had such an intense one and it turned out to be a really difficult to treat to. I immediately suspected the machine and asked them if they just "disinfect" it and use it on everyone. They said yes. The probe had crevices (it was also made out of both plastic and metal) and looked like it would be hard disinfect properly anyway. There have been studies showing that surgical sterilization is often not enough so I strongly suspect that that was the case. Also, I am sure the machine is used on lots of women with cystitis, which means they have got bad microbes in their vaginal microbiome (you don't want to share their equipment is what I am trying to say). I recommend doing your own exercises instead that don't require a machine if weakness is the problem. It turns out that wasn't the problem for me and instead I needed to work on the systemic inflammation. I don't have this problem anymore. I figured I might as well share my story in case it is helpful.

Deirdre Murray Sep 17, 2015 5:55pm

Hi! Your article was very funny indeed! Just to let you and any readers know that when a muscle or area is restricted, from a past trauma (trauma's can include: major trauma like being born or giving birth, or micro trauma like sitting with poor posture every day, or emotional trauma like being abused or bullied) it cannot function optimally. So trying to strengthen it with kegels etc can only do so much. Its sort of like the restricted area is like a clenched fist, doing a kegel is like trying to strengthen it while its still clenched. However if you release the restriction and allow the area to function optimally (as it already instinctively know how to do) then many times the endless strength training isn't necessary. So once the fist is unclenched the hand can then open and shut as strongly and as optimally as it needs (use this analogy for your pelvic floor). John F Barnes Myofascial Release is a type of therapy that works with your body (never, ever forcing it) to gently release the restrictions so that your body, and muscles can function optimally. Often once the restrictions are released then the pelvic floor knows exactly how to function all by itself without and need for kegels and biofeedback. JFB Myofascial Release therapists who are licensed to carry out pelvic floor work can be so helpful to women (and men) who have difficulty in their pelvic region. I am a Massage Therapist who exclusively practises JFB MFR, however my license doesn't cover me to do internal pelvic work. So this is not a plug for my but rather some really important information for you all to be aware of. Best wishes on your journey's to health.

KB Dec 22, 2013 8:55pm

Thank you SO much for sharing this. I feel like so many people are unaware of this treatment. I sure was. I started Pelvic Floor PT a couple months ago. I’ve already seen huge changes that have greatly improved my quality of life. I share the same sense of humor and always thought I was the only gal getting a personal massage down there weekly. So good to know I’m not alone! 🙂

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Lynn Shattuck

Lynn Shattuck lives in Portland, Maine with her husband and two young children. Lynn is currently writing a memoir about her brother’s death. She writes about grief, parenting, imperfection, spirit, and truth telling—you can connect with her through her website or find her on Facebook.