With insights from Pelvic Floor PT, Dr. Lia Palomino
If there’s one topic women everywhere wish we talked about more openly, it’s pelvic floor health. Whether you’re pregnant, postpartum, years into motherhood, or just now realizing something in your body feels off, you’re not alone, and this post is for you.
Recently on the podcast, I sat down with Dr. Lia Palomino, a pelvic floor physical therapist in Traverse City, Michigan. She is on a mission to change the way women understand their bodies, and after one conversation with her, I’m convinced she’s doing exactly that.
Below is a breakdown of our conversation — why pelvic floor health matters, common signs something might be wrong, and what you can do today to support your body.
So… What Is the Pelvic Floor?
If you’ve never heard the term before, you’re not alone.
Most of us grow up hearing about abs, glutes, “the core”… but the pelvic floor? Not so much.
Dr. Lia describes the pelvic floor as the bottom of your core. It’s a sling of muscles stretching from your tailbone to your pubic bone, supporting three major organs:
- Bladder
- Uterus
- Rectum
These muscles help you pee, poop, and have sex — three major functions we absolutely rely on every day. They also play a critical role during pregnancy, labor, postpartum, and beyond.
And yes, the human body is amazing…and wild.
Common Signs of Pelvic Floor Dysfunction
When most people hear “pelvic floor issues,” they think urinary leakage. And yes — that’s a big one. But it’s far from the only sign.
According to Dr. Lia, pelvic floor dysfunction can look like:
- Leaking urine when you cough, sneeze, laugh, or exercise
- Feeling sudden urgency to urinate
- Constipation
- Pain with bowel movements
- Hemorrhoids
- Pain with intercourse
- Pelvic pressure
- A feeling like “something is falling out”
That last one? Often connected to pelvic organ prolapse — when the bladder or uterus descends and puts pressure on the vaginal wall. Not fun, and definitely not something to ignore.
Her rule of thumb?
👉 If something feels “off” in the way you pee, poop, or have sex — that’s a sign.
These things may be common, especially postpartum…
…but they are NOT normal and you do not have to live with them.
“But My Delivery Was Easy — Could I Still Have Pelvic Floor Issues?”
Short answer? Yes.
Long answer? Also yes.
Even the smoothest, quickest, least-complicated birth puts enormous strain on your pelvic floor. And C-section mamas — you’re not exempt either.
Because your pelvic floor is part of your core, and a C-section goes right through major abdominal muscles, many women struggle to reconnect to their core properly afterward. That affects pelvic floor engagement, pressure regulation, and organ support.
If you returned to running or intense exercise too early, that could also worsen symptoms.
Rest matters. Gradual strengthening matters. Awareness matters.
What Is Prolapse? (AKA the New Fear You Didn’t Ask For)
Prolapse sounds terrifying, but Dr. Lia breaks it down simply:
Pelvic organ prolapse happens when the ligaments and pelvic floor muscles stop fully supporting the bladder or uterus, causing them to drop or press downwards.
It can feel like:
- Heaviness
- Pressure
- Something “falling out”
But the good news?
Pelvic floor therapy can dramatically improve it.
You’re not alone — and you shouldn’t be embarrassed.
Building Pelvic Floor Strength (Hint: It Starts With Your Breath)
Pelvic floor therapy isn’t just about kegels. In fact — some people shouldn’t be doing them at all. Many women actually have tight pelvic floors, not weak ones.
That’s why individualized assessment matters.
But across the board?
Breathing is huge.
Shallow, chest-heavy breathing increases tension and pressure on the pelvic floor. Learning diaphragmatic breathing helps calm the nervous system, support the core, and reduce strain.
From there, Dr. Lia typically works with women on:
- Core re-engagement
- Hip and pelvic mobility
- Gentle strengthening
- Functional movements (like squats)
- Eventually — dynamic activity like running, lifting, and jumping
This isn’t fast. It’s foundational.
When Should You See a Pelvic Floor Specialist?
Here’s the breakdown:
During Pregnancy
YES — and not just if you have symptoms.
Pelvic floor specialists can help you:
- Manage pain
- Prepare for birth
- Learn optimal pushing positions
- Reduce risk of tearing
- Learn perineal massage
And yes — they can help identify what delivery positions may be best for your body.
Postpartum
General recommendation: six weeks postpartum, once cleared by your OB.
But if you’re leaking, in pain, or something feels abnormal?
You can go sooner — as soon as you feel ready to leave the house.
Anytime Something Feels Off
There’s no “too early” or “too late.”
How to Choose the Right Pelvic Floor Specialist
This was one of my favorite parts of the conversation because so many women don’t know where to start.
Here’s what Dr. Lia recommends:
✔️ You get a full hour each session (anything less is rushed)
✔️ You see the same therapist every time
✔️ They’re trained in internal exams (even if you choose not to have one)
✔️ They specialize in pregnancy and postpartum
Internal exams can feel scary, but Dr. Lia explains they are:
- Similar to a pelvic exam
- Done with one gloved finger
- Gentle and deeply informative
- Always optional
A good therapist will walk you through everything with care and zero judgment.
You Don’t Have to “Just Live With It”
Your pelvic floor is the foundation of so many essential parts of your health — and yet it’s one of the most overlooked areas in women’s medicine.
If something feels off…
If you’re experiencing symptoms you’ve been told are “normal”…
If you want to prepare your body for pregnancy, birth, or long-term health…
Getting an evaluation is one of the most empowering things you can do.
Because motherhood may change your body — but it doesn’t have to take your comfort, confidence, or quality of life with it.
Want more information from Dr. Lia? Contact her through her website or Instagram:
www.mipelvicrehab.com
www.instagram.com/mipelvicrehab
Looking to schedule maternity and/or newborn photos? I would love to schedule a consultation with you! Click here to get started!
