How Pelvic Floor Therapy Can Transform Lives at Every Stage with Dr. Rachael Cappuccino, Pelvic Floor PT
Recently, as part of our Expert Spotlight Series, our founder Lauren chatted with Rachael Cappuccino, founder of Cappuccino Physical Therapy in the Thousand Oaks, CA area. Dr Rachael founded Cappuccino Physical Therapy after having her two children, driven by her belief that an active lifestyle doesn’t end with motherhood. Having experienced both vaginal and cesarean deliveries, she understands the physical challenges of pregnancy and recovery and believes most can be treated with pelvic floor physical therapy. With a doctorate in physical therapy from the University of St. Augustine and specialized training in pelvic health and postpartum athleticism, Rachael is passionate about helping women return to the activities they love. She enjoys running, exercising, and spending time with her husband and children.
In their conversation, Lauren and Dr. Rachael delve into the transformative role of pelvic floor therapy. Dr. Rachael shares her journey from orthopedic physical therapy to specializing in pelvic health, driven by her passion for helping women, especially moms, navigate the physical challenges of pregnancy, postpartum recovery, and beyond. She emphasizes the importance of pelvic floor therapy at all stages of life and dispels common myths like the over-reliance on Kegels. With a focus on personalized care, Dr. Rachael highlights how treating issues like leaking, pain with sex, and prolapse can dramatically improve quality of life.
Check out 5 of our highlights below, or catch the full conversation on YouTube!
1. “You Don’t Have to Suffer in Silence”: Why Your Pelvic Health Deserves Attention
Lauren:
For folks who aren't as familiar with pelvic health--maybe they have no knowledge or little knowledge--how would you explain the importance of pelvic health to somebody coming at it with that kind of baseline?
Dr. Rachael:
That's a great question because I would say most people come to us and they're like, "What's the pelvic floor?" So just knowing that the pelvic floor affects everyone. We're even hearing young girls dealing with leaking and all that fun/not fun stuff too. So I just would like them to know that it's a very important and vital component of everyday health because some people associate pelvic floor with pregnancy and postpartum, but it's also your bowel, your bladder, your sexual function. We don't do pediatrics, but young kids wetting the bed is related to pelvic floor health, and there's help. I just wish people knew that you don't have to suffer in silence and there's help, but your pelvic floor is such a vital part of your life, your daily functioning, and so you go get help. There is help out there.
Lauren:
And I think that that's such an important point because I feel like oftentimes folks can feel like, "Oh, this is just how it is; postpartum, you leak" or something like that. And I feel like that's kind of been normalized a little bit. And because it's kind of taboo, people don't talk a lot about it and share that with their friends and family, they just are kind of like, "Well, this is just my path now."
And so yeah, raising that awareness of if something is bothering you, there's a good chance that we can work to improve it, even if it's not "a problem". It's like, if it bothers you, it shouldn't have to bother you.
Dr. Rachael:
It's a problem and go get help. There is help.
Lauren:
I think that's so important for people to hear.
2. Debunking Common Pelvic Health Myths: Kegels, Incontinence, and More
Lauren:
Another thing I'm curious to ask you about is what's on your top list of misconceptions or myths about pelvic health that you hear and have to actively work to overcome?
Dr. Rachael:
My favorite one is, "Just do your Kegels". I'm like, "Oh my God, if I had a dime for any time somebody ever told me that..."
Lauren:
So many media articles. It's everywhere.
Dr. Rachael:
And it's so bad because it's the worst possible advice that you could ever get. We rarely prescribe Kegels. Kegels can make you worse, especially postpartum, especially if you have a painful condition. So many people are like, "Yeah, I was doing my Kegels and my pain got worse, my leaking got worse." I'm like, "Well, yes, because first you need to learn how to relax the pelvic floor." And so I would say that's the number one thing that we have to tell people. Like, okay, we're going to stop doing Kegels. We're going to do other things. That's number one.
And then another one is probably that it's normal to pee in your pants after you have a baby. So many people are like, "Well, my grandma and my mom..." I'm like, "I don't care what they say. No, it's not normal. Tell your grandma to go get help too."
Speaking of grandmas and getting into menopause, UTIs are so common post-menopausal because of lack of estrogen. And this one, especially in the menopausal population, can be helped with a topical estrogen cream. That's another myth: that estrogen is bad for you. That's another, I won't go off on a tangent there, but yeah, that's another myth.
Lauren:
I do feel like they're pretty pervasive. I think a lot of people have those misconceptions coming into it, so there's definitely a steep education hill to climb there.
Dr. Rachael:
Yes, very much so.
3. Pelvic Floor Health Isn’t Just About the Pelvic Floor
Lauren:
Can you talk to us about a success story that you've had with one of your clients?
Dr. Rachael:
Yes, I had a patient who came in with complaints of hip pain, prolapse symptoms, and pain with sex. I think I've seen her three or four times. When somebody comes in with that many things, I'm like, "Okay, what is the most important thing for us to address today? I can't look at all of them. Let's pick one." And so she said her hip pain. And hip pain can be caused by the pelvic floor, so we want to rule out all the things, but it can also come from the lower back. So with her, her hip pain specifically was coming from her lower back, which I found in my assessment. And so we treated her back on the first day, and I told her I was pretty sure this would make her feel pretty good.
The next week, she came in, and her hip pain was 75% better. Amazing. So we worked on that again. Then we moved on to the pain with sex. I released her pelvic floor twice and she was still having pain with sex. And then I was like, "All right, let me look elsewhere." So we looked at her abdomen. This is another thing: pelvic floor isn't just looking at the pelvic floor. You have to look at the whole body. And she had a lot of fascial restrictions in her abdomen. So I did some work on that. And I told her, "I'm pretty sure this is going to help your pain with sex." She came in this week, and she had no pain with sex. Amazing! So that was awesome. Now we're working on her prolapse symptoms. She just has some poor lifting mechanics because she's a horseback rider and she's lifting horses and kids and that kind of stuff. So now we're working on coordinating her breath when she's lifting and making sure that she's not bearing down because she tends to bear down. So that was our most recent success story with multiple things.
Lauren:
Amazing. Yeah, that's huge.
Dr. Rachael:
I would say postpartum pain with sex is something that we see very often. And in combination with releasing the pelvic floor and then using a topical estrogen cream, that tends to resolve pretty quickly as well. And then leaking is also one where people will come in after a couple of visits and be like, "I was able to run a mile without leaking." Amazing. So exciting.
Lauren:
Yes, it's huge, right? You start getting your life back and do the things you love to do.
Dr. Rachael:
Yes. Seriously.
4. Feeling Hesitant to Ask for Pelvic Health Help? Here’s Why It’s Worth It to Speak Up
Lauren:
I know sometimes people who are struggling with something may feel hesitant to reach out for various reasons. If you were talking to them, what kind of guidance would you give somebody who's hesitant to reach out and seek help?
Dr. Rachael:
I get it. It's scary. Just do it. If you are hesitant and you have concerns, especially about an internal exam or something, let your pelvic floor PT know, because they will walk you through it. And you definitely don't have to have an internal exam, especially not in the first couple of visits. It does give vital information, but we're not going to do anything that you are not comfortable with because our goal is to make you feel comfortable first and foremost.
And then if they can, try to find success stories from other people, because a lot of our business is word of mouth, which is really nice, but there are people who are out there who are getting help. So try to ask your friends, because a lot of people don't talk about it. But then a lot of people are like, "Oh, yeah, I'm going to pelvic PT."
And then the other thing is not all clinics are created equally, so make sure that your pelvic floor PT specializes in pelvic floor and that they're not just kind of doing it on the side. That is something that we see. We do get people who come to us who are like, "Oh, I went to this other clinic, but it was just cookie cutter. They're just having you doing stretches. They didn't really watch me." I'm like, "Oh, that's not good." Just make sure that you're asking the right questions when you call people.
5. Pelvic Floor Physical Therapy: It's a Thing!
Lauren:
What is something that you wish folks knew about pelvic floor or physical therapy or health, that maybe they don't?
Dr. Rachael:
Honestly, that it's a thing.
Literally, people are like, "Wait, that's a thing? You do what?" I'm like, "Yes, this is a thing. This is very important thing." And still to this day, people are like, "I didn't know that this existed." Especially people who have delivered a baby, I'm like, the OBs know that this is a thing. Providers know that this is a thing and it should be an automatic referral for pregnancy and postpartum, because there's so many things that you can do. So yes, honestly, that this is a thing. Pelvic floor PT is a thing and you can get help!
Lauren:
Yeah, I think that's such a good one. Especially when I've talked to people, especially if they're men, they're kind of like, "Hmm." I'm like, "You have a pelvic floor too. Everyone has a pelvic floor. This is not just a women's issue or people with a vulva issue. Everyone has one."
Dr. Rachael:
For sure. And we don't treat men in our practice, but I have a couple friends in the area who do treat men, so we'll always refer to them. Yes, this is a thing for men as well.
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**Medical Disclaimer: This post is intended to provide information and resources only. This post or any of the information contained within should not be used as a substitute for professional diagnosis, treatment, or advice. Always seek the guidance of your qualified healthcare provider with any questions you may have regarding your healthcare, conditions, and recommended treatment.