Breaking Up With My Pelvic Floor Physiotherapist

In my twenties, I was a gynecological model for medical students. Dozens of doctors in training did their best to be calm and professional as they performed the sensitive examination for the first time. They reported their findings to me and to the supervising doctors. I paid careful attention to their technique and bedside manner. Afterward, I gave them detailed feedback. Between my ‘modeling career’ and giving birth to two robust baby boys, I’m used to having things going into and coming out of my vagina. That’s why I was surprised to find myself crying in the back seat of my car a few minutes after my first appointment with my pelvic floor physiotherapist.

A few weeks ago I wrote about how excited I was to discover that there’s an entire profession dedicated to helping women heal from giving birth to babies. Pelvic floor physiotherapists help strengthen and restore the work that those foundational muscles do—ensuring we have bladder control and strong orgasms.

When I called to make an appointment with the physiotherapist, I felt comfortable telling the receptionist – a complete stranger to me – that I needed help with bladder control and asked her to please book me an appointment with one of her physios. For many women around the age of 40, something freeing happens – we stop caring so much what other people think about us.

I’m 41 and feel mostly unselfconscious about my body. I’m at ease being naked in changing rooms. There are a few rare times when I wish I had a flat stomach, but I find my new curvy body beautiful and sexy. Like many moms I know, I see my stretch marks as medals of valor.

For all these reasons, crying in my car after the appointment was completely unexpected. I’d been a little nervous before the appointment, but my years of experience as a gynecological model meant I was accustomed to similar exams. Grace, my physio, had been professional and helpful. Before the internal exam, she showed me diagrams of all the muscles she’d be checking and described what to expect. During the exam, she was respectful and gentle. Why was I crying? Even though nothing violent or rough had occurred, it felt intense to be touched right in all those deep, inner muscles.

Our pelvic floors hold a lot of history for us women. The muscle memory of all of our lovers, all of our physical exams, abortions, the babies that arrived through the birth canal, and any unwanted penetration. The pelvic floor is also the physical embodiment of what our culture sees as shameful – our private parts. The words for its functions are powerful enough to become some of our most potent swear words.

I have no definite memory of sexual abuse or interference, but all my life I’ve lived with a sensitivity that I can’t place. During my university years, I volunteered for the campus sexual assault phone line. Several of my close friends were survivors. As I began to explore intimacy with my partners, I found myself skating around the edge of a black hole. Sometimes I would fall in, dissociating to some degree. I kissed people because they wanted me. I careened around the bases, when all I wanted was to take time on first. I held my breath, closed my eyes, and let men touch me, fighting the urge to push them away. I blasted past my own comfort zone and hated myself and my partner the next day. The sensation was like stumbling at the top of a tall slide, and not being able to stop the fall. Did something happen to me as a child that I can’t remember?

As I sat there, crying in the car, I realized that I just didn’t like Grace, my new physio. Despite her being professional, respectful, and gentle, Grace wasn’t warm with me. I didn’t feel a therapeutic presence in the room. The work she was doing made me feel very vulnerable. It brought up emotions, and while Grace was competent in treating my body, she wasn’t at all helpful with my emotions. There was a part of me that wanted to tell her, “No!” just like I’ve wanted to say ,”No!” to some past sexual partners. My tears were for the girl who couldn’t find her voice to protest what she didn’t want.

Some of the tears were also for my womanhood, measured and found lacking. “Your pelvic floor muscles are very weak,” Grace informed me. “A one out of five, or two out of five.” I’m acutely aware of the use of numbers in evaluations. I’ve made a long and concerted effort to find my value inwardly, instead of from all the A’s and A+’s, but one out of five means utter failure.

I broke up with Grace, in person, after our third appointment. She wasn’t the right fit for me, even though the exercises she prescribed were helping me to heal. I could have left without telling her about the switch. It would have been easier and more comfortable, but having the conversation in person felt more grown up.

I have a longstanding habit of doing things ‘the hard way’. In the past I would have stuck it out with Grace, convinced that there was something to learn about why I felt ill at ease with her. But I don’t have time for that anymore. My job is to take care of myself, not to take care of her. In saying, “No!” to Grace, I’ve opened the door for someone better.

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2 thoughts on “Breaking Up With My Pelvic Floor Physiotherapist

  1. Birdie, thank you for your transparency and honesty. My name is Carolyn Vandyken, and I am an instructor in Canada in pelvic floor rehabilitation at Pelvic Health Solutions (www.pelvichealthsolutions.ca). Your story makes me sad and happy at the same time. Happy that you found your voice and were able to articulate that something wasn’t right. Happy that you “broke up” in person and stated your concerns. However, it makes me extremely sad that someone in a caring profession such as physiotherapy couldn’t come along side you and see your pain……to see Birdie, the person behind the pelvic floor muscles that were weak, and create safety for the vulnerability that you felt. Shame and vulnerability are so intertwined with our experiences when talking about sex, our sexual history, and childbirth…..our stories. Please know that we are in the process of creating and teaching a course on developing skills to identify and address this very thing- vulnerability and shame…..so important in all areas of medical intervention, but particularly pelvic floor rehabiltation. This will become an integral part of our education for pelvic floor physiotherapists; it is much needed and overdo. You can learn the technical side behind medical interventions but if you can’t bring the human side to that intervention, your interaction will fall on “infertile” ground. It will not take root and blossom. As a caring profession, pelvic floor physiotherapists will do better. You have my word.

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