Going Strong

If we’ve learned anything over the past couple of years, it’s that health really is wealth. And, in this case, we are talking about pelvic health, something that can affect both women and men. It can be the reason why you pee a little when you sneeze or why you can’t take a deep cleansing breath. So many issues can arise when your pelvis isn’t in tip-top shape and Indigo Wellness wants to help with that.

The practice, with offices in Stamford and Westport, is owned and operated by Sarah Swanberg, doctor of acupuncture and Chinese Medicine. In addition to an array of other services, Indigo offers pelvic floor therapy to help achieve and maintain optimal pelvic health. The misconception, Swanberg says, is that pelvic issues are only something women who have had difficult childbirth experiences need to pay attention to. That theory was debunked when we chatted with Swanberg and two of the experts on her team to learn more. Kara Fanelli, PT, DPT, board-certified clinical specialist in women’s health physical therapy, and Jodie Lippman PT, DPT, work with patients—both female and male—on pelvic rehab for a variety of ailments. Pelvic physical therapy focuses on all musculoskeletal and behavioral aspects of the abdomen and pelvis. Pelvic floor muscles aid in everything from bladder, bowel and sexual function to postural stability and organ support.

How does one know if they might benefit from pelvic floor therapy?
“If you are aware of your pelvic region when you shouldn’t be, there’s a problem. It’s a part of your body but think of it like your nose…you know you it’s there, but you don’t feel it all day, says Fanelli. An initial appointment at Indigo includes an exam, comprehensive history, and a look at the patient’s posture, understanding strength throughout the body and the way muscles feel and fire are all crucial in developing a treatment plan.

Why does the pelvis affect so many other parts of the body?
“If you picture your body as an actual house, your pelvic floor would be the ground, the foundation; your abdominals and core would be the walls, helping to stabilize; and your diaphragm would be the roof, some people even think of as high up as the glottis in the throat as the top,” says Lippman. With this structure in mind, “you can’t breathe properly unless your diaphragm and pelvic floor are working together. Upper chest breathing can be caused by a lack of movement in the diaphragm, which can contribute to pelvic floor muscle tension. We’ll often hear patients say things like ‘I can’t talk and walk without getting out of breath’ and it’s because their diaphragm isn’t moving the way that it’s supposed to,” says Fanelli.

What are some signs of pelvic issues that might be blamed on something else?
“The inability to take a deep breath, symptoms that feel like a yeast or urinary tract infection (that test negative), back pain and diastasis recti (abdominal wall separation) can all be due to pelvic dysfunction,” says Lippman.

Are women, pregnant and postpartum, the most susceptible to urinary issues?
“Yes. Pregnant women, postpartum women, and menopausal women are prone to urinary issues. However, people who have a lot of stress and anxiety can also be susceptible to pelvic floor dysfunctions. Our pelvic floor gets tight and reacts to tension just like our shoulders do. Also female athletes who have repetitive high-intensity and do high-impact activities with improper technique and poor breathing, like lifting weights, kicking balls and jumping and shooting, are also particularly susceptible to pelvic floor dysfunction and bladder problems,” says Lippman.

Leakage is normal after having a baby, right?
“After childbirth, many women assume that leakage is normal. It isn’t. While it’s initially common right after childbirth, it can be dramatically improved with pelvic physical therapy and shouldn’t be a lifelong issue,” says Fanelli. For women who have had C-sections, bladder issues seem surprising but not to the experts. “The scar lives right on top of the bladder, if it doesn’t move well it can cause issues for the bladder. Leakage can also arise from pressure management problems. When picking up something heavy, if the abdominal wall doesn’t contract and fire while also allowing the pelvic floor to lift, this is where issues with leakage will occur,” says Fanelli. “The pressure always goes to the weakest point. If there is weakness in the abdominal wall’s connective tissue or in the pelvic floor muscles, then all the pressure will follow that weakness,” adds Lippman.


In addition to Pelvic Health Physical Therapy, Indigo offers acupuncture, Chinese herbal medicine, cupping, nutrition counseling and group programs. Their abundant toolbox of services are all interwoven to help their patients achieve optimum mind/body health.

“The end goal is to create a robust support system. We believe that the best patient care happens when everyone involved is talking—the more eyes on the patient to help with their journey of wellness, the better,” says Swanberg.

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