Your Pelvic Floor Needs More Than Kegels with Dr. Charlotte Lange

You sneeze and leak. You jump and immediately wonder whether you need to find a bathroom. You stop running because something feels wrong, but you tell yourself you’ve had babies, you’re getting older, and maybe this is just what happens.

I understand that conversation because I had it with myself. I kept living my life, working out, taking care of my children, and pushing through symptoms that deserved my attention. Eventually, I could not push through them anymore.

In episode 187 of The Dr. Danielle Difference, I’m joined by Dr. Charlotte Lange, my physical therapist and the owner of Inform Physical Therapy and Wellness in Centerville, Ohio. Charlotte has been part of my care team for five years. She knows how stubborn I can be, she knows how much I love lifting, and she knows how to help me keep pursuing my goals while respecting what my body can handle.

This conversation gets personal. I want you to understand why the way your body moves belongs in the conversation about your health—and why you do not have to be an athlete for that to matter.

I kept explaining away what was happening

After my third child, I was experiencing leaking and other symptoms I thought of as normal postpartum problems. During our conversation, Charlotte corrected that word: common. I had been treating something common as something I simply had to accept.

Over time, I started having spasms that I could not explain. At first, I thought they might be related to ovulation. Then I began experiencing painful urgency during exercise, even when there was nothing in my bladder to release.

One day, a spasm hit while I was shopping at a pet store. I ended up on the floor, crying and unable to stand. I had to crawl out the front door. It was painful, it was embarrassing, and even then, I kept trying to find an explanation that would let me handle it myself. Maybe it was coffee. Maybe I could change that one thing and keep going.

The spasms continued. Eventually, I sought help from a urogynecologist, had an assessment, and underwent surgery. But when I heard restrictions on lifting and running, all I could think about was the life I wanted to keep living.

I wanted help getting back to that life. That is part of what led me to Charlotte.

Kegels were not what my body needed more of

When people hear pelvic floor, they often think Kegels. Squeeze, strengthen, repeat. That was not enough to understand what was happening in my body.

I did not realize how much tension I was holding. During one assessment, I tried to do a Kegel and experienced a painful spasm. Charlotte was there to help me through it, and that experience made it very clear that I needed more than a generic instruction to squeeze harder.

Charlotte describes the pelvic floor using a trampoline analogy. In her explanation, it needs to be able to produce force and absorb force. She looks at how the muscles contract, how they relax, their endurance, and how they work with the rest of the body. The question becomes what this particular person needs to do the things she wants to do.

For me, that work included hands-on care, mobility, strengthening, breathing, and changes to how I moved. We worked on squats, deadlifts, band walks, and hip movement. At one point, we even changed my shoes. I had no idea how many pieces would become part of my care.

Your everyday life asks your body to do things

Charlotte put it plainly in the episode: “Life is load.”

You carry laundry. You pick up your children. You lift dog food into a cart and push groceries through the store. Your body needs to support the life you actually live, whether or not you ever walk into a gym.

That is why I care so much about function. I want to keep lifting as I age. I want to climb mountains when I’m older. I want to show up and do the things that matter to me. Those goals give me a reason to pay attention to the way I move now.

For you, the goal might be playing with your grandchildren, working comfortably, or going for a walk without planning every bathroom stop. Tell your provider what you want your life to look like. Give them more information than the name of the body part that hurts.

Learning to notice my body took practice

One of the things Charlotte helped me develop was awareness. Am I holding tension? What am I doing with my breath? How am I moving during this exercise?

I still use exercises and mobility work she has given me over the years. I also notice when stress changes the way I’m holding myself. That awareness did not appear after one appointment. I had to practice it, and I continue practicing it.

Charlotte was honest about this, too. She does not expect herself or her patients to do everything perfectly. The point is to begin noticing patterns and bring that information into your care. You can pay attention without turning every breath and every movement into another thing to grade yourself on.

Modifying gave me room to get stronger

This is the part of our conversation that made me emotional. Charlotte gave me permission to modify.

I’m a perfectionist. I want to do the workout as written. I want to lift the weight, get the reps, and feel like I did the thing. But my capacity can change depending on what I have already asked my body to do that day or during that workout.

Charlotte helps me think about my priorities and make adjustments. Sometimes that means step-ups instead of box jumps. Sometimes it means an assisted movement. Those choices have helped me keep participating and keep working toward strength.

I did not have to abandon my goals. I needed someone who understood my body well enough to help me pursue them. There is so much freedom in that, especially when your instinct is to push harder and figure everything out yourself.

Find care that fits your needs and goals

Charlotte and I talk candidly about why hands-on care has mattered in my experience. We discuss manual treatment, dry needling, movement assessment, and the value of having someone observe me in person and make adjustments in the moment.

Charlotte also acknowledges a place for virtual education and coaching. In our conversation, she distinguishes those services from the in-person assessment and treatment she believes my needs require. If you are experiencing symptoms, the next step is to talk with a qualified provider about the care that fits your situation.

When you contact a pelvic floor physical therapist, ask about their training, how they evaluate your concerns, and how your goals inform the plan. Explain what is happening during exercise and everyday activities. You can also ask how they coordinate with other members of your care team.

Charlotte has referred me to other providers when she believed different expertise would help. I value that. I want a team that can recognize what I need and help me find the right support.

Take the next step

If you have been explaining away leaking, pain, or limitations because you think you should be able to manage them yourself, let this conversation be a reason to ask for help.

Connect with Dr. Charlotte Lange by calling or texting (937) 965-9909, emailing charlotte@informphysicaltherapy.com, or submitting a request at Inform Physical Therapy and Wellness. Her practice is in Centerville, Ohio. You can also follow her on Instagram at @inform_physicaltherapy.

If you’re ready for support with your health foundations, explore [Wilderness of Wellness]([APPROVED WOW URL — ADD BEFORE PUBLICATION]). We talk in this episode about building a team around you, and individualized physical therapy may be one part of that team.

Listen to episode 187 of The Dr. Danielle Difference and share it with someone who needs to hear this conversation. You deserve to tell your provider what you want to be able to do—and ask for help working toward it.