Halifax Pelvic Health Physiotherapist, Brittany Klingmann Answers FAQ
LET’S START BY TELLING EVERYONE ABOUT WHO YOU ARE, YOUR BUSINESS AND WHY YOU DECIDED TO BECOME A PHYSIOTHERAPIST.
Brittany: “My name is Brittany Klingmann. I am an Orthopedic and Pelvic Health Physiotherapist who works at Young Kempt Physiotherapy in Halifax. I have always been so fascinated with the human body. That was what initially sparked my interest and an undergraduate degree in Kinesiology, then my love of working with people and helping them sparked my interest in Physiotherapy. I’ve now been in practice for 12 years. I am also a Mom to two beautiful and wonderful tiny humans. They are now 8 and 5 years of age. Both were brought into the world via C-section. Although Pelvic Health was an aspect of my practice prior to my pregnancies, it was my journeys in return to exercise postpartum that really sparked my passion for helping individuals navigate this time. Despite working in the area, I found that there was a big lack of information for individuals trying to navigate their return to exercise postpartum. After my children, I was just told go home and to not lift anything heavier than my baby for the next 6 weeks. This information felt vague and somewhat terrifying especially coming home after my second child when I already had a toddler at home. Knowledge is power, and when individuals are armed with information beforehand, it can ease the transition postpartum.”
WHAT TRAINING HAVE YOU DONE?
Brittany: “I have an Undergraduate Degree in Kinesiology and Master of Physical Therapy both from the University of Saskatchewan. Upon Graduation, I have pursued several continuing education courses.”
- Certificate in Anatomical Acupuncture (Acupuncture Canada)
- Levels 1-3 Upper Quadrant. Diploma of Advanced Manual and Manipulative Physiotherapy: Canadian Physiotherapy Association – Orthopedic Division
- Levels 1-2 Lower Quadrant. Diploma of Advanced Manual and Manipulative Physiotherapy: Canadian Physiotherapy Association – Orthopedic Division
- Level 1 Treatment of Urinary Incontinence
- Uplifting Guide to Management of Pelvic Organ Prolapse
- Julie Wiebe: Female Athlete: Ready for High Impact or High Intensity
- Antony Lo: Female Athlete Course
- Member of Global Pelvic Health Alliance – online membership to up to date information/education in various pelvic health topics
- Kathe Wallace: Pelvic Floor Support Systems in Postpartum Recovery, Pelvic Pain and Prolapse (currently taking)
WHAT SERVICES DO YOU OFFER AND WHERE?
Brittany: “As an orthopedic and Pelvic Health Physiotherapist, I treat everything! Haha, a very simple answer to that question.
More specifically – at Young Kempt Physiotherapy we have in-person and tele-health sessions. We also have a satellite location at Ironstone Strength and Conditioning where I can work with clients in a gym setting, we also have a private treatment room there as well.
The virtual sessions have been an excellent resource for new Moms as they can remain in the comfort of their own home with their baby. “
Specific things I treat in the world of Pelvic Health include:
- Treatment of Urinary Incontinence (Involuntary loss of urine from cough/sneeze, urge)
- Treatment for Urinary Urgency (Overactive Bladder)
- Painful intercourse
- Tailbone pain
- Pregnancy-related discomforts
- Exercise modification/education during pregnancy
- Birth Preparation as it relates to the pelvic floor
- Postpartum support
- Return to exercise postpartum
- Treatment for Pelvic Organ Prolapse (feelings of bulge, heaviness, dragging at the vagina
WHAT IS IT LIKE WORKING WITH YOU? WHAT IS THE PROCESS TO BOOK? WHAT WOULD YOU SAY ARE YOUR CORE VALUES?
Brittany: “Wonderful questions. Well, I believe I am an easy person to talk to. Personally, I love getting to know my clients and help them achieve whatever their goals/interests/aspirations may be. I book clients 1:1 so that I have the entire session with that individual and can focus entirely on their needs. The easiest way to book with me is by calling our clinic at 902-446-4303.
I love this question – my core values. I have spent a lot of time reflecting upon this question recently. I am part of a small Pelvic Health Mentorship group, and the facilitator of the group is a wonderful friend and colleague who shared some information with me on this topic recently. My core values are accountability, authenticity, balance, collaboration, commitment, family, growth, knowledge, respect, vulnerability and well-being. As it relates to my practice, I hold myself to the highest standard that I would like to bring forward my best self with all my patient interactions. This happens through making sure I am being accountable and authentic. I also practice implementing and upholding boundaries in order to maintain an appropriate balance between work and home life. I am an advocate and encourage collaboration amongst various health care professionals to support a holistic and interdisciplinary approach. My family fuels my passion and inspires me every day, and I believe that children are amazing teachers. In the world of Physiotherapy, our knowledge is constantly changing, and it motivates my ongoing growth professionally. Personally, I’m also on a growth journey. I aspire to share knowledge with the world, to help build awareness, dispel myths, and support autonomy. Above all, it takes vulnerability to push the limits, and to get outside one’s comfort zone.”
HOW OFTEN SHOULD PREGNANT WOMEN BE EXERCISING?
Brittany: “The 2019 Canadian guideline for physical activity throughout pregnancy states that all women without a contraindication should be physically active throughout pregnancy (even those who were previously inactive). Pregnant women should accumulate at least 150 min of moderate-intensity physical activity. This should be accumulated over a minimum of 3 days/week; however, being active every day is encouraged. This should incorporate a variety of aerobic and resistance training activities.
One area of practice I thoroughly enjoy is helping individuals navigate their exercise in their pregnancy journey. There tends to be a lot of conflicting information on the internet and a long list of DO’s and DON’Ts – which can be intimidating and overwhelming. Modifications to exercises can occur to facilitate continued comfort with exercise as the pregnancy progresses. In my experience, each pregnancy is unique, and what one individual may need to change won’t apply to the next. An individualized approach is key! Collaborating with the individual’s Primary Health Care Provider facilitates continuity of care as well. “
SO MANY PEOPLE THINK THAT PEEING WHEN THEY LAUGH OR SNEEZE WHILE PREGNANT OR AFTERWARDS IS NORMAL. WHAT DO YOU HAVE TO SAY ABOUT THAT OR HOW CAN YOU HELP THEM?
Brittany: “Yes – I hear this one a lot, and it is a myth I am working hard to dispel. Leaking urine with a laugh/cough or sneeze certainly is more common during pregnancy or after childbirth, but there are things that can be done to help. Seeing a Pelvic Health Physiotherapist for an assessment is very helpful as there can be many different variables that contribute to it occurring. Another misconceived notion is that individuals often believe the leaking is caused by weak pelvic floor muscles – but it can also occur when the pelvic floor muscles are overactive, or perhaps not coordinating the way that they should! Kegels are not always the answer!!!
Also – the strategies we bring forward into our daily tasks may be contributing as well. The pelvic floor muscles can often become the victim, rather than the root cause, so making sure the system is being viewed as a whole is very important.”
WHAT IS DIASTASIS RECTI AND HOW COMMON IS IT?
DO YOU HAVE ANY TIPS IF SOMEONE HAS THIS AFTER PREGNANCY?
Brittany: “Diastasis Recti Abdominis or DRA is when the connective tissue at the midline of the abdominal wall – called our linea alba – starts to thin and the rectus abdominus muscles spread. It may sound scary – but this connective tissue at the midline of the body is very strong, and this will occur to some degree in 100% of pregnancies by the end of the 3rd trimester. To what extent it occurs in pregnancy will vary on the individual. Are you carrying multiples? Do you have a connective tissue disorder increasing the likelihood of it? Do you have a short torso? All of these can be contributing factors.
When someone does have DRA, you can often see a coning or doming occur at the abdominal wall during tasks that load your trunk. For example, sitting up from a reclined position later in pregnancy, or returning to abdominal exercises like a sit-up postpartum can cause coning or doming if DRA is present.
During pregnancy, if DRA begins to occur, I often offer suggestions around modifying the activity so that individuals can complete the task without noticing the doming or coning. I usually suggest this because during pregnancy our abdominals are at a disadvantage. Postpartum, however, the research supports progressive loading of the abdominals as a way to assist!
Pressure management is also a variable to consider with diastasis. Things such as a stiff rib cage, breath-holding, or abdominal wall gripping can all contribute to increased abdominal pressure, which can result in the abdominals being the leaking point, thereby causing DRA. While DRA is common with pregnancy, DRA can also happen to anyone – regardless of gender, age, or whether an individual has had a baby or not!”
SPECIAL TIPS FOR HELPING TO HEAL AFTER A C-SECTION?
Brittany: “As I had mentioned – I am a Mom of 2 c-section babies. After my first child was brought into the world by an emergency c-section, I struggled. I experienced many negative emotions and a sense of failure. The messaging I had received after my son was brought into the world was one of negativity. I was provided with very little information as to how to begin my healing journey at home. I was told to not hold anything heavier than my baby for the next 6 weeks, then after an excruciatingly painful pelvic exam at 6 weeks, I was told I had the “green light” to return to physical activity and intercourse – I was alarmed!
While yes, I completely agree that limiting what you do for the first 6 weeks is very important for wound healing, there are many small tips one can practice for comfort and to support healing.
- Use of a compression garment in the early days can be very helpful.
- Strategies of compression and positioning for getting in/out of bed, using the toilet, lifting/holding your newborn.
- Breathing techniques to re-connect with your deep belly muscles and pelvic floor and assist with pain management.
- Hydration, nutrition, gradual return to exercise. “
AFTER BIRTH, WHAT IS THE BEST WAY TO EASE BACK INTO EXERCISE?
Brittany: “I often provide what I describe as the Core Breath. This uses breath to assist with re-connecting/re-coordinating your pelvic floor muscles and your deep abdominal muscles which undergo much change during pregnancy and birth. This can often be incorporated in small chunks throughout your day.
Then starting with short walks, and gradually progressing in intensity and challenge of exercise as your body feels ready. I will spend time educating individuals about what signs and symptoms that may indicate your body has reached its current limit. What we often forget is that our bodies took +/-40weeks to get to labor and delivery, then had a period of rest and recovery for an additional 6 weeks. It is not realistic to get right back to the intensity/duration and type of exercise that you previously were at, immediately postpartum.
Helping Moms set realistic expectations of type, the quantity of exercise, as well as how to build gradually, is very helpful.”
YOUR NUMBER ONE TIP FOR LABOUR? FOR PREGNANCY? POSTPARTUM?
Brittany: “For labor – develop a “road map” vs. a “specific plan”. In the final weeks of pregnancy, I have individuals practice pelvic floor relaxation in various positions they think they may want to labor in, that way they will know what it feels like in advance.
For pregnancy – you don’t have to just “live with” discomforts during pregnancy. There is always something that can be done to give someone relief. Whether that is education, modifications in strategies, exercise, use of supports, etc.
Postpartum – you can absolutely get back to high intensity and high impact activities (eventually). Having an approach that is gradual and progressive over time is the best approach for lasting success! Seeing a Pelvic Floor Physio for individualized guidance is always an option. It does not have to include an internal pelvic floor exam if you do not want/wish to have one. “
ANYTHING ELSE YOU WOULD LIKE TO ADD?
Brittany: “In general, I believe it’s important for individuals to understand the various symptoms that may indicate your pelvic floor is not functioning quite as it should, in order to build awareness of how seeing a Pelvic Floor Physiotherapist may help.
Things we can help with:
- Urinary Urgency or Increased Frequency
- Heaviness/Pressure/Dragging at the Pelvic Floor (Pelvic Organ Prolapse)
- Involuntary loss of urine/gas/stool with a cough/sneeze/laugh or effort
- Painful intercourse
- Tailbone pain
- Pelvic pain/hip pain/low back pain
- Scar pain (perineal or c-section scar)”
To get in touch with Brittany you can find her on Instagram and at Young Kempt Physiotherapy’s website.
More posts that I bet you’ll love:
