Perinatal Physical Therapy


Sandra is passionate about advancing women's health and women's fit pregnancy. She began her practice in pelvic floor physical therapy beginning in 2001.  She also became certified as a Preparation in Childbirth Educator and Pre & Postnatal Fitness Educator in 2002.

At Evoke we offer Pre and Postpartum Physical Therapy. Our complete body wellness sessions help prepare the pelvis for the birth in many ways. We teach women specific exercises in preparation for childbirth and how to avoid injury that may develop during the childbearing years. As an integrated holistic practice offering both manual orthopedic and pelvic floor physical therapy, we are uniquely suited to provide care for the Perinatal population. Many women experience pain during pregnancy. We offer manual physical therapy treatment for common pregnancy conditions and Wellness Programs designed specifically for you. There are many common causes of pain or discomfort during pregnancy. The more knowledge you have in understanding the physical changes your body undergoes and what is required to be pregnancy fit and ready, the more adept you will be in helping yourself and feeling empowered and strong— body, mind and spirit. We are here for you! "Being pregnant is really an amazing journey. Since having a child, my appreciation for mothers has greatly deepened. We must all support each other on this journey! At Evoke, we provide lots of educational classes and resources to help! Pregnancy and Postpartum PelvicFloor2Core Classes, Diastasis Recti Recovery  Classes and more! For more information see our Classes page or feel free to reach out to us at our Cary office. P.S. My personal favorite book to prepare you during pregnancy and after is Essential Exercises for the Childbearing Year.  See "Our Favorites" for more resources. ∼Sandra

Pre and Postnatal PelvicFloor2Core Wellness Program
Prenatal Program
Manual Physical Therapy45-60 minute sessions of hands on manual therapy including myofascial release, deep tissue massage, trigger point release, soft tissue mobilization and other manual therapy techniques to balance and align the pelvis and posture. To have a relaxed and opened pelvis we facilitate opening during childbirth!
Pelvic Floor RelaxationConnect with your pelvic floor. Learn pelvic floor relaxation, breathing and awareness techniques and another way to push during labor. Understand how to connect with your pelvic floor and release tension; so important during labor and delivery!
Pelvic Floor StrengtheningYour pelvic floor muscles have many functions including supporting your organs (uterus, bladder, rectum). You will be given a specifically designed strengthening program to meet your needs. Having a functional and  strong pelvic floor is important and may help to prevent incontinence and prolapse.
Integrated Core StrengtheningHaving a strong core and abdominals is important for trunk and pelvic stabilization; aiding in back pain and diastasis recti prevention.  Your core muscles work in synergy together. We provide proper core muscle retraining exercises based on your personal evaluation and findings.
Labor Position Ready There are many positions you may choose to labor in on your very special day of childbirth.  Our general strengthening and stretching program, specifically designed for pregnant woman, can help to improve flexibility and endurance.
Body Mechanics TrainingIncorrect body positioning with sitting, standing, breast feeding and sleeping or improper body mechanics while bending, lifting and daily tasks can cause or exacerbate pain.We teach you proper body mechanics to help prevent common pain conditions.
Pregnancy Labor Ready ClassThis educational class teaches you about your pelvic floor, anatomy, function and its role during childbirth. We cover important topics including a functional pelvic floor and what that means, breathing and pelvic floor relaxation, pelvic floor opening, inner core (trunk and pelvic stabilization), pain prevention: back safety, posture & body mechanics, common conditions during pregnancy and how physical therapy can help. We leave time for question and answer…nothing is taboo! Understanding how to connect with your pelvic floor and release tension is so important for an easier labor and delivery! We look forward to seeing you at our group educational class!
Postnatal Program
Manual Physical Therapy45-60 minute sessions of hands on physical therapy including myofascial release, deep tissue massage, trigger point release, soft tissue mobilization and other manual therapy techniques based on your evaluation. Balancing and aligning the pelvis and posture will help with your pelvic floor program and progressive stabilization exercises.
Return to Prior FitnessWe offer specifically designed exercise programs to help get your body back after pregnancy. Dysfunction, injury and C-Section surgery can cause alterations to core stabilization and your muscles ability to contract properly. This can be seen as a belly pooch below the belly button. We provide you with individualized retraining exercises to improve your core strength, prevent dysfunction and avoid injury. Proper body mechanics and body positioning with baby is a part of all our programs which can also help to prevent dysfunction and pain.  
Scar ManagementWe provide manual therapy to improve scar tissue mobility and normalize skin sensation.  We teach you self help tools for at home.
Diastasis Recti CorrectionDiastasis Recti is a separation in the abdominal muscles in the midline called the linea alba. Typically due to weak abdominals, hormonal softening, stretching of the muscles or excessive straining. We design specific exercise programs for diastasis recti correction.  Some exercises that you may think can help improve your condition can actually increase the gap.  See a physical therapist for help with this condition. Closing the gap can help prevent dysfunction and pain.
Incontinence & Prolapse HelpA weak pelvic floor muscle, excessive straining or injury during labor can cause  urinary or fecal incontinence (leaking of urine or fecal matter) or prolapse (falling down of the organ/s).  As pelvic floor physical therapy specialists we provide you with corrective exercises to help return your pelvic floor to normal strength and function. We teach bladder and bowel training to help prevent future dysfunction. We offer home biofeedback and home exercises to help progress you safely at home.
Home VisitsFor our local clients we offer home visits.  We understand how difficult it is to get out of your house to an appointment with a new baby at home.  For our patients that are coming from far away, we will tailor our in office appointments that best meets your schedule and your baby is welcome to come always!
Postpartum Recovery ClassThis educational class teaches you about your pelvic floor, anatomy, function and the changes it may undergo with childbirth. We cover important topics including painful scars, vaginal flatulence, diastasis recti, incontinence, prolapse, constipation, back pain, pelvic pain and more. We discuss treatment options and how physical therapy can help. Important education on pain prevention, core stabilization, back safety, body mechanics, posture and breast feeding support is provided. We leave time for question and answer...nothing is taboo! We look forward to seeing you at our group educational class!
Fit pregnant mom doing perinatal physical therapy stretches

Common Causes of Pain
HormonesCertain hormones are released during pregnancy that loosen the ligaments and joints of your pelvis. This will help the passageway of the baby through the birth canal during child birth. The resulting joint laxity can destabilize the pelvis and sacrum and cause discomfort and pain. In addition, muscles of the back and buttock can become overworked and spasm while trying to protect loosened joints.
Increased WeightAs your baby develops during pregnancy, weight gain is normal. This extra weight can cause pain or discomfort in your back or other areas.
PostureAs each month passes your baby belly grows. This shifts your center of gravity and alignment in posture. This can cause pain or discomfort in various areas of your body.
Stress With all the changes that your body undergoes and the unexpected firsts during pregnancy, it is normal to have stress. As with any other condition, stress can cause or increase pain, especially when combined with muscle guarding and postural changes. Stress pain is often felt in the weak link of the body.
Body Positioning & MechanicsIncorrect body positioning with sitting, standing, breast feeding and sleeping or improper body mechanics while bending, lifting and daily tasks can cause or exacerbate pain.
Physical Therapy Can Help!
StabilizePhysical Therapy can educate you in proper body mechanics and stabilizing exercises to protect your body and back.
ExerciseAccording to the American College of Obstetricians and Gynecologists, there are many benefits to exercise during pregnancy including reducing backaches. Physical therapy can design a specific exercise program tailored to meet your needs. Always check with your doctor before commencing an exercise program. For more information on exercise during pregnancy see, ACOG FAQs Exercise During Pregnancy
Correct PosturePhysical Therapy can teach you how to improve and align your posture. We will provide you with home exercises to stretch and strengthen areas to support a good posture.
SupportHaving a good support system during the childbearing year is so important. This includes the many wonderful supports groups available and "us" —we are here to support your journey too! We offer training to family or other significant support person on safe ways to help you. This may include stretches or a gentle massage!
Education and ExtrasPhysical Therapy will teach you proper body positions and body mechanics to prevent injury and pain. Extras during pregnancy may include body pillows, cushions for sitting or other supports if necessary.

Perinatal Conditions

  • Sciatica
  • Lower Back Pain
  • Pubic Bone Pain
  • Incontinence
  • Pelvic pain
  • Sacroiliac pain
  • Hip Pain
  • Neck|Rib Pain
  • Coccygodynia
  • Myofascial Pain
  • Carpal Tunnel Syndrome
  • Thoracic Outlet Syndrome
  • Pelvic Floor Dysfunctions
  • Prolapse
  • Diastasis Recti
  • Scar Pain
  • Episiotomy
  • Cesarean Section

 

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