Brittany Mahomes Is Normalizing Pelvic Floor Disorders That Can Occur Postpartum

The wife of NFL star Patrick Mahomes shares news of her fractured back as a result of pelvic floor issues.

Fact checked by Sarah ScottMedically reviewed by Alyssa Dweck, MS, MD, FACOG

Brittany Mahomes is bringing attention to a condition that impacts many people postpartum but is often not spoken about.

The wife of Patrick Mahomes, the Super Bowl-winning Kansas City Chiefs quarterback, says she’s suffering from a fractured back as a result of pelvic floor issues that occurred since giving birth. She is mom to 3-year-old daughter, Sterling Skye, and 15-month-old son Patrick “Bronze” Lavon Mahomes III.

“Just a daily reminder: Once you have kids, please take care of your pelvic floor,” she wrote in her Instagram Stories in March. She added, “Seriously. From: a girl with a fractured back."

Pelvic floor disorders (PFDs), also described as pelvic floor dysfunction, are common postpartum. These issues can even begin as the body changes during pregnancy. But giving birth vaginally has been linked to developing pelvic floor disorders likely because of the pushing and pressure in the second stage of labor. Although the risk for pelvic floor issues may be less after a C-section, the muscles can still be impacted.

Yet, pelvic floor issues are not well-discussed and symptoms are often undiagnosed. And PFD can greatly impact a person's quality of life.

“Historically, not a lot of attention has been paid to these conditions so many women may brush them off, thinking they are ‘normal’ or something they just have to live with,” says Lauren Stewart, MD, who specializes in female pelvic medicine and reconstructive surgery at NYU Langone.

Overall, a quarter of women in the United States suffer from at least one pelvic floor disorder, whether urinary incontinence, fecal incontinence, or in more severe cases, pelvic organ prolapse (POP). The latter occurs when tissue and muscles can no longer support the pelvic organs and they drop down.

The number may even be higher as Dr. Stewart believes PFDs affect as many as 1 out of 3 women. And 1 out of 10 women will have surgery for this issue in their lifetime, adds Dr. Stewart.

A PFD typically occurs when pelvic muscles and connective tissue are weakened or injured. This prevents the pelvic floor muscles—or the hammock-like muscles in the pelvis stretching between the tailbone and the pubic bone—from working properly. These muscles support the bladder and bowel, as well as the uterus.

PFD can occur even without giving birth, and can impact men, too. Research shows it can be related to genetic, structural, or hormonal factors. No matter the cause, the condition typically does not go away on its own, and if some of the symptoms (like an overactive bladder) are left untreated, they can become worse.

More Pelvic Floor Dysfunction Risk Factors

Having a big baby can be a risk factor for PFD, as well as:

• Pressure on the pelvic floor. This can be due to body weight, chronic constipation or chronic straining for a bowel movement, heavy lifting, and chronic coughing from smoking or health issues.

• Age. Pelvic floor muscles may weaken as a person gets older. They can also weaken during menopause.

• Genetics. Some people are born with conditions that affect connective tissues. This can make them more likely to have POP.

Pelvic Floor Dysfunction Symptoms

Brittany's social media warning serves as an important reminder for anyone who gives birth to consider getting examined and to know the symptoms of PFDs. Some of the common symptoms, according to the National Institutes of Health (NIH), include:

• Feeling a heaviness, fullness, pulling, or aching in the vagina (This usually gets worse by the end of the day or it can be related to a bowel movement.)

• Having a hard time starting to urinate or fully emptying the bladder

• Leaking urine when coughing, laughing, or exercising

• Feeling an urgent or frequent need to pee, having pain when peeing, or having a hard time making it to the bathroom in time

• Constipation

Much like what Brittany described on Instagram, some other complications that may arise from having a PFD include back, hip, neck, and shoulder pain. Janice Paredes-Alvarez, DPT, a lymphedema and pelvic physical therapist at CentraState Healthcare System, notes that these discomforts can arise during pregnancy when deep core tissues stretch and weaken.

Pelvic floor issues can also cause pain during sex, as well as in the pelvic region, genitals, or rectum.

Symptoms of a POP, according to Katherine Shapiro, MD, a urology specialist at RWJ Barnabas Health in New Jersey, include feeling a ball or bulge coming out of the vagina, during which a person can also experience bleeding or urinary incontinence. She says it is also not uncommon for people to experience fecal incontinence, too.

"It is important to know that these issues affect a woman’s quality of life,” says Dr. Shapiro. But “they are not life threatening.”

Some symptoms of PFDs can be very common in the first few months after giving birth and do not necessarily indicate a long-term problem. However, experts say, symptoms deserve a closer evaluation, and treatment when necessary.

Pelvic Floor Dysfunction Treatment

You've probably heard of Kegels. These exercises are often mentioned when discussing pelvic floor issues, but they are not helpful for everyone or for every pelvic floor condition.

If you experience any pelvic floor symptoms postpartum, it’s important to speak to your health care provider who can make a referral for pelvic floor therapy. That’s recommended for anyone suffering from a pelvic floor disorder.

“It can help rebuild your deep core strength, retrain your anterior abdominal wall and pelvic floor muscles, reduce the pain, teach you correct body mechanics, and improve posture,” explains Paredes-Alvarez.

Currently, pelvic floor therapy is not routinely recommended postpartum and many physicians and therapists including Paredes-Alvarez are advocating for treatment to become standard practice. Keep in mind, this can be covered by insurance but, often, pelvic floor specialists will be out of network.

Pelvic floor therapists typically work on muscles internally, both vaginally and anally, as well as externally. Sometimes, biofeedback, which uses sensors and video to monitor your pelvic floor muscles as you relax or clench them, will be used. Therapists will likely show you exercises for bladder and pelvic floor muscle training.

If issues persist despite physical exercises and therapy, seeking care from a urogynecologist is advised, and treatment options may include medications and trigger point injections. These are most effective when done along with pelvic floor therapy.

“There are a lot of online resources and emerging tech devices available to help,” Dr. Stewart says, “but sifting through all of this information on your own can be daunting.”

Some devices include pelvic floor trainers and wands. Vaginal dilator therapy that can be done at home can also help certain pelvic floor issues. But it's a good idea to be evaluated by a professional before engaging in at-home treatments as these aren't appropriate for every condition.

Dr. Stewart says many people are hesitant to get help because the issues are inherently associated with feelings of shame or embarrassment. While PFDs are pretty common, in some cases, due to the female anatomy, they typically can’t be avoided.

“There’s no reason to feel shame,” Dr. Stewart says. “The symptoms are treatable, you just have to let your doctor know what’s going on.”

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