Can you run a leak free 5K?

After I had my second child, I experienced my first episodes of leaking with running. My pants were soaked. At first I thought it was increased sweating but I quickly realized how wrong I was!

I was so embarrassed and discouraged. I tried running a few more times thinking that it would “just go away” if I ignored the symptoms. Then, I tried about ten thousand kegels and my symptoms became significantly worse. (If this sounds like you too, check out one of our most popular blogs Kegels not working for you…3 Reasons Why)

I wanted to continue running for fitness and stress relief but at that point every run was causing more stress because I was experiencing so many problems with incontinence. I knew that my pelvic floor was the problem so I used my skills as a physical therapist to dive into the research and take the specialty training to learn how to fix this for myself.

My issues are now resolved and inspired me to help women just like you through my online clinic and video education.

If you want to join me in the club of women who now run races carefree click below to download Leak Free 5K.

Do you have a Prolapse? 3 ways to know

You know how there are times when you just know something isn’t right or isn’t the way it used to be with your body? If you are having this feeling about your pelvic floor after having a baby or as you get older, you may be experiencing prolapse. Check out the information below as your first step to determining if this is your problem.

What is a pelvic organ prolapse?

A pelvic organ prolapse (POP) is when the structures that hold your pelvic organs in the correct place become either loose, weak or dysfunctional. Your pelvic organs (uterus, bladder, rectum) can move into or out of the vaginal opening based on how much laxity or weakness is present.

3 Common Symptoms of Prolapse

Bulging, heaviness, dragging feeling in your pelvic region

Many women are able to feel the bulge of a prolapse, especially when sitting on the toilet. Other women describe symptoms of heaviness, or feeling like something is hanging down inside the pelvis. Menstrual cycles often increase this heaviness or dragging feeling.

Cannot keep a tampon in place

Due to the fact that you actually do have structure that are falling toward or out of the vaginal opening it will be difficult to keep a tampon in place. Many women report being able to insert a tampon but that it gradually pushes out through the day with moving around. It also may be difficult to insert a tampon because the bulging is blocking the tunnel the tampon goes through and sits in.

Sitting on a small ball

Women with prolapse often report as they sit down they fell like a small ball is underneath them and often so much so that they have to stand back up and readjust positioning to relieve that feeling.

Prolapse is common but never normal. Prolapse can be caused by different problems, intra-abdominal pressure problems, pelvic floor weakness or dysfunction, or injury to internal structures.

If the symptoms above sound just like what you are struggling with, we recommend downloading our FREE video series below.

Struggling with Incontinence? Here Are 3 Mistakes We See Women Make

Struggling with incontinence can often feel like an isolating and lonely problem. Women don’t talk about it or admit to it, rather it is swept under the rug or joked about in passing. 43% of women ages 50-64 struggle with leaking and 51% of women ages 65-80. Two-thirds of those women have not asked for advice from a healthcare provider for what to do about it. Here are the three most common mistakes our specialist see women in their 40’s, 50’s, and 60’s make who are struggling to manage incontinence on their own.

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#1 Going “Just in Case”

Do you go to the bathroom every time you pick up your keys to leave the house? If this sounds like you, stop going the bathroom “just in case.” Going to the bathroom too often and before your bladder is full can trigger your brain to start signalling you that it is time to pee well before you actually need to. The signal is sent that your bladder is full when it really isn’t. This can create a pattern urgency and urge incontinence. Also, break the habit of having your kids or grandkids do this as well. Their little bladders are susceptible to the same conditioning and problems as adult bladders.

#2 Not Drinking Enough Fluids


You stop drinking or drink too little to avoid filling up your bladder to avoid leaks. Drinking too little causes the urine in your bladder to be extremely concentrated. Concentrated urine leads to bladder irritation, urge to go, and pain. Your urine will look dark yellow in color if it is concentrated and closer to light yellow or clear when it is diluted. If your pee look more like orange juice than lemonade your next stop is the kitchen to get a glass of water.

#3 Straining on the Toilet

Your pelvic floor muscles need to be completely relaxed when you urinate to completely empty your bladder. Leaving urine in your bladder can lead to irritation, infection, and a whole other host of problems. Straining when you are pooping is equally as bad and can contribute to incontinence. We recommend if you are someone who strains on the toilet to support your feet with a stool and our favorite the Squatty Potty. This squat like position “unkinks” your hose and makes it easier to completely empty. Peeing should look like a garden hose watering flowers (steady and constant) and not like a fireman putting out a wildfire (pushing hard for speed or distance).

What can I START doing?

Grab our Freebie: “5 Tips to Eliminate Incontinence Safely and Naturally”

You will learn 5 simple steps, from Dr. Anne Madden, a women’s health physical therapist, that you can START doing today to become leak free naturally and safely.

Is my Diastasis Recti treatable?

Hi Ladies! Are you a busy mom who is struggling with a condition like diastasis recti (abdominal separation)? Any mother who has been asked, “When is your baby due?” AFTER she has already had her baby completely understands this and how frustrating it can be.


The answer is yes, if you focus on identifying the factors contributing to your diastasis recti symptoms and perform the RIGHT exercises and strategies for YOU. This is why a generic fitness program of exercises will not work for many women. Our specialists see many contributing factors like scar tissue, intra-abdominal pressure problems and rib flare to name a few. Many women have more than one factor making recovery not so straight forward.

Individual treatment sessions are the gold standard for diastasis healing and strength and will speed your recovery compared to generic exercises. Our goal is to reduce your symptoms by making you stronger doing the activities you need or want to do not eliminating those activities from your life.

Each woman is as unique as the baby she has welcomed into the world and our treatment of mothers needs to reflect this
— Anne Madden, Founder of Proximity Telehealth


Breathing! We always start with breathing. I know what you are thinking. That isn’t an exercise…is it? Yes it actually is. Your diaphragm, the muscle that controls breathing, is active 24/7. Breathing significantly affects how you use the rest of your core system. Click on the video below to learn from Dr. Anne Madden, a women’s health physical therapist, what a “360 breath” looks like and how to do it.

What’s next? Join our “Diastasis Recti Challenge”

Exercising while pregnant seem overwhelming? 3 tips on where to start

Ideal vs. Reality

I am a mother of three and the owner of a physical therapy practice focused on women from pregnancy through to their return to fitness. With my first daughter, I was sick from 5 to 15 weeks while working full time as a PT, my husband was deployed, and I was throwing up constantly. Working out was so far from my mind. I wanted to be the fit and healthy mom who can handle it all and look adorable in pregnancy workout clothes. But sometimes reality just ain’t that pretty. So if you are like how I was, I want to give you some tips on what you can be doing to help prepare your body for birth if exercise just isn’t happening.

3 Practical Tips To Start Today



Really, breathing? Yes, really. I will admit that early in my career as a physical therapist I thought focusing on breathing was a waste of time and blew it off as not important. After over ten years of experience and retraining breathing with women I am a true believer in breath work.

The way you breathe influences the pressure placed on your abdominal muscles and pelvic floor EVERY TIME you take a breath. Many of the conditions causing pain for my patients can be directly attributed to the inability to handle the pressure created by the way they are breathing. This also influences how much stress hormone, cortisol, is floating around your body.

Cortisol is your body’s built-in alarm system and can contribute to anxiety, depression, headaches, problems with digestion, trouble sleeping, and weight gain.

Does this sound like a list of the many things women struggle with, especially after having a baby, that can all be tied back to how they breath? That’s why we place such importance on this with the women we work with at our practice.

Using Your Arms Now

In a few short months, you will birth a rapidly growing infant that you will carry, feed, diaper, place in a carseat, take for walks, and love on. Most newborns are 6-10 pounds and quickly get heavier and heavier. Are your arms and neck ready for that? How much do you use your upper body right now?


Many new moms I speak to complain of neck and shoulder pain that they attribute to feeding or nursing positioning. What I most often discover is that women are all of a sudden using their upper body more frequently with sustained holding and carrying. Their neck and shoulders simply are just not prepared for it. Start using your arms more now in preparation. Here are some examples. Place the cup or pan you use most often on the highest shelf of the kitchen so that you are reaching and holding above your head many times per day. Carry your groceries in one bag at a time to increase carrying time. If you are at the park with other children use some of the playground equipment to hang on, or do inclined push ups on the slide while your kids are playing. Get creative and have fun with it!


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Walking is the first exercise I have every one of my patients start if exercise seems impossible or overwhelming. If you are currently someone who does not walk for exercise, start with 10-15 minutes at a comfortable pace. You should be able to talk without difficulty during this walk to gauge that you are not walking too intensely. If you are someone who does walk for exercise already, I recommend adding intensity by adding inclines or declines.

Ready for More?

Pregnant with Back Pain? What You Can Do Right Now To Feel Your Best

Pregnancy and back pain go hand-in-hand for many women. Increased stress from weight gain, hormones, and even the way you move throughout the day can all contribute. As a mom of three and a physical therapist, here are three tips I used while was pregnant and that I also give my pregnant patients to relieve back pain.

Use a Towel Roll While Sitting

Take a towel or small pillow and place it on the back of your chair. Sit on the front half of the towel to force your hips forward in a neutral sitting posture by pushing them slightly forward. A neutral posture allows your spine and pelvis to support the weight of your upper body efficiently. This also helps you avoid sitting on your tailbone. Your tailbone (coccyx) was never meant have the weight of your body on it while sitting and can be extremely sensitive during pregnancy.

Use a Foot Stool While Standing

Standing, just like sitting, in one place all day is not healthy. A foot stool encourages movement while you are standing and is one of the best ways to reduce pain in the low back for women who stand for a long period of time. Raise your foot up on the stool, rock it on the edge, and stretch to reduce the amount of static stress on your back.

Tennis Ball Massage

The tennis ball massage is my absolute favorite tip for any type of muscle pain in the body. I use single or double tennis ball setup to massage different body parts depending on the pain. I find that a single tennis ball is the most pain relieving when muscles are located away from the spine like the hips, legs, and shoulders. I use the double tennis ball, or bean shaped ball, to massage the muscles on the sides of the spine from my neck down to the low back. Keep tennis balls handy in your desk or family room so they are always nearby and ready to use. And here is the link to the Yoga Tune Up Balls I mention in the video.

Want More?

Are you Ready to Start Working Out Again After Having a Baby? Here are Three Signs That You are NOT

We all know that having a baby is a happy and joyful time, but there are some very common physical problems that can occur that I wish someone had warned me about during my pregnancy. I am a physical therapist and mother of three, and my goal, like most of you, was to get back to activity and be a healthy mom. Instead, when I thought I was doing something healthy for my body, like returning to running and exercise, I was really overwhelming a system that wasn’t ready for it. I started to have every one of the symptoms below and felt like my body was falling apart.

“I am a physical therapist and mother of three, and my goal, like most of you, was to get back to activity and be a healthy mom.”

I used my knowledge as a PT and extensively researched my conditions and the treatments available. The common solutions were surgery or kegels, and nothing in between. Kegels didn’t work and surgery wasn’t acceptable to me. What changed things for me was a small group of women and pelvic health focused PTs who were determined to provide treatment for these conditions without surgery. I was ready to join that movement and took all the education I could get my hands on to solve my own problems. This inspired me to focus my practice on educating and helping women get back to the activities they love, like I was able to do.

Three Common Symptoms

Here are the three most common symptoms I treat in my women’s focused PT practice that you need to consider as you get back to activity after having a baby.

1. Leaking - Your Body is Telling Your Something is Wrong


Incontinence, unintended leaking of urine or feces, happens to up to 40% of women after having a baby. Most often this occurs when women cough, sneeze, or jump. Because this symptom is so common many women accept this as badge of motherhood. Here is the reality - leaking is your body telling you that something is wrong, just like a faucet only leaks when there is a problem. The pressure and stress placed on your system is overwhelming its ability to function properly. Continuing to place those same stresses on your body will only further weaken your system. I’ll say it again...leaking is not OK and is important to resolve now. Take care of your body so that you are not one of the 50% of women over the age of 65 who are incontinent in the U.S. today.

2. Bulging or Heaviness - aka Prolapse


Prolapse literally means falling out. In this case, we are talking about internal organs such as the bladder, uterus, and rectum that can descend to the point of coming out of the vaginal opening or give you the feeling of falling out.  Again, if you have a heaviness or bulging in your vagina then your support structures are currently being stressed beyond their maximum capacity. Further pressure and stress without treatment will continue to weaken the system and ultimately lead to failure of the support structures.


3. Abdominal Separation

Diastasis Recti, a separation between your abdominal muscles along the midline, often leaves women continuing to look pregnant or have a “pooch” long after they have given birth. This is a symptom that your abdominal muscles are currently stressed beyond capacity and unable to heal due to continued stress, pressure, and/or weakness. This separation can be wide and deep and its important to know how deep and wide yours is. Over the long run, this condition can lead to further symptoms like back and hip pain as your body tries to compensate for this weak link in the system.

Go From These Symptoms To The Activities You Love- There is Something You Can Do

The common theme here is that stress and pressure beyond the capacity of the system can cause these symptoms to occur. In my case, I became my own most important physical therapy patient and learned I could train my pelvic floor and abdominal muscles to handle stress and pressure better. Through that, I eliminated the symptoms I was experiencing. For you, no matter how long you have had this condition, there is something that can be done.

Take Our Free Pelvic and Core Health Mini-Course

Don't Ignore Your Pelvic Floor

What difference does a good foundation make?


About a year our house was completed, we noticed large diagonal cracks were forming above the doors. We patched the cracks and then three months later noticed they reappeared and were slowly getting bigger and bigger. Nail pops in the ceiling came next, followed by doors that would no longer open or close correctly.

Time to call in the experts

What is going on here? Why do these issues keep reappearing and getting worse? We quickly realized that we needed help. We needed experts to assess what was really going on. We called in foundation experts who performed all kinds of tests and determined the symptoms we were seeing, the cracks and misaligned doors, were caused by a faulty foundation.

What does this have to do with my pelvic floor?


We see the same type of pattern in our bodies. The foundation of your body (your pelvis and pelvic floor) need to be functioning well to support the rest of your house (shoulders, knees, neck, etc). When your foundation is faulty, the pain and symptoms can be felt in body parts that are far from the problem site. These symptoms are like the nail pops and cracks in my house and cannot be resolved without correcting and maintaining your alignment. We know that your body is not in a static position all day long (or shouldn't be) so we need a healthy pelvis and pelvic floor to function during our movement/work/daily activities. Once you have a healthy foundation in place, you have a solid base from which your arms and legs can work.

Time to get to work


Good news for you! Physical therapists are the foundation experts for the body. We assess your normal standing and sitting alignment and pelvic floor function. We teach you how to find your ideal alignment to get your pelvic floor activated and stabilizing your pelvis. I refer to this as your "home base." In the beginning, we teach you to start from home base before you move and over time your body will naturally return to this new home base without consciously thinking about it. Like with our house, you may need professional guidance or expertise to figure out how to adjust your foundation or change your habits to maximize the ability to use your body in pain free ways. Have you tried to spot fix your body only to have the pain return or new pains begin?

If this sounds like you...It might be time to call in an expert.

Get started right now

Kegels Not Working For You? 3 Reasons Why

If you are a woman, chances are you and kegels have crossed paths before. Kegels have traditionally been the ONLY exercise prescribed to women trying to recover after giving birth. Unfortunately, studies have shown that pelvic floor muscle training programs (kegels) are successful for only about 55% of women. So what about the other 45%?

I have been a physical therapist for over thirteen years and own a practice focused on women returning to activities they love with a healthy pelvic floor. Our specialists know that there is so much more to offer women than just one exercise. Here are the top 3 reasons we see kegels fail for women and what else women can do to recover!


Traditional pelvic floor exercises, such as kegels, treat the symptom of the pelvic floor weakness. But is your pelvic floor actually weak? Or is your problem that the communication between your brain and the pelvic floor has been disrupted due to having a baby, having surgery, changing medication, trauma, or having been on bed rest?  With the women I work with, I want to discover why the pelvic floor is not functioning correctly before prescribing exercises.


Many women have pelvic floor muscles that are too tight. Performing a kegel exercise on top of an already too tight muscle will only make it tighter. A tight, short pelvic floor that cannot relax then becomes weak and can cause symptoms of incontinence and pelvic pain.


A healthy pelvic floor responds automatically to stress from gravity, movement activities, and increased pressure in your abdomen. Your pelvic floor should react differently depending on the type of challenge. For example, your pelvic floor will need a stronger contraction when you are lifting your toddler vs. lifting a pencil. Training the pelvic floor with proper timing and with proper force is essential for healthy function. A traditional kegel trains your pelvic floor to react one way and when you are laying or sitting. Most women have symptoms of pelvic floor problems when they are up and moving. We need to train the muscles to react correctly in the movements where the symptoms happen.

Sign up here for our “5 Tips to End Incontinence Naturally”

Why You Should Consult a Physical Therapist After Having a Baby

Ask any woman who has recently had a baby if her body changed during that 9 month process. The resounding answer will be “Yes!” These body changes affect the way you sit, stand, walk, and even sleep. Then comes the birth of your baby! There are hours of stretching, pushing, pulling, potential tearing, and even possible major surgery in the form of a cesarean. Does that sound like a walk in the park or more like a serious injury?


Here is some common advice new moms get, “Just rest, recover, and slowly ease back into exercise as you feel you can after your 6 week checkup.” Sound familiar? Does that seem like adequate medical advice for what you just went through or what activities you hope to return to? How do you know when you are ready to return to the gym, running, Crossfit, or yoga? What are the symptoms that your pelvic floor is not recovering as it should? Is there a danger in returning to activities too soon?

Great News! That outdated care and lack of information is about to go out the window. The American College of Obstetrics and Gynecology (ACOG) released new recommendations in April 2018 acknowledging the lack of follow up care for women post delivery.

ACOG now recommends that postpartum care should be an ongoing process, rather than a single encounter

Women have different problems at all different times in that first year of recovery so a single visit at 6 weeks post delivery is no longer cutting it. Each woman's recovery from birth is as unique as her new baby. These 6 areas that now must be included in care:

• mood and emotional well-being
• infant care and feeding

• sexuality contraception and birth spacing
• sleep and fatigue
• physical recovery from birth
• chronic disease management
• health maintenance


Do you want to return to being a fit and healthy person even though you are a mother now? Of course you do! Physical therapists are the ideal providers to address the majority of these conditions. We will customize a plan for you based completely on your strengths and struggles but most importantly on who you want to be at the end of the sessions.

Want to get started right now? Join our FREE Pelvic and Core Health Mini-Course to see EXACTLY what I teach all my patients during their first one-on-one treatment session.