Working in Clark County: Christina Trautman, women’s health specialist

Since she was 7 years old, Christina Trautman had many issues with incontinence. At age 15, exhausted by the shame, she and her mother visited a gynecologist. But the doctor’s advice to the 15-year-old Trautman was something she wasn’t ready to do: have a baby.

“They took me in, and my pelvic floor apparently was so tight, I wasn’t fully able to relax,” Trautman said. “Basically, the gynecologist told me I need to have kids, and it’ll all go away, that I just need to have a vaginal birth. Obviously, that was not an appropriate treatment. I was 15.”

Now, Trautman, 35, specializes in physical therapy of the pelvic floor. Out of her Hazel Dell home, she operates The Pelvic Floor Place.

What’s called “myofascial pelvic pain” is very under-diagnosed, according to an article in Harvard Health Publishing. A lot of people haven’t even heard the term “pelvic floor,” which refers to the bowl-shaped set of muscles that supports the bladder, bowels and uterus. Trautman said taboo around women’s health also contributes to misdiagnoses and under-reporting.

“Literally everything you do during the day requires some type of pelvic floor function. All of those things require stabilization and support,” Trautman said. “If they’re not working properly, you’re going to have problems.”

The Columbian was curious to learn more about this little-known topic.

Tell me about yourself.

I’m from Billings, Mont. I went to the University of Portland for my undergraduate degree. There is where my passion for pelvic-floor work started. I started having pelvic-floor issues much earlier than that. I didn’t really know what they were until I got to college and I started working at a physical therapy clinic. It so happened the clinic had a pelvic-floor therapist. She noticed some things, like that I had to go to the bathroom a lot. She started treating me at the clinic when I wasn’t working there and things got a lot better.

So, what is a pelvic floor? I’ve never heard of pelvic-floor issues.

The pelvic floor is basically the central part of your body. It should be one of the strongest areas of our body. But for women, especially women who have kids, we go through stretching of our abdomen to grow the belly. The pelvic floor has to stretch to deliver a baby vaginally. Issues arise. If those pelvic-floor muscles get stretched out, the organ can shift and move in ways that are uncomfortable. Leaking, incontinence, constipation, pelvic-floor pain, like pain with sex, pain on the lower back. All these symptoms that can arise due to that. I’d say every woman in the course of her life will have some sort of pelvic-floor issue.

What kind of physical therapy helps these issues?

A lot of breathing and coordination of the pelvic floor, the diaphragm and the core. They need to be working together — just reestablishing the balance of all three areas. I’ll teach them how to relax their pelvic floor and give them tools and exercises to relax it. We’ll do core strengthening, hip mobility or yoga exercises.

What are some of the challenges you face in this work?

I think the biggest challenge is people being comfortable and vulnerable enough to want to work on these things and talk to someone they don’t know about really sensitive topics. Especially people who never even talk to their partners; how likely are they going to schedule an appointment with a total stranger and then have an exam on these areas? It’s the biggest struggle, just trying to normalize it and trying get more education out there that it’s just another part of our body. Most people struggle with at some point in their lives.

How has the pandemic impacted your work?

I definitely don’t see as many clients. They’re nervous about coming in. For a while like in March, April, May, patients didn’t come in — and because they didn’t come in, they were having much more significant issues when they could come in, like in June. People are holding off on some of the preventative holistic care. So when they do come in, it’s a lot harder to fix because they’ve waited so long.

Going back to the doctor who told you to have a baby: That’s jarring.

My mom was mortified. We like ran out of there. She like knew I was a good kid and I wasn’t going to listen to bad advice. We just didn’t know what to do with that information then; I just basically had to deal with it. I bottled a lot of those emotions up because I didn’t really have a lot of people to talk about it. My girlfriends made fun of me in a joking way: “She wears a pad because she can’t put a tampon in.” It wore on me after years of it. When I got treatment in my 20s, I was like, “Oh my god. There is treatment for this,” and it wasn’t in my head. My mom — I think she thought I was making stuff up; she had never heard of it. I have heard that from my patients too. I have a lot of patients with pelvic pain. A lot of doctors will just say, “You need to just have a glass of wine and take a bath and then have sex. You just need to relax.” And that’s the type of education that people are getting. So then of course these women feel like, “What’s wrong with me? I can’t relax.” Wine and a bath are not treatment. It’s unfortunate and that’s where we still have a lot of work to do.