Postpartum Healing: Reclaiming Confidence After Motherhood

Justine Buchanan with her horse and her daughter

Therapeutic Associates

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When Sarah Jean entered the world, her arrival came with a traumatic delivery complicated by severe preeclampsia that nearly cost her mother her life. The experience left Justine Buchanan needing time to heal — not just physically but emotionally — so the new mom avoided doctors for a while.

Time passed and Justine embraced life as a new mom, finding joy in caring for her infant daughter and slowly regaining her sense of self and confidence. When time came to get back to her job at Wilco Farm Store, Justine also felt eager to reconnect with her passion for horseback riding and newfound pursuit of barrel racing.

Yet, when she returned to work and settled back into the saddle, persistent pain and incontinence dominated her days. Determined to persevere, Justine decided to start barrel racing again. With her powerhouse of a horse beneath her, she took a run that made it impossible to ignore that something wasn’t right.

Young mom holding new baby posing by horse with husband

“When my horse left the third barrel to run home, it was so powerful that I grabbed the front of the saddle with both hands and just left the reins on his neck,” Justine described. “I felt everything just kind of release — like I had no power, no strength. I almost went out the back end of my saddle.”

Frustrated and needing to find answers, she contacted her OB, describing her struggles with pain and urinary leakage that prompted her to wear pads. Her OB recognized the need for intervention and wrote a referral for physical therapy, opening the door to a new chapter in Justine’s recovery.

Unfortunately, Justine’s journey continued to be riddled with challenges as she faced long wait times and limited options for the PT she desperately needed. The referral, she felt, led her to a dead end.

Determined to find a solution, she turned to Facebook, posting a request for recommendations for pelvic floor physical therapy in Central Oregon, and that’s when she found Therapeutic Associates PT and everything changed.

The turning point: discovering Therapeutic Associates PT

When Trey Alley, administrative supervisor at the Therapeutic Associates clinic at the Athletic Club of Bend, answered Justine’s call, she not only listened but also took charge, handling the transfer of her referral and even coordinating with her insurance. The helpfulness and efficiency were a welcome surprise, leaving Justine relieved to finally feel supported.

Justine Buchanan enjoys being back in the saddle, taking her new daughter Sara along in the front pack.

Trey validated Justine’s concerns about her situation and made it a priority to have her begin PT as quickly as possible. Within weeks Justine was sitting down with physical therapist Laura Cooper.

“It was hard to sit down and talk about it at first, but I kept telling myself, ‘She’s a doctor. She’s seen worse, she’s heard worse.’ And then she told me, ‘What you’re experiencing is real. It’s real trauma. It’s real life, and it needs to be addressed. It’s not something to be put off.’”

Laura’s compassion, understanding and validation was a turning point for Justine, who left that first appointment feeling hopeful for the first time in months.

“The education I walked out with was mind-blowing,” Justine explained. “She told me that what my body went through was severely traumatic and that it’s very downplayed by media and society. She said we have to give ourselves grace.”

Most importantly, Laura made recovery feel achievable. She focused on creating a practical plan that fit into Justine’s busy, physically demanding life.

“She was willing to work with me on lifestyle changes and things I could easily incorporate into my days,” Justine explained.

Transformative progress: small steps lead to big results

For Justine, physical therapy quickly became a cornerstone of her recovery journey. Each session blended physical therapy, education and emotional support.

“I joked that she was my physical therapist, my friend, and my shrink,” Justine shared.

Justine’s progress was tangible and empowering. Within about a month, she transitioned from relying on period panties and pads daily, to no longer needing them at all. “I tried going to work without wearing anything, and it worked out — I didn’t leak,” she said.

What stood out most to Justine was the foundational lesson Laura emphasized: tuning in to her body’s signals.

“The biggest message I got from her was to be aware of your body, pay attention to yourself,” Justine explained. Laura encouraged her to focus on recognizing early cues, like the sensation of needing to use the restroom, and responding thoughtfully rather than reactively.

Reinforced by similar advice from her osteopath, the message resonated deeply. “It just really stuck with me,” Justine said. “This must actually work.”

Understanding the pelvic floor: education as the foundation

Pelvic floor physical therapy often starts with education and inquiry, Laura stated.

“I never assume what someone knows about their pelvic floor,” she explained. “I ask, ‘What’s your understanding and ability to connect with your pelvic floor?’ Some people are confident and say they’ve been doing Kegels for years. Others feel like it’s a dark cave in their body they can’t understand.”

Laura helps patients uncover imbalances in their pelvic floor function, often discovering a chronic holding pattern.

“Many think pelvic floor issues stem from weakness, which isn’t untrue, but often the muscles are fatigued from holding tension, like clenching your jaw without realizing it,” she described. This tension, Laura added, can lead to issues like urinary incontinence, where the muscles are too tapped out to respond effectively during something like a sneeze or cough. When such an action leads to leaking, instinct is that you were not holding enough tension, which is essentially backwards.

Patient education in pelvic floor PT also extends into breathing.

“I assess patients’ ability to diaphragmatically breathe, and their understanding of what happens with their pelvic floor muscles when they inhale and when they exhale,” Laura shared, noting that when you inhale, the pelvic floor should relax, and when you exhale, it should engage. Understandably, people often get it backwards, she said. Therefore, part of pelvic floor PT is emphasizing breath awareness and guiding patients in retraining their pelvic floor muscles to align with this natural rhythm.

Teamwork in action: enhancing recovery through collaborative care

Justine’s journey to recovery was enhanced by the collaboration between Laura and Bren Schmidt, an orthopedic and spine specialist at the clinic. Bren joined Justine’s care team to focus dynamic control, functional movement and stabilization, particularly in her low back and hips.

“Pelvic floor dysfunction almost always implies some sort of lumbopelvic dysfunction,” Bren said. “The lumbopelvic region includes the lumbar spine, abdominal muscles, glutes, and everything connecting to the pelvis. In Justine’s case, this whole area was significantly weak.”

Together, Laura and Bren designed a holistic approach to address Justine’s interconnected issues while also engaging in shared decision making, keeping her goal of getting back in the saddle at the forefront.

“We included Justine in every step of the plan,” Bren emphasized. “It was critical to ensure the exercises fit her life, balancing childcare, work, and her personal goals.”

Their collaboration began with foundational movements to target key deficits.

“Most of the work involved helping Justine understand her weaknesses and how her homework addressed them,” Bren explained. “We started small, focusing on stabilization and control, and gradually progressed to more dynamic movements as her strength improved.”

Justine Buchanan and daughter Sarah on a horseback ride.

Manual therapy played a minor role, with most of the intervention centered around education and exercise. Regular check-ins allowed Bren and Laura to adapt the plan of care and advance Justine’s exercises as she gained strength and functional control.

By combining Laura’s pelvic health expertise with Bren’s focus on functional movement and stabilization, Justine’s care was both comprehensive and personalized, helping her return not just to daily activities such as work and childcare, but also to the pursuits that brought her joy and fulfillment, including horseback riding and barrel racing.

From challenges to triumphs: finding strength in every achievement

Reflecting on how far she’s come, Justine expressed deep gratitude for her physical therapy team.

“I wouldn’t be here without the care I received. Without it, I’d still be stressing my muscles without truly building them up,” she said. “Now I’m stronger, and I can run my horse, and I don’t feel like I need to have a pad on when I run. I have the strength in my core that I can actually sit in the saddle and be strong.”

One milestone stands out vividly in Justine’s mind — when she was running barrels recently.

“For the first time I did not drop my reins. I held the horn with one hand, which I have to do to stay out of my horse’s way, but I kept my reins in my other hand and rode him. It felt so powerful. I almost cried.”

Justine Buchanan barrel racing in Prineville Oregon
Barrel racer Justine Buchanan rounds the barrel

Empowering others: sharing the journey

Her progress hasn’t gone unnoticed. “To have ladies who are well-respected riders take the time to say they’ve been watching me and how aggressive I’ve been riding — it means a lot,” she said. “When I first started trying to ride, I felt like I might not be able to compete. I told my sister, ‘I don’t know that I’ll ever do this horse justice. Like, I feel like I shouldn’t do this; it’s not fair to him.’ But she was my biggest cheerleader. Working with Laura, I feel like I’m stronger than I’ve ever been. I have the strength I’ve needed to ride and to be good.”

She’s also gained invaluable body awareness. “If my back hurts during the day, I engage my pelvic floor and lift it up to help. If I feel my belly has dropped, I engage everything to hold it up. I’m just trying to be aware of my body and also stay hydrated, because that’s a delicate balance.”

Justine also wants to empower other women to seek the help they deserve.

“Anyone I talk to, I’m like, ‘This is something you need to do. You need someone professional who can tell you what’s happening and explain it — like Laura did when she sat me down that first time. She explained that you don’t have to be embarrassed by what’s happening with your body.’”

Her resolve is clear.

“Because of how society is, I think 90 percent of the problem is we’re trained to ignore bad symptoms our bodies are telling us. Sometimes it gets bad because it’s just taboo to talk about. But you know what? I’m not embarrassed. I’m good now.”

Justine Buchanan poses with husband and daughter on their Prineville Oregon ranch

Learn More About Pelvic Health Physical Therapy

A mother and her daughter ride scooters outdoors together

Pelvic health PT for better health and wellness.

Pelvic health physical therapy addresses the unique musculoskeletal problems of the pelvic floor that can have a significant impact on quality of life. Our goal is to improve your function, decrease your pain, guide you on your journey and get you back to the things you love.

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