Dr. April Bolding, PT
Women's Health Physical Therapy
April runs a solo private practice providing much needed care to women. She uses an integrative, compassionate approach to help women with issues such as prolapse, incontinence, pelvic pain, pain with intercourse, abdominal pain, pre- and post-childbirth. She loves working with women in any stage of their lives.
Because of her background and specialized PT training in pregnancy, childbirth and postpartum, as well as in the pelvic bowl and abdomen, her goal is to provide physical therapy to as many pregnant and post-birth mothers as possible. This hard-working population is under-referred and under-served as a whole. In other developed countries, it is a given that a woman be seen by a physiotherapist during this time. Women undergo tremendous change on all levels within the childbearing year and their bodies need specialized attention to prepare for and rehabilitate from the Olympic event of pregnancy and childbirth.
All clients are seen in April's home healing space in West Seattle. This allows for more personalized attention in a private, safe space. She has intentionally transitioned out of a formal clinic setting so she can focus less on paperwork and documentation and more on YOU.
To honor her clients' commitment to pay for their own healing, April donates a portion of what she receives from clients to help other women heal. Regular donations are made to organizations that help women and children, including: New Beginnings (they provide shelter, advocacy and support for women and children affected by domestic violence); GAPPS (Global Alliance to Prevent Prematurity and Stillbirth); Open Arms Perinatal Services (they provide community-based support for women through pregnancy, birth and postpartum).
When women have issues within the pelvic bowl, women of all ages tend to wait to get treatment until symptoms become severe or unbearable. There is no clear path given to women as to who they should see for the different dysfunctions. Most of us turn to Western medical practitioners to help us identify what is causing the dysfunction. Interventions can range from not doing anything, doing kegels, taking medications or hormonal birth control to invasive surgery. Women's Health physical therapy is not yet routinely seen as a less invasive option (though there are those practitioners who have been referring their clients for years). Many practitioners still classify some women's pelvic floor dysfunction as being within the range of normal.
We need a new normal! In this modern age, we don't need to accept that women who can't control their urine every time they cough is normal. Sex is normal part of human function and it should not hurt. Our pelvic floor is made up of and surrounded by muscles. Muscles can be strengthened! If the muscles are too tight (shortened or overactive) and causing dysfunction, they can be lengthened and encouraged to release tension. Our bodies are dynamic and change with what we do with it. Our bodies are intelligent extensions of us — our collective body-mind-emotions-spirit. On a basic physical level, gravity is a constant force on this planet that will have its way if we don't apply some counter-balance to it.
Does this mean everyone should do kegels? Absolutely not. There are few rules that apply to everybody. A Women's Health physical therapist is a specialist in pelvic floor musculature and function, in addition to knowing the whole body. She can work with women to identify what the issues are and empower her with the right strengthening exercises, stretches, activity modification or intervention that she can do to heal herself. Our bodies want to heal themselves — it's called homeostasis. Our bodies are constantly trying to balance our complex systems to regain/maintain function. Becoming structurally aligned, receiving manual therapy, and doing some personalized therapeutic exercises help reset our bodies to function optimally again.
Working with our bodies like this empowering. It's an act of self love to reject that dysfunction and pain as normal just because someone said it was. We have so much learning and unlearning to do especially as it pertains to our pelvic organs, pelvic floor and our sexual function. Our reproductive and sexual health matter. Our pelvic bowls carry our pelvic organs, memories, traumas, emotions, pleasure, babies, pain, creativity. It is bigger than the physical realm. It is the seat of the sacred feminine embodied within us. We as a culture must stop ignoring dysfunction and pain in this region. It is yet another dismissal of us as women. Another fibroid surgery doesn't address why dysfunction keeps manifesting in the pelvic bowl. Working with this region holistically, with loving reverence and courage in a safe environment, is what can restore lasting health and function. When women are healthy, we all are healthier. When we finally believe this, we can teach our children to really believe this truth, too.
After experiencing my first session with April, it was clear to me that not only had I never been touched in a non-sexual, non-medically invasive way in my life, but that I had never touched myself in that way either. Gentleness and open curiosity was never modeled to me so I never knew how. I wish every woman and girl knew how to explore and touch themselves in this way. I think it would create an entirely different pathway and relationship to our vaginas and pelvic bowl.
Women's Health Physical Therapy client
Women's responses to this work
Note from April: The women below have been very gracious with thanking me for their successes. Try and see past how they attribute to their success to me. They are the motivated and brave ones who stepped forward to regain their health. We worked together and not only restored function, but in many cases, changed their lives for the better. This work is powerful like that.
The incidence of urinary incontinence experienced by women is 10–30% in this country. This is a common issue that frequently worsens and impacts what activities people feel they can do. Urinary leakage with sneezing or vigorous activity is called stress incontinence and can be eliminated with education and treatment. There is also Urge incontinence and Mixed Incontinence.
Post-partum, I played the waiting game. Six weeks, six months, sixteen months. I regained significant (bladder) control but sneezing was an issue and running wasn't an option. Finally I saw a urologist who recommended surgery. It scared me enough to finally try physical therapy. I was fortunate to find April. Working with her reduced my anxiety and gave me hope and confidence. I feel physically different after a few short weeks. When I do her prescribed exercises, I can sneeze and run with confidence and continence! Thank you April.
Women's Health Physical Therapy client and mother of 1½ year old twins
Pelvic Floor Issues
Knowing I was lacking in pelvic floor strength, I was on a quest to get help. I was referred to April and, from the moment we met, I could tell what a good person she is. Gentle, patient and absolutely understanding of my concerns. No one has ever, ever worked with me and helped me to establish what I needed to know. I wasn't sure what I was in for but I knew what outcome I wanted! With the boosted confidence April helped me with, I will continue to exercise for the rest of my life. I consider myself a "work in progress" at this point. I strongly encourage anyone to seek needed help to build a stronger, more confident, empowered and in-control woman. April was (is) sincerely one of the best things I could have done for myself!
Teresa, Women's Health Physical Therapy client
Birth is a peak experience in a woman's life. It's a physical, emotional, mental, spiritual, and social event. It brings us to our end, then expands us in ways we couldn't foresee. It is sacred, challenging, beautiful, messy, painful, ecstatic, complicated, rarely easy and sometimes traumatic. No matter what a woman's birth experience is, there is a lot to assimilate afterward. Like the hero's journey, a woman walks into the unknown territory of birth where she must meet the transformational challenges that ultimately lead to the death of who she was (her old story falls away) and to the rebirth of her new self as a mother. In the aftermath, there is reckoning to be done, a reintegration of the parts of her self that still serve her. There are parts of our birth stories that can leave us confused, guilty, sad, regretful, even victimized. These feelings are held in our bodies, especially in our pelvic bowls. I work with women to find the parts of their experience that are keeping them stuck in sadness and pain (physically and otherwise) so they can fully embody the hero role they earned by moving through this birthing rite of passage.
April got me back on my feet again and on the road to recovery. An early-term cesarean after four weeks of bed rest left me with limited mobility and unable to lift my baby three month post-surgery. After just halfway through sessions with April, I was able to get up from a seated position, felt less vulnerable and able to 'wear' my infant. I attribute my quick turnaround to her intuition, deep knowledge of the physical/mental/spiritual connection, compassion and personalized care. I'm so grateful for finding her so I can be the able mom I want to be.
Lisa Tiedt, Women's Health Physical Therapy client and mother
Rectus Abdominis Diastasis
Our rectus abdominis is one layer of our abdominals that go lengthwise up the body from our ribcage down to our pubic bone. We have a left and right layer that is joined by the linea alba, connective tissue at the midline of the body. In pregnancy (and more commonly in subsequent pregnancies), these layers can separate and the connective tissue between them widens. Normally, they should not feel separated or be up to one finger width of separation. Anything more than a finger-width all along the muscle is indication for specialized exercises. In pregnancy, there are body mechanic modifications that can help prevent this (see Pregnancy, Childbirth and the Newborn). After pregnancy, this separation heals as much as it will on its own by six weeks. If there is still a separation after six weeks, women have to do some specialized exercises to heal this. Note: Sit ups are not the right thing to do! I help women heal these a lot in my practice.
After my second baby was born, I had a large, four-finger width separation between my abdominal muscles. It was discouraging feeling like I wanted to start exercising, but I didn't even have my body physically ready without making things worse. I started seeing April Bolding and doing physical therapy exercises at six weeks. Eleven weeks later, my abdominal separation is down to 1.5 finger width and most importantly, I've begun running, working out and feeling much better all around. It's made a difference.
Karen, Women's Health Physical Therapy client and mother of two boys
Orthopedic Physical Therapy
I provide traditional orthopedic physical therapy for all types of musculoskeletal issues, including repetitive stress injuries, traumatic and sports injuries, acute and chronic pain and pre/post-surgical rehabilitation. I offer this therapy to both women and men. While women's health is certainly my specialty, I am an experienced orthopedic PT who has worked in the outpatient orthopedic clinic setting for years.
April is incredible. She treated me holistically in the truest sense of the word; with advanced expertise in physical therapy, emotional support, and energetic wisdom. I now make a point of scheduling a yearly exam with her for the benefit of my health and wellbeing. We are lucky to have her doing this work for our community.
Melanie, Orthopedic Physical Therapy client
Physical Therapy can help many issues that come up in the childbearing years and beyond. Some of these include:
Coccyx or tailbone pain (women don't get this addressed for years!)
Sacroiliac (SI joint pain)
Pelvic Floor Issues (short list)
Bladder and bowel incontinence / straining / dysfunction
Pain with sex (scarring, high tone in muscles, trauma, etc)
Prolapse (cystocele, rectocele, etc)
Pelvic Pain (vaginismus, etc)
Difficulty or inability to coordinate orgasm
Fixing Rectus Abdominis Diastasis (abdominal separation)
Round ligament pain
Nerve Compression Syndromes
Carpal Tunnel Syndrome
Thoracic Outlet Syndrome
Lateral Femoral Cutaneous issues
Tarsal Tunnel issues
Cervical pain / headaches
Upper back / thoracic issues
Extensor Pollicus longus
Hip Adductors/Gluteus medius
Lower leg cramps
Artwork by Mara Berendt Friedman