Interview with Sarah Miller, PT, DPT from Revive Rehab in Columbia, MO (Part Two)
Back in January of this year, Dr. Sarah Miller with Revive Rehab in Columbia, MO took the time to answer some questions I had for her regarding her role as a physical therapist supporting women during the perinatal timeframe. If you haven’t read that first interview yet, here is the link to that blog post! I loved Dr. Sarah Miller’s answers so much that I thought it would be great to interview her again for some more great insights! Enjoy!
Me: What sets you apart from other physical therapists?
Dr. Sarah: My vision when creating Revive Rehab was to create a space where people would know they were getting experts in their field. Dr. Olivia and I dedicate our careers to continuing our education in pelvic health and women's health conditions. We have over 10 years of clinical experience combined in pelvic health. Our goal is to help individuals stay active without telling them to stop the things they love. Our movement-focused, personalized treatments are designed to get to the root of the concerns. With a warm, approachable environment, we make pelvic health a normal, empowering part of life.
Me: What has been the most rewarding part of providing care for women in the perinatal timeframe?
Dr. Sarah: We get to walk alongside women at such a transformative stage in their lives. So often women don't feel they have the support they need throughout the perinatal period, and we want to provide just that. A nurturing, healing atmosphere for women to navigate pregnancy and postpartum without judgement, regardless of what that entails. We love talking pee, poop, sex, and anything in-between!
Me: What has been the most challenging part of providing care for women in the perinatal timeframe?
Dr. Sarah: Women who are pregnant and postpartum are under-informed, wildly under-supported, and often dismissed before they ever make it to us. By the time they walk through our door, they've usually heard a mix of “that’s normal,” “just wait it out,” or “come back after you’re done having kids,” which means we're not just treating symptoms, but we're untangling months of frustration and misinformation.
Me: How do you help women prepare for their return to exercise after giving birth?
Dr. Sarah: It's all individualized! A mother that is recovering from a vaginal deilvery requires a different focus than women recovering from a c-section delivery. We assess pelvic floor function, ensuring the deep core can coordinate as a system. We then incorporate postpartum exercise plans with lower and upper body strengthening depending on what the mama's needs are.It's truly a full-body approach! A postpartum CrossFitter has a different program than an avid runner. Single leg stability/strength, deep core and pelvic floor coordination, and mobility are always priorities.
Me: Why is scar tissue mobility so important, especially after a vaginal birth or a cesarean birth?
Dr. Sarah: Scar tissue is something I see show up years down the road as a problem. After a vaginal birth or a C-section, scar tissue can create stiffness and limit how tissues glide, which can mess with comfort, strength, and even how well muscles activate or relax. For vaginal births, tight perineal scar tissue can lead to pain with intimacy, low back pain, hip pain, pelvic floor tension, or that “pulling” or "heaviness" feeling with certain movements. For C-sections, the scar can affect abdominal strength, core coordination, and even contribute to low back or hip discomfort because the layers underneath get sticky instead of sliding. When you improve scar mobility, you’re basically restoring normal movement, improving blood flow, reducing pain, and helping the whole system function the way it was designed to. The earlier it's addressed (yes, before symptoms even show up) the better you'll feel long-term!