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Carrie Pagliano Physical Therapy, 2160 N Glebe Road, Suite R, Arlington, VA (2025)

12/02/2025

Ever been told your pelvic floor is just a supportive little hammock “holding it all in”?

Cute… until a sneeze or a trampoline has you clenching for dear life. 😅

Here’s the thing:
💠 If you think the pelvic floor is the be-all, end-all for leakage or prolapse…
💠If you think you’re doomed because Kegels didn’t fix everything…
💠If you think complexity = bad news…
You’re actually sitting on opportunity. Literally.

The beauty of a system this intricate is that there are multiple reasons symptoms show up—and multiple ways to change them.

Understanding the anatomy matters because:
✨ It tells us WHY you have symptoms (or why you have none).
✨ It shows how your genetics and connective tissue influence what you feel now—and what you might notice later.
✨ It reminds us that holding organs in place, staying continent, and moving like a full-on active human is a freaking miracle of engineering.

And no, we don’t have to dive into the weeds of every ligament and fascia layer or urethral sphincter muscle (unless you want to… then pull up a chair).

But we do need to understand it’s way more than a hammock down there.

Think trampoline + dynamic walls + reflexive support system:
💠Your front wall supports your bladder with the pubocervical fascia.
💠Your back wall teams up with your re**um and perineal body.
💠Your urethra isn’t dangling; it’s anchored by ligaments, fascia, and sphincter muscles that should fire anticipating impact—not lock up like concrete.

So if you're leaking after a million Kegels, or were told you have a prolapse but feel fine… you're not broken.

You just need a plan that respects timing, coordination, and real tissue support—not brute strength.

What do you think—was the hammock analogy enough for you, or does this deeper layer finally make the puzzle make sense?👇

12/01/2025

The first thing out of their mouth is almost always the same:
“But…I’m not a runner anymore.”

Enough with the apologies.

I hear this “confession” in so many first sessions, and it’s always a glimpse into a self-story that deserves a gentle, fast reframe.

Please don’t apologize that you’re “not a runner” or you “used to be and now you’re not.”

If you’re a mom sprinting after a toddler while trying to nurse baby #2, trust me—you’re more of a runner than you realize.

If you’re a mom sprinting your kid’s forgotten lunch into school while you’re late to work, you’re a runner.

I’ve had seasons where I didn’t feel like one either. When mileage stats were replaced by sleep schedules and finger-food tips…when intervals and thresholds disappeared under snack lists, mommy-and-me activities, and sports practice calendars.

Even now, I don’t run daily. (Recovery is a MUST & TBH my lifting days are priorities—but I'm also playing the long game here.)

I run slow AF on my long runs some days while people whiz by…because I know the work I put in won’t break me down—it builds me up.

And I know I’ll have “fast” in the tank when I need it. (Don't forget those speedwork days!)

Even my walks with the dog—when I lace up, I’m putting in the time. And it matters.

My 20-something self might think what I do now “doesn’t look like a runner,” but dang if I don’t feel more like one than I ever have.

40+ years of putting on my shoes, more or less…and that number feels strong AF.
If you’re not feeling like your runner-self lately, it’s all good. It looks different for everyone navigating mom-life—and I see you.

So tell me: are you in your mother-runner phase right now, or in an “other-activities” season?

(❤️ this quote & also a HUGE OG fan of Nobody Asked Us with Des & Kara)

11/18/2025

6 weeks. You're good to go, right?

In many cases at 6 weeks you're just starting to feel human again, walks are just starting to feel good and maybe you've started a few workouts.

That said, there's no blanket master switch that you flip at 6 weeks that says that you're ready to hit the trails just like you were pre-pregnancy.

I'm an exception you say?

Yes, there's always exceptions. I've worked with many women who met initial criteria, were educated in red & yellow flags that would require a change in our plans but had other data points to show us we were making the right decision.

(Remember, I'm flexible & we're not all the same)

Those were INDIVIDUAL conversations that took into consideration past running and medical history, birth story, current mental and physical health, pelvic and MSK symptoms, sleep, fueling and overall stressors.

So next time your OB says "You're good to go," it's ok to say thank you and then consider YOUR scenario so that you ensure your best return with all the variables you have to navigate to succeed in your postpartum run progression.

Even better, have a chat with your local running informed PFPT to map it out!

What did your postpartum return to running look like for your pregnancies when you were told you were "good to go?" What do you wish you'd done differently?

--------
Check out the post to see what an expert consensus said (Some great Delphi studies led by in 2024 looking at readiness and run progression)

11/15/2025

WTF, Christopher?

Sometimes you read a line in a book & it hits that nerve you didn’t even realize was still tender.

I’ve been a PT for 26 years...I’ve heard it all—triumph, heartbreak, embarrassment, shame, the whole messy human spectrum. So when I picked up "Brief Flashings in the Phenomenal World" & saw physical therapy enter the chat, I braced myself.

Katie—an ultrarunner—breaks her leg in a freak rafting accident & ends up seeing a young PT, Christopher, 3x/week.

Honestly? The cringe starts early and builds fast.

“He smiles too much at the parts of the story that aren’t funny-falling out of the raft… & spends more time talking about his mountain bike racing than what I can do to heal my leg.”

Then… the classic line:
“You know running is so hard on your knees. I mean it’s brutal. Mine just can’t take it.”

WTF, Christopher?

Read any research since graduating? Running being “bad for your knees” is a myth, an old wives’ tale, & projecting your issues onto your patient is peak cringe.

Katie—bless her—calls it out. She literally tells him:
“If you believe that negative story about running while you’re trying to heal me so I can run again, the therapy won’t work. Your mindset matters just as much as mine.”

Exactly.

So Katie, on behalf of my entire profession… I’m sorry. I’m sorry for every PT who treats from their own lived experience instead of evidence. I’m sorry for those who forget the person in front of them & make themselves the main character.

And yes—my own lived experience as a runner, mom with 2 C-sections, miscarriage, hip surgery, prolapse, diastasis recti, stress incontinence, & perimenopause chaos absolutely helps me relate. But it is a conscious practice to not turn my story into someone else’s limitations.

If you’ve ever had a provider—PT or otherwise—become a barrier instead of a bridge, I’m sorry for that too.

If running is your jam, I’ve got you. If running isn’t your jam, I’ve got you too.

What’s a “Christopher moment” you’ve had that made you question everything— & how did you find your way back?

11/11/2025

🦃 PRE-THANKSGIVING SALE ALERT 🦃

Attention all pregnancy, postpartum, and peri/menopause PROS—

If you’re anything like me and prefer to the Friday after Thanksgiving instead of shop ’til you drop… you won’t want to miss this deal, Nov 14-24.

Before the turkey, before the chaos, before we blink and it’s 2026—it’s your chance to grab Run Strong Again PRO at 25% off the regular price. 👀

If you’ve been waiting for a sign to level up your game with pelvic floor confidence—this is it.

👉 DM me to get on the list for Run Strong Again PRO pre-Thanksgiving sale, or make sure you’re signed up for my weekly newsletter so you don’t miss out.

Because let’s be honest… nothing says gratitude like helping women feel strong again. 💪

11/08/2025

Some days, it feels like everyone else is out there crushing miles while you’re stuck in the “pause.”

The season of waiting. Healing. Holding it together.

Maybe you’re pregnant and the thought of pounding pavement with a full bladder sounds like your own personal nightmare.

Maybe you just had a baby and your pelvic floor still feels like it’s negotiating a peace treaty with gravity.

Maybe you’re nursing an injury that finally screamed loud enough to make you stop—right when life finally gave you space to chase your running goals again, only to realize your body feels heavy and slow, like you’re running through wet cement while your mind still moves at full speed.

Or maybe life just… got loud.

Kids. Work. Hormones. Exhaustion that no amount of coffee can fix.

You start wondering if you’ll ever get back to feeling like you again—the version of you who could run free, strong, and pain-free.

I’ve been there.

🔹After hip surgery 18 years ago.
🔹After two C-sections.
🔹And last year, staring down another labral tear.
🔹Even this morning I feel this, body aching, recovering from 21 miles and 13 hours hiking the Grand Canyon.

It’s frustrating as hell, even when you “know better.”

But here’s what I’ve learned: the fire doesn’t actually go out.

It flickers, sure. It hides behind all the logistics and self-doubt.

But it’s still there, waiting for the moment you decide to start again—slow, messy, imperfect.

The first walk-run after surgery.

The first time your body feels strong enough to lift again.

The day you realize your hips aren’t screaming anymore.

Those are the quiet wins that matter more than medals or PRs.

So if you’re in the hard middle right now—

The “plugging away” season where progress feels invisible—

Keep going. Head down. One small step at a time.

Because I promise, the best really is yet to come.

🔥 Here’s to finding your way back—on your terms.

What season are you in right now: rebuilding, recovering, or rising? Share 👇

10/29/2025

My client DM'd me in the middle of her marathon. No joke.

I don’t take these moments lightly.

Marathons aren't just about shiny PRs or podium pics—it’s about the little stories on the edges.

Promises kept. Big, maybe-a-little-crazy ideas that became real. The vulnerable, human moments that stick with you.

This client and I clicked right away—we’re both moms of tweens/teens, trying to juggle work, kids, and life-ing.

Neither of us had the kind of return to run guidance in our early postpartum days that moms have now (it didn't exist).

No one was talking about strength and coordination training back then, especially for mother runners!

Last Sunday, she DM’d me in the middle of the Marine Corps Marathon.

We’d met a few months ago and I was helping her with pain at her p***c bone when running longer than 8 miles (yep, not just pregnant or postpartum women deal with this).

What she didn’t have in perfect training (ok, let's be honest...lack of strength training), she made up for in showing up—small runs, consistency, attitude, and the guts to go back to basics to see if what we could do in a short time.

Her only goal: make it across the 14th Street Bridge before the cutoff and still be able to walk. That stretch is long, lonely, and brutal. I’ve run it more times than I can count over the years—it’s a total gut check.

And she did it. She kept going. She finished. And then she sent me that pic at the Marine Corps statue with her family—everyone smiling, everyone across the line together...and hardly any pain to boot.

This is why I do what I do.

It’s not just working with elites or hitting PRs with the Insta-worthy finish line shot.

It’s helping someone create a memory with the people they love. It’s saying yes to something that wasn’t perfect on paper, but mattered anyway.

It's about not saying no, but instead..."yes, and..."

It’s an absolute privilege to witness moments like these. Honestly, it means more than I can say.

👉 Have you ever given up on a race (or even skipped signing up) because the buildup wasn’t perfect?

10/27/2025

Things that aren't a good idea...ever.

Can you relate? You hear an active warm up in postpartum is good.

You hear jumping and impact is good for your bones and pelvic floor.

In your brain, all this translates to those "warm ups" we used to crush in high school... you remember the ones!

How that can those feel in postpartum?

Not so good.

I still remember doing butt kicks, high knees, and carioca (yes, we all thought it was karaoke 😂) for XC and track (they even showed up in CrossFit MANY years later).

Here’s the actual kicker—those drills pack way more vertical impact than we give them credit for.

And when you’re postpartum, skipping straight to them is like running before you’ve even relearned how to walk.

Been there. I wanted so badly to jump back into what felt familiar. (It's an easy grab for your brain...I get it!)

But just because we used to do something (as kids) doesn’t mean it’s right for our bodies now. I had to unlearn a lot of “default drills” and learn how to actually progress impact step-by-step (without leaks, pressure, or pain).

👉 Coaches, trainers, moms—can we agree it’s time to retire the 1994 warm-up routine and meet our bodies where they are?

Meet your body where is is NOW, build smarter, and the brainless “fast high knees” will be there waiting for you when you’re ready.

Be honest—have you snuck your high school warm-up back into your adult workout life? 👀

10/25/2025

Felt cute, might delete later 🔥✨🤣

To my fellow GenX moms — I’ll get you caught up and give you the Cliff Notes.

And to the postpartum millennials reading this… we promise we’ll have it figured out by the time you get here. 😉

Because whether it’s postpartum, perimenopause, or full-on menopause — none of us are doing it perfectly, but we’re doing it together.

✨ What stage are you in right now — postpartum chaos, peri plot twists, or somewhere in between?

10/18/2025

Did you think it was over?

Whether you stopped working out in pregnancy or in those hazy postpartum days when your belly felt like a waterbed and there were fluids leaking from every direction…

“YOU” felt further away than ever.

That’s why I’m so proud of this generation of moms. We’re rewriting what’s possible.

We stand on the shoulders of women who fought just to get into the arena.

On the shoulders of women who had to return too soon because their jobs were on the line — but who stood up and told the truth anyway.

Now, we get to show the power of what’s next. That motherhood doesn’t erase your athletic goals — it adds to them.

And mother runner .sophie is proof. She’s not only toeing the line this weekend at the 24 Hour World Championship in Albi, France representing Great Britain & Northern Ireland…

✨ In January 2025 she set the Guinness World Record for the greatest distance run on a treadmill in 48 hours — 370.90 km (230 miles!).

✨ May 2024 she became the fastest woman to cross Ireland on foot — 347 miles in just 3 days, 12 hours, and 8 minutes.

And now? She’s lining up for 24 hours of running — literally resetting the bar of what’s possible for herself, and for every mom who sees her out there.

Go Sophie!

Because “mom” isn’t the end of the journey. It’s just part of the job description. And we’re out here killing it — not in spite of being moms, but right alongside it.

✨ How did you think your sporting journey would change when you became a mom?

______
Hear my conversation with Sophie on the Season: 3
Episode: 21

10/13/2025

It’s not the 1940’s anymore & Dr. Kegel is dead.

Back then, he coined the one-size-fits-all solution for pelvic floor issues—especially leakage and pelvic organ prolapse: the Kegel exercise.

Contract AND relax. Somewhere along the line though, we put all the attention on contract and forgot about relax.

Now, more and more women in postpartum are realizing their pelvic floor isn’t “weak”—it’s tight. Muscles that don’t know how to switch off, even when they’re supposed to.

How do you know if that’s you? Check out the post for some of the telltale signs of a high-tone or overactive pelvic floor.

Think of it like a light stuck in the “on” position. If you don’t know what “off” feels like, you have no idea your muscles are already overworking.

And when it’s time for them to turn up the volume—during running, jumping, or anything high impact—they don’t have much left to give.

(You need a fast functioning dimmer switch and you're stuck with an on/off switch stuck to "on")

That’s when symptoms show up: leakage, heaviness, pressure, or just a nagging awareness of your prolapse.

Here’s the kicker: trying to strengthen a muscle that can’t relax first is a recipe for worsening symptoms. I’ve seen women leak more, feel more pressure, and actually notice their prolapse more once they started doing endless Kegels.

Don’t get me wrong—Kegels aren’t the enemy.

They can be a powerful tool. But if your pelvic floor is overactive, the first step is learning to let go, to build that “dimmer switch” control.

Once relaxation is on the table, adding coordination exercises and strengthening later actually works with your body instead of against it.

Were you told to do Kegels for your prolapse symptoms? How did it go?

10/11/2025

Why is it always moms who get asked how we “balance it all”?

Spoiler alert: balance isn’t real. A dear friend once told me it’s more like juggling — some balls are glass, some are rubber.

The key is knowing which is which…and making sure you don’t drop the glass ones.

When my kids were babies, the glass balls were sleep (my oldest challenged my faith for more than a few years), feeding, and just keeping them alive.

The rubber ones? Laundry piling up, unanswered texts, and even squeezing in a workout or run.

When they were toddlers, the glass shifted to bedtime routines, getting out of the house to burn off energy, and surviving the tantrums with my sanity intact.

The rubber ones were spotless floors (I gave that one up early and punted to our amazing cleaners) or home-cooked dinners every night (kids got fresh meals, we ate leftovers).

Now with teens and tweens, the glass balls are being present when they actually want to talk, showing up for games and meets, and keeping the big conversations open (I'll take any tips from you high school moms out there!)

The rubber ones? Staying on top of every email, every detail, every “Pinterest-perfect” version of life.

(If I’m slow replying to DMs… now you know why.)

The juggle never stops — it just changes. And yes, I still drop balls. A lot of them.

But I’m getting better at being okay with that, and letting go of the idea of “balance.”

As long as the glass ones don’t shatter, I know I’m doing just fine.

✨ What’s a “rubber ball” you’ve learned to let bounce in this season?

Carrie Pagliano Physical Therapy

12/02/2025

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