Postpartum physical therapy
Birthing Folks Deserve Comprehensive Postpartum Care.
Authored by Bodyful PT and Wellness Team
In this country, if you received a surgery for your hip, knee, or any major joint in your body, the assumption is that you would, of course, rehabilitate that joint.
Why? Because that part of your body underwent a major trauma, tissue was cut through, muscles atrophy, and scar tissue forms. You risk loosing proper function of that part of your body without rehabilitation.
In this country, when a person gives birth, the assumption is often that the person can return to “normal” after 6 weeks. Without rehabilitation. Even though that person’s pelvic floor also underwent trauma, tissue may have been cut through, and key muscles of the deep core have become de-conditioned or at the very least uncoordinated in way that can lead to prolonged pain and dysfunction.
When you look at most European countries’ healthcare for birthing people, the standard of care is to have postpartum physical therapy. In France, any person who delivers a baby is given 10 free physical therapy sessions that focus on pelvic floor health to prevent issues such as prolapse, incontinence, and pain.
It is no surprise that healthcare for people with vulvas is severely lacking in this country, and it is worse for vulvar bodies of culture. So while we wait for major systemic and policy changes, it is our job as healthcare providers to educate the public and model what should be the standard for postpartum care.
When to start postpartum physical therapy after birth?
If you have pain, it may be ideal to reach out to a pelvic PT sooner than later.
The 2022 APTA Clinical Practice Guidelines for Pelvic Girdle Pain in the Postpartum Population states that sacroiliac joint pain and pubic joint pain significantly reduces for those who seek treatment within 3 months postpartum.
The further out postpartum you are, you are still treatable, of course. However, if you are experiencing fear of movement, it can take more time to remap your brain’s relationship to pain.
If you have cesarean delivery or perineal scars, it is best to gently mobilize it regularly for the first 6 months. After 6 months, the scar is set.
What if you are reading this and you have scars that you did not mobilize within that time frame? If you are experiencing symptoms that you think are related to the scar, such as back pain, pain with vaginal penetration, abdominal pain, then feel free to reach out to us. We can still help you!
If you are at least 6 weeks postpartum, and you are experiencing urinary incontinence, fecal incontinence, or vaginal heaviness, we can help you! Your symptoms are very common and treatable!
Once a pelvic assessment is indicated, this can be essential for rehabilitating the pelvic floor muscles which play a key role in alleviating urinary and fecal incontinence, preventing prolapse, and allowing for pain free sex.
Pelvic physical therapists will not do an internal assessment until the 6 week postpartum mark with clearance from your OBGYN, however pelvic physical therapists do so much more than just the internal assessment.
What else to expect from the initial postpartum physical therapy visits?
Pelvic physical therapists specialize in the whole deep core system, which includes the abdomen, diaphragm, and even some deep back muscles.
This means that right after delivery, topics such as breathing techniques and pressure management, as well as scar tissue management can be addressed right away to prevent worsening or development of dysfunction.
You deserve postpartum pelvic physical therapy. And, if you expect to get pregnant again, pelvic physical therapy during, and even before, your pregnancy can improve the outcomes of your birth and decrease dysfunction profoundly.
At the beginning of a pregnancy, the body starts to subtly make changes in posture and how muscles function that can add up in signifiant ways. Working with a pelvic physical therapist for even just a few sessions in order to develop awareness of postural changes and how to safely adapt to them, as well as how to engage your deep core properly can set you up to have a more pain-free pregnancy and better outcomes with delivery.
Throughout the pregnancy, you may notice small signs of changes such as mild low back pain or occasional urinary incontinence. Although this is often brushed off as “normal” or told to patients that “it will pass after the pregnancy”, this is often the body’s first cue that something is not functioning optimally.
Studies show that unaddressed urinary incontinence in pregnancy has a higher risk of urinary incontinence later in life.
Getting ahead of these symptoms with a few sessions of physical therapy can prevent the symptoms from worsening after delivery. It is also often much easier to address these changes earlier on as symptoms get better quicker, saving you time, money, and energy down the road.
Let us support your safe and healthy birthing journey. You deserve to feel informed and empowered.
It is a privilege to be both of service and a witness to the profound life event that is birth. Such an event is stronger in community, and pelvic physical therapists are eagerly ready to be a part of that community.
Want to work with a pelvic health specialist at Bodyful in Oakland, CA? Book a discovery call with us today!
