Postpartum Physical Therapy
“When to start pelvic floor therapy after birth?”
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3 Weeks: Virtual
Virtual pelvic floor therapy visits are available and are effective for reducing urinary incontinence in postpartum folks as soon as 3 weeks postpartum.
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6 Weeks: In Person
Postpartum pelvic physical therapy in person is generally appropriate after 6 weeks postpartum, following your visit with your OBGYN to confirm safe return to exercise and penetrative sex.
What are the signs of weak pelvic floor after childbirth?
You may experience vaginal heaviness after exertion, urinary incontinence with coughing or jumping, or fecal incontinence.
Your post-pregnancy posture may benefit from retraining and strengthening, so that the pelvic floor muscles have their best chance to recruit under physical stress.
Prolonged tension in your pelvic floor muscles can weaken them over time. If you are constipated, you experience urinary urgency and frequency, or if you have a history of discomfort during vaginal penetration, then you may have tense pelvic floor muscles.
What can cause burning pain during sex after C-section?
Acutely after a C-section delivery, the inflammation, increase in myofibroblast activity, and binding between the layers that house your visceral organs can restrict movement after it has healed.
Scars are like icebergs — they are much deeper than what we see on the surface. This is especially true for cesarean-section scars.
The resulting restricted tissue mobility can limit the mobility of the surrounding muscles and joints. The limited blood flow and tissue mobility can cause pain if provoked.
Pelvic physical therapy and scar massage modalities have been shown to significantly reduce pain in the long term.
We value gentle and slow approaches to manual therapy, with care of your whole being during the process of tending to your scars and your story.
Sacroiliac joint (SIJ) and pubic symphysis pain after delivery is common postpartum and is a leading cause of disability postpartum.
A subset of individuals with persistent pelvic pain postpartum may also experience fear of moving and avoiding activities that may cause symptoms.
You may be more at risk if you have history of low back or pelvic pain during pregnancy.
Other risk factors include posterior pelvic pain while rolling in bed, while weight bearing, if you have had more than one pregnancy, if you have a history of cesarean delivery, if you are depressed, and your position during chest feeding.
If you have more intense pain, and more disability due to your pain, then your pelvic PT prognosis is good. You can expect to recover more rapidly, the higher your pain level is.
There is strong evidence that if you are experiencing SIJ and pubic symphysis pain, that outcomes are best if you get pelvic therapy interventions before 3 months postpartum.
Interventions include manual therapy to reduce pain, education, and stabilization exercises.
If your symptoms are more persistent, and you are beyond 3 months postpartum, you will likely benefit from training your brain to tolerate movement again. See this blog about our somatic approaches to chronic pain and ask us about our somatic movement offerings!
Pelvic organ prolapse (POP) after delivery can vary in severity and dysfunction for postpartum bodies.
See this blog for an example of pelvic floor exercises for mild pelvic organ prolapse.
Unfortunately, the evidence is mixed and inconclusive about the efficacy of pelvic floor muscle training to reduce a pelvic organ prolapse.
Pelvic PT outcomes for mild pelvic organ prolapse is more promising.
If you have had surgery for pelvic organ prolapse, and you are experiencing pain, urinary incontinence, or constipation, then please contact us.
You may ask, “How to heal diastasis recti naturally?”.
We offer manual therapy to improve abdominal wall and diaphragm mobility and coordination.
We are trained in visceral fascial mobilization which can help this fascia heal more quickly.
We offer unique exercise progressions to improve core support and functional outcomes.
It takes about 3 months of consistent practice to experience gains in strength.
We treat urine leaking.
Examples of urinary incontinence include, leaking urine after peeing, how to stop urine leakage while coughing, and leaking while running.
Intensively supervised pelvic floor muscle training programs targeted to improve strength of the pelvic floor, had marked more benefit in reduction in urinary incontinence, compared to the group that had a minimally supervised pelvic floor exercise program. (Woodley et al. 2020)
We recommend 2-6 pelvic PT visits, Telehealth option available.
Expect significant results within 3 months of treatment with us.