Meghan Krill, PT, DPT
Owner Flora Physical Therapy, a pelvic health physical therapy practice in downtown Fairfield, CT
Did you know that in France every woman who has delivered a baby is automatically referred to 10 sessions of pelvic floor physical therapy?
The prenatal and postpartum timeframes are most likely the periods of greatest change for the female body. However, due to these changes, many women struggle to feel like themselves again in the postpartum period. We are bombarded with the unrealistic fantasies presented by bounce back culture and a seemingly arbitrary 6 week clearance for intercourse and return to exercise without any education as to how to properly heal our bodies.
Each woman’s birth story is unique and her recovery journey will be as well. As pelvic health physical therapists, we are trained to holistically assess our patients and create personalized postpartum goals. This article aims to address some of the most common postpartum symptoms treated by pelvic health physical therapists, but please be aware that this list is not comprehensive. While these issues are COMMON they are NOT NORMAL and should always be addressed.
Leaking when you cough, laugh, or sneeze? Still feeling like you have to pee every 10 minutes? You are not alone. One in three women will experience urinary incontinence in the postpartum period. If you delivered vaginally, there may be perineal (pelvic floor muscle) stretching and tearing present which inhibits proper pelvic floor engagement. If you had a C-section, you may have leakage issues as well! During pregnancy, all women experience an immense increase in pressure on the pelvic floor which fatigues these muscles. A pelvic floor physical therapist will help you reeducate both your muscles and bladder to work together to resolve leakage issues.
- Diastasis Recti
Diastasis Recti, Rectus Diastasis, DRA. We are constantly bombarded with ads for online programs to fix this issue, but how do we even now if we have this!? Diastasis recti is the widening of the ligament between the muscle bellies of the rectus abdominis (your “6-pack”) due to increased intra abdominal pressure and stretching of the abdominal wall as your baby grows. Our core is composed of 4 layers of muscles. Oftentimes, it is our deepest layer, the transverse abdominis which requires the most strengthening in order to restore the centralized core stability that may be lost during pregnancy. A pelvic floor physical therapist will help resolve this issue by teaching you proper breathing techniques for pressure management and proper engagement techniques for each layer of your core.
- C-section and Perineal Scar Discomfort
There are very few women who leave the delivery room without a few stitches. In the United States, currently 33% of all births are Cesarean sections. We must be reminded that while our scar is superficial, a C-section involves multiple deep tissue layers including skin, muscle, fat, and fascia. We often lose sensation in this area due to severing of nerves which can create immense difficulty in sensing and reengaging the muscles in this region. For those with a vaginal delivery, the tearing of pelvic floor muscles can lead to the build up of scar tissue which can be not only uncomfortable, but also restrict the pelvic floor from properly engaging. A pelvic floor physical therapist can help teach you the proper scar management techniques to help facilitate healthy scar healing.
- Pelvic Organ Prolapse
This topic can definitely be intimidating. However, most times, postpartum prolapse does not require surgery. Most women with pelvic organ prolapse will feel a heaviness or bulge in their pelvic floor. Pelvic organ prolapse occurs when your pelvic organs (bladder, vagina, or rectum), protrude into your vaginal canal. Pelvic floor exercises can help provide relief and restore the strength of your pelvic floor to support these organs in order to return to all of the activities you love.
- Pain with Sex
Cleared at six week but not quite ready to have sex? You are not alone. There are many reasons women experience pain with sex in the postpartum period whether they had a vaginal or cesearean delivery. Pain is typically caused by muscle spasm, scar tissue build up, or nerve injury which can all be addressed by a pelvic floor physical therapist. There are many physical and emotional factors that must be taken into account and every woman is encouraged to wait until she feels ready.
At Flora Physical Therapy, we encourage women to begin pelvic floor physical therapy at 2-3 weeks postpartum as ACOG recommendations state postpartum healing can begin as soon as day 1 for most women. Keep in mind that we offer in clinic, in home, and virtual appointments all of which will get you on track to begin your healing journey. For those of you who are further along, it is never too late to begin to address any of these issues…please don’t just live with it!!