Postpartum Physical Therapy. The Ultimate Guide to What it is, Who it Can Help, and Why You May Need it.
What is postpartum physical therapy?
Postpartum physical therapy is a specialized form of physical therapy that focuses on helping women heal from pregnancy.
Postpartum physical therapy aims to strengthen the pelvic floor muscles, address postural changes that occurred during pregnancy, improve common postpartum symptoms of urinary, bowel, sexual health changes, and pain including lower back pain, pelvic pain.
Physical therapists that specialize in postpartum physical therapy are typically pelvic floor physical therapists. Pelvic floor PTs have more advanced training in women’s pelvic health conditions.
How do I know if I need postpartum physical therapy?
Everyone would benefit from postpartum physical therapy! Just as you would receive rehab after a knee injury or surgery, you should absolutely receive rehab after pregnancy.
The body goes through a lot of changes during pregnancy including postural changes, ligament changes, muscle weaknesses, and trauma associated with childbirth. Our body needs expert guidance on how to rehab; we cannot expect our body to just “figure it out” on its own.
In addition, C-sections are major abdominal surgeries, so rehab afterwards is recommended to help retrain the abdominal muscles to function again, as well as to ensure that pelvic floor function was not affected by the C-section.
When to start postpartum PT?
We can start physical therapy immediately postpartum, or whenever you are ready! If you are struggling with symptoms such as pain, leakage, pressure, hemorrhoids, there is a lot that we can work on immediately postpartum.
We typically forgo internal treatments until you are cleared by your birth professional, but your physical therapist can work on the other muscles and joints that surround the pelvis and pelvic floor.
What does treatment look like during postpartum physical therapy?
Initially, treatment will consist of a lot of manual therapy and breath work to promote healing. Overall in the beginning of treatment, therapy is extremely gentle.
As you progress through your postpartum journey, exercises will progress to consist of more difficulty core and pelvic floor strengthening exercises and functional movements that can help guide you back to safe return to full activities.
Return to sport or recreational activities needs to be slow, progressive, and well thought out. Unfortunately many patients are given the "all clear” at 6 weeks postpartum and told that they are “cleared to return all activities”, and therefore jump right back into their pre-pregnancy activities. Unfortunately this is when injuries happen because the body hasn’t been properly transitioned back into these activities.
A pelvic floor physical therapist can help with guidance and progression of safe return back to activities, or safe return to new activities.
Do I need to see a pelvic floor physical therapist if I had a C-section?
Absolutely! C-sections are major abdominal surgeries in which 7 layers have been affected! Your abdominal muscles are significantly affected after a C-section due to the incision.
Research is very inconsistent about whether or not C-sections are protective against pelvic floor dysfunction, and some studies do report that there is still a risk of pelvic floor dysfunction even with a C-section. This may be due to the impact of the incision on the functioning of the core and pelvic floor.
If you ended up having a C-section after attempting a vaginal birth, you experienced the trauma of both the vaginal birth and the C-section. Therefore, pelvic floor physical therapy should absolutely be part of your postpartum journey and recovery.
What types of diagnoses the do they treat at postpartum PT?
Besides general postpartum recovery, postpartum physical therapy helps to address common postpartum concerns such as:
Diastasis recti
Prolapse
Urinary incontinence
Fecal incontinence
Hemorrhoids
Pelvic floor and core weakness
Sexual pain
Orthopedic or Pelvic Girdle Pain