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Many new mommies have no idea a pelvic floor physical therapy is an option after birth. Here are 5 reasons you need to see a physical therapist for your pelvic floor.

This is a guest post written by Dr. Jena Bradley, DPT, mommy of 4, and blogger over at Live Core Strong. She is awesome and has some great tips on when to see a physical therapist.

A lot of women suffer from postpartum pain, incontinence, abdominal separation such as diastasis recti, or other women’s health-related diagnoses after childbirth. Did you know that you can seek physical therapy to help restore these problems so you no longer have to suffer from them? You don’t have to live with these issues forever. Learn about the 5 most common diagnoses that women suffer from during postpartum that physical therapy can treat.

5 Top Reasons To See A Physical Therapist After Birth

Physical Therapy has many branches to it. When it comes to postpartum therapy and diagnosis caused by pregnancy and childbirth, that division is called Women’s Health.  A Women’s Health Physical Therapist specializes in specific treatment for women-related diagnoses including prenatal and postpartum therapy.  

The top 5 reasons why someone would want to see a physical therapist after giving birth would be the following:

• Diastasis Recti
• Back Pain
• Pelvic Pain
• Incontinence
• Pelvic Floor Weakness and Prolapse

In this post, you will have a better understanding of what each of these diagnoses is, the signs and symptoms for each and what are the clear indicators for when it’s time to see a physical therapist.

Diastasis Recti

Diastasis Recti is very common and occurs in 33-60% of pregnant and postpartum women. Diastasis recti are very common in pregnant and postpartum women because of the stretching that occurs in the abdominal wall. Because of this stretching from the uterus growing, both the right and the left abdominal muscles separate and the connective tissue between them stretches to the point where your abdomen is no longer functioning properly.

The #1 sign and symptom of Diastasis Recti includes a separation between the right and the left side of your abdomen. This separation can be apparent when lying flat and attempting to lift up your shoulders like you are doing a sit-up. If you see a bulge appear between your left and right side, then you may have diastasis recti. You can do a self-test to find out if you have diastasis recti.

Symptoms:

• Back pain – abdominal weakness causes more strain on the back. Your body relies on your back to work harder since your abdominal muscles are so weak, therefore causing increased back pain
• Poor posture- With poor abdominal muscles, your posture will tend to diminish as well because your weakened muscles will not be able to hold your torso up well against gravity.
• GI disturbances and Constipation  

You can check out Katie’s  Ab Rehab and Pelvic Floor Restore program, which is a part of The Postpartum Cure to guide you through healing your core and diastasis recti at home, to see if her specialized videos and knowledge of Pilates is enough without having to see a professional!

When to see a Pelvic Floor Physical Therapist:

It is time to schedule an appointment with a Women’s Health Physical Therapist when you have done a self-exam and have determined you have greater than a 1.5 finger width separation between your right and left abdominal muscles.

If you have this size or larger of separation and you are having other aggravating symptoms related to diastasis recti, then you will want to see a Physical Therapist.

You may have difficulty maintaining your posture, thus your back is starting to have increased pain. The weakness in your abdominals is making your daily activities such as rising from bed or sitting up from the floor more difficult with each passing day.

If you plan on having more children and you want to be proactive by fixing the gap now, then seeing a physical therapist during postpartum recovery is best. This way you’re less likely to have a worsening of diastasis recti during your next pregnancy.

The longer you wait to have your DR treated the more likely it is to become more strained and worsen, so seek physical therapy sooner rather than later.

If you feel that you are ready to start now with physical therapy exercises to treat your diastasis recti, or you were previously diagnosed and want to begin diastasis recti exercise routine again, you will really enjoy this one: “11 DIastasis Recti Core Exercises For Your Postpartum Belly + Video”.

Back Pain can also be a reason to see a pelvic floor physical therapist:

Having back pain during pregnancy is very common due to the added weight and strain from your pregnant belly. The ligaments in your back are lax from the hormonal changes during pregnancy, and, therefore, injury is common in pregnant women.

Back pain usually persists into postpartum; the ligaments and muscles are already strained and have not had time to recover properly. Also, it’s common for injuries to occur during the act of childbirth. The pushing and added demand of the back muscles during childbirth increase the chance of back pain and injury during postpartum.

Symptoms:

1. Ache and pain in your back during the following activities:
2. Sitting
3. Standing
4. Walking
5. Lifting
6. Nursing
7. Lying Down
8. Rest
9. Numbness or Tingling in the legs
10. Weakness in the legs
11. Loss of motion in your spine, difficulty bending over

When to see a Pelvic Floor Physical Therapist for Back Pain:

If over a span of 2-3 weeks your back pain continues to get worse or doesn’t improve, seek a physical therapist to perform an exam and provide you with the proper treatment.

Back pain is easily treatable with the proper exercises and modalities to mitigate the pain. Back pain can quickly get worse during postpartum due to the added strain from carrying your newborn and feeding your newborn (whether it is breastfeeding or bottle feeding). The prolonged positions of holding your baby will definitely add wear and tear to your back.

Pelvic Pain 

Pelvic pain is very common after giving birth due to the passage of your baby through the birth canal and the pressure your baby puts on your pelvic bone. Sometimes a women’s pelvic bone can be fractured and bruised. Other times, a woman’s pelvis may be overly stretched where the connective tissue between the right and left side of the pelvis becomes strained.

Symptoms:

• Pain in the hip, groin, and/or pubic regions
• Sharp pelvic pain during the following activities:
• Sitting,
• Standing
• Lying Down
• Resting
• Walking
• Intercourse
• Direct pressure causes pain
• Incontinence (bowel or bladder)

When to see a Physical Therapist

If the pain cannot be relieved by common means while at home (rest, sitting on a pillow, proper positioning) then you want to seek a physical therapist within a matter of 2 to 3 weeks. Physical therapy can help you to relax the proper pelvic floor muscles which will help reduce the tension around the pelvis or help strengthen the pelvic floor muscles for those women who have strained their pelvic connective tissue. A proper physical therapy exam will help determine which route of treatment is best for your diagnosis.

Incontinence

Incontinence occurs when urine leaks due to pressure that is placed on the bladder. This is not normal, and our pelvic floor muscles are typically strong enough to withstand the everyday pressures on our bladder muscles. So if you get the slightest drip of wetness on your panties when you weren’t obviously intending to, then you have incontinence.

Symptoms of Stress incontinence after childbirth:

• Having loss of normal bladder function and wetness due to:
• Coughing
• Sneezing
• Laughing
• Standing up
• Getting out of a car
• Lifting something heavy
• Exercise
• Intercourse

When to see a Physical Therapist

If you continue to have bladder problems 6 weeks postpartum, this is when you will want to call a women’s health physical therapist for proper treatment. If the episodes of incontinence are frequent and affect the quality of your life, definitely seek medical advice. The exercises and neuromuscular retraining that take place during physical therapy can really help reactivate your pelvic floor to function more normally and prevent further accidents.

Pelvic Floor Weakness and Prolapse

Having weakness after pregnancy and childbirth is a common problem. The muscles have had constant pressure and straining for 9 months. After almost completing the 9-month marathon, those pelvic floor muscles are required to finish strong at the finish line, childbirth! It’s no wonder so many women suffer from pelvic floor weakness during postpartum.

If you think you have pelvic floor weakness, here are some of the most common symptoms associated with this condition:

Symptoms:

• Incontinence and leaking small amounts of urine when coughing, sneezing, laughing, or running
• Unable to control gas/air being released from either the anus or vagina when bending over or lifting
• Reduced sensation in the vagina
• Tampons that dislodge or fall out
• A distinct bulge at the vaginal opening
• A sensation of heaviness in the vagina
• Constant, deep aching in the vagina
• When to see a Physical Therapist

These symptoms can be quite disturbing and should not be left untreated. If you have the sensation of heaviness and a bulge in your vaginal opening, which is called prolapse, this needs to be treated and can be fixed with physical therapy.

A physical therapist can teach you the proper way to perform pelvic floor exercises and use specialized equipment to help determine if you are performing these exercises properly.

The muscles in your pelvic floor just continue to get weaker with age and lead to further complications such as worsening incontinence, pain, and difficulty with intercourse if left untreated. Seek a Physical Therapy Exam if your symptoms continue past your 6-week postpartum check-up.

Schedule An Exam With A Women’s Health Physical Therapist

If you are looking for a Women’s Health Physical Therapist (PT) you can use this tool FIND A PT, where you can quickly search for a PT specialist in your zip code.  Or you can always contact me and ask me any questions related to Women’s Health and Physical Therapy. I am more than happy to help and always respond promptly to my messages. I would love to hear from you.

Keep Smiling,

Dr. Jena Bradley, DPT

Meet Dr. Jena Bradley:

Dr. Jena Bradley is a mom of 4 darling little girls, a physical therapist, and the founder of Live Core Strong, a blog focusing on motivating moms to live a life that incorporates fitness and fun throughout their motherhood journey. She aims to be the friend you always wanted to have who could guide you through the “fog” when faced with an “I don’t know what to do” mommy moment. At the most inconvenient time of her life, she embarked on a journey of sharing her story and expertise to inspire the next generation of healthy moms. You can learn more about Jena and check out her blog here.

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