You did it! Although there were some minor complications, you successfully welcomed your bundle of joy into the world 8 weeks ago. You couldn’t be more thrilled to start your new life as a mother but you’re still dealing with some urinary leakage and back pain. Also, what happened to your abs and why is sex so painful now? You’re at a loss about what to do and feel overwhelmed.
Some women may find relief from muscular issues experienced during pregnancy shortly after their baby is born. On the other hand, many women continue to suffer from pain, weakness, postural instability, and incontinence (leakage) postpartum. The same issues that existed during pregnancy have persisted and possibly even worsened. Additionally, new issues may arise after delivery justifying the need for further women’s health PT services. These issues include but are not limited to:
Pelvic floor muscle trauma
This may result after prolonged pushing, vaginal delivery with instrumentation (i.e. forceps, vacuum), or even an uncomplicated vaginal delivery. It can cause pain or urinary or fecal incontinence among other issues.
Diastasis recti (abdominal muscle separation)
Some women may experience further separation of their rectus muscles after delivery. Treatment includes: core strengthening, bracing, taping, postural education, lifting mechanics, diaphragmatic breathing, and avoiding Valsalva (breath holding) w/ activity.
Urinary and fecal incontinence
These conditions are often treated with pelvic floor muscle strengthening.
Pelvic organ prolapse
This condition occurs when muscles/ligaments loosen and provide less support for internal organs. As a result, our bladder, uterus, or rectum can drop a little bit and put pressure on our vagina. A higher risk for prolapse is associated w/ vaginal delivery, instrument delivery, and trauma to pelvic floor muscles. Patients can experience a reduction in symptoms and/or prevention of worsening prolapse with pelvic floor strengthening and core stabilization exercises.
Painful sex (dyspareunia)
This is common after delivery (vaginal or cesarean) and associated with perineal trauma, scar tissue, vaginal dryness, infections, depression, and breastfeeding. Dyspareunia is typically caused by muscular dysfunction (i.e. weak and/or tight pelvic floor muscles) and therefore, highly treatable with physical therapy.
Cesarean Birth scar management
Treatment includes: incision care, pain management, postural education, pelvic floor and transversus abdominis (core) co-contraction, positioning, lifting mechanics; *scar massage after 6 weeks typically*
Posture and positioning during breastfeeding
Remember to bring baby up to breast not breast down to baby with use of pillows or other supports. PTs will also provide education on biomechanical strategies for transfers, sleeping, carrying children, housework, baby care, etc.
Persisting musculoskeletal pain (body aches)
Treatment includes: core strengthening to promote stability, postural education, bracing recommendations for pain relief, walking and stair training
Recommendations for return to exercise
If you are suffering from any of these symptoms or after further thought feel that women’s health physical therapy is the thing you need, then contact us! Simply ask your physician for a referral and call 864-454-0952 to schedule an appointment. Services are offered at ATI Physical Therapy– Patewood Medical Campus 200 Patewood Dr. Suite 250 (2nd floor).
Sarah Snyder, PT DPT