Table of ContentsView AllTable of ContentsPostpartum ConditionsPhysical Therapy OptionsWhen to Seek CareFrequently Asked Questions:
Table of ContentsView All
View All
Table of Contents
Postpartum Conditions
Physical Therapy Options
When to Seek Care
Frequently Asked Questions:
Being pregnant and giving birth can be a beautiful and emotionally fulfilling time in the life of a mother. That said, this time period can also be physically daunting.
On top of caring for a newborn while operating on little to no sleep, many women are left with one or several musculoskeletal conditions as a result of the pregnancy and birthing process.
Fortunately, however, there may be an effective solution. Many postpartum diagnoses can be successfully managed or treated with the help of a physical therapist.
This article discusses postpartum conditions, physical therapy options, and treatment options.
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Over the course of a pregnancy, a woman’s body is subjected to many different stresses. This includes:
Some of the most frequently seen diagnoses in postpartum women are listed below:
Urinary Incontinence
Urinary incontinenceor leakage is a common issue that many women deal with during and after pregnancy. In fact, some estimates suggest that up to 30% of females experience this condition at the six-month postpartum mark.
This problem is thought to occur because the muscles of the pelvic floor get weak during pregnancy, and even when the uterus shrinks back to its normal size, the muscles are still weak from when it was larger.
Low Back Pain
These changes make your core muscles less able to support the spine and can lead toback pain during pregnancyand after birth.
Diastasis Recti
As your abdominal muscles (specifically the rectus abdominis) stretch out during the second and third trimester, the tendinous structure that runs down the middle of this muscle (called the linea alba) can start to widen and separate.
This condition, calleddiastasis recti, is estimated to be present in up to 59% of women immediately after labor.As this fibrous area thins and widens, it also becomes weaker and may even tear. When this occurs, a palpable lump is often present in the middle of the abdomen, especially when your stomach muscles contract.
Pelvic Pain or Dysfunction
The pelvic floor is a group of important muscles that line the bottom of a woman’s pelvis and provide support to the bowels, bladder, and uterus.
During pregnancy, the weight of a growing child can place excessive pressure on these muscles and cause them to become lax and ineffective. The trauma associated with childbirth can also cause further laxity or tearing in these structures.
If you are dealing with any of the pregnancy-related conditions listed above,pelvic floor physical therapy(PT) may be an effective treatment option. The first step is speaking to your physician about your symptoms. If your doctor feels therapy is appropriate, they can help you find a PT who is certified in women’s health.
Physical therapists with this specialization are trained to help you relearn to utilize your pelvic floor muscles appropriately and to regain any strength that was lost during pregnancy or birth. Because each woman’s postpartum condition is unique, they are also skilled in developing an individualized treatment plan based on the details you share and the findings of their examination.
If you are experiencing pain in the pelvic, groin, hip, or low back region after the birth of your child, you should speak to your doctor about whether postnatal physical therapy is appropriate.
The same is true if you are dealing with incontinence of the bowel or bladder, a palpable bump over your stomach (especially when you clench your abdominal muscles), or pain or difficulty during sexual activity. Finally, women who feel a full or heavy sensation in the pelvis or a bulging in the vaginal area should also seek the care of their physician.
What can you expect at a physical therapy session?
After your evaluation, a home program is typically created that focuses on improving strength and coordination in the muscles listed above. This program is typically progressed in subsequent therapy visits as you gain strength and coordination. Manual techniques may also be utilized to help reduce pain and teach you to properly activate these muscles.
What exercises help treat pelvic floor dysfunction (PFD)?
Physical therapy exercises that focus ontraining the pelvic floor musclescan help treat many different symptoms of PFD, including urinary incontinence, sexual pain or difficulty, and pelvic pain.
This type of training typically revolves around Kegel exercises, which teach you to activate and strengthen the important muscles located under your bladder, large intestine, and uterus. Your physical therapist may also utilize a biofeedback machine to help you visualize your muscle contractions and better learn to turn on these structures.
Pelvic floor therapy often focuses on structures that are too tight/constantly contracted in the pelvic floor as well, so it’s not always about contracting the muscles. Sometimes it’s about learning how to relax the muscles.
How long should postpartum physical therapy last?
Depending on the severity of your symptoms, it may take some time before your postpartum condition begins to improve. That said, physical therapy has been shown to begin helping with some issues like pelvic pain in as little as five weeks of treatment. Other issues, like urinary incontinence or pelvic floor prolapse, may take several months or longer before significant improvement is noted.
After a thorough evaluation, your PT will be able to provide you with a more accurate estimate of your recovery timeline.
Pelvic Floor Dysfunction: What Is It and How to Treat
A Word From Verywell
The first three months after the birth of your child is frequently referred to as the fourth trimester of pregnancy. During this time, it is important to focus some of your energy on letting your own body heal. Postpartum conditions, like the ones discussed above, are extremely common and most are well-managed with conservative measures like physical therapy.
With this in mind, it is crucial to speak to your OB-GYN about any symptoms you are feeling. While it may be tempting to focus on your child’s needs and to ignore your own, working hand in hand with your doctor will help set you on the road to recovery.
5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Gonzales AL, Barnes KL, Qualls CR, Jeppson PC.Prevalence and treatment of postpartum stress urinary incontinence: a systematic review.Female Pelvic Med Reconstr Surg. 2021;27(1):e139-e145. doi:10.1097/SPV.0000000000000866Benjamin DR, van de Water ATM, Peiris CL.Effects of exercise on diastasis of the rectus abdominis muscle in the antenatal and postnatal periods: a systematic review.Physiotherapy. 2014;100(1):1-8. doi:10.1016/j.physio.2013.08.005Wu Y (Maria), McInnes N, Leong Y.Pelvic floor muscle training versus watchful waiting and pelvic floor disorders in postpartum women: a systematic review and meta-analysis.Female Pelvic Medicine & Reconstructive Surgery. 2018;24(2):142-149. doi:10.1097/SPV.0000000000000513Cleveland Clinic.Vaginal prolapse.Wallace SL, Miller LD, Mishra K.Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women.Current Opinion in Obstetrics & Gynecology. 2019;31(6):485-493. doi:10.1097/GCO.0000000000000584
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Gonzales AL, Barnes KL, Qualls CR, Jeppson PC.Prevalence and treatment of postpartum stress urinary incontinence: a systematic review.Female Pelvic Med Reconstr Surg. 2021;27(1):e139-e145. doi:10.1097/SPV.0000000000000866Benjamin DR, van de Water ATM, Peiris CL.Effects of exercise on diastasis of the rectus abdominis muscle in the antenatal and postnatal periods: a systematic review.Physiotherapy. 2014;100(1):1-8. doi:10.1016/j.physio.2013.08.005Wu Y (Maria), McInnes N, Leong Y.Pelvic floor muscle training versus watchful waiting and pelvic floor disorders in postpartum women: a systematic review and meta-analysis.Female Pelvic Medicine & Reconstructive Surgery. 2018;24(2):142-149. doi:10.1097/SPV.0000000000000513Cleveland Clinic.Vaginal prolapse.Wallace SL, Miller LD, Mishra K.Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women.Current Opinion in Obstetrics & Gynecology. 2019;31(6):485-493. doi:10.1097/GCO.0000000000000584
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Gonzales AL, Barnes KL, Qualls CR, Jeppson PC.Prevalence and treatment of postpartum stress urinary incontinence: a systematic review.Female Pelvic Med Reconstr Surg. 2021;27(1):e139-e145. doi:10.1097/SPV.0000000000000866Benjamin DR, van de Water ATM, Peiris CL.Effects of exercise on diastasis of the rectus abdominis muscle in the antenatal and postnatal periods: a systematic review.Physiotherapy. 2014;100(1):1-8. doi:10.1016/j.physio.2013.08.005Wu Y (Maria), McInnes N, Leong Y.Pelvic floor muscle training versus watchful waiting and pelvic floor disorders in postpartum women: a systematic review and meta-analysis.Female Pelvic Medicine & Reconstructive Surgery. 2018;24(2):142-149. doi:10.1097/SPV.0000000000000513Cleveland Clinic.Vaginal prolapse.Wallace SL, Miller LD, Mishra K.Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women.Current Opinion in Obstetrics & Gynecology. 2019;31(6):485-493. doi:10.1097/GCO.0000000000000584
Gonzales AL, Barnes KL, Qualls CR, Jeppson PC.Prevalence and treatment of postpartum stress urinary incontinence: a systematic review.Female Pelvic Med Reconstr Surg. 2021;27(1):e139-e145. doi:10.1097/SPV.0000000000000866
Benjamin DR, van de Water ATM, Peiris CL.Effects of exercise on diastasis of the rectus abdominis muscle in the antenatal and postnatal periods: a systematic review.Physiotherapy. 2014;100(1):1-8. doi:10.1016/j.physio.2013.08.005
Wu Y (Maria), McInnes N, Leong Y.Pelvic floor muscle training versus watchful waiting and pelvic floor disorders in postpartum women: a systematic review and meta-analysis.Female Pelvic Medicine & Reconstructive Surgery. 2018;24(2):142-149. doi:10.1097/SPV.0000000000000513
Cleveland Clinic.Vaginal prolapse.
Wallace SL, Miller LD, Mishra K.Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women.Current Opinion in Obstetrics & Gynecology. 2019;31(6):485-493. doi:10.1097/GCO.0000000000000584
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