Postpartum Pelvic Floor Therapy

Postpartum pelvic floor therapy

Having a baby is no simple feat. Your body goes through a lot of taxing changes to grow and delivery a baby safely. Whether you delivered vaginally or via c- section, there is a lot potential for injury and dysfunction postpartum that isn’t given the time and attention it deserves. Continue reading to learn how postpartum pelvic floor therapy can help get you back to yourself! 

THANKFULLY, the times are changing for postpartum mothers. Many medical providers are getting much better at referring mom to pelvic floor therapy postpartum for care. In addition to this, moms are also more educated and they know how advocate for themselves.

With all that being said, let’s talk about what IS and IS NOT normal postpartum. Because let’s remember, just because it is a common symptom postpartum doesn’t mean it is normal!!

Postpartum pelvic floor therapy

Postpartum Stress Incontinence

Stress incontinence occurs when you leak urine with a cough/laugh/sneeze/etc. It is SO common for postpartum women [at any stage in their postpartum journey]. This can be normal in those first few weeks postpartum, but if leaking lasts longer you should look into postpartum pelvic floor therapy.  Even if you are only noticing just a little bit of leaking-- we think it's worth looking into! So whatever is driving the incontinence won't turn into something worse someday.

Initially, we want to make sure you are able to cough/laugh/sneeze without leaking. Eventually, we want you to be able to return to everything you enjoy doing without leaking! This includes running, jumping, and higher intensity exercises if you desire.

If you are in the first few weeks postpartum [or still pregnant] start practicing diaphragmatic breathing & a candle breath. Both can significantly help your postpartum incontinence symptoms improve faster.

Want to learn more? Check out these videos on stress incontinence.

Urinary Urgency/Frequency

Postpartum women often report overactive bladders. This can be urinary urgency symptoms or urinary frequency issues or a combination of both. During pregnancy, there are changes in your hormones, pelvic floor length/tension, as well as your core. All of these can impact urinary urgency or frequency postpartum.

Here’s what is normal:

    • Going 3-4 hours between bathroom trips
    • Fully filling your bladder, meaning going for at least 8-10 seconds when you void
    • Being able to walk to the bathroom calmly when you have to go
    • Not needing to rush to the bathroom the second there is an urge to go
    • Being able to sleep through the night without needing to get up to go to the bathroom

Here’s what’s not normal:

    • Only being able to make it 30-60 minutes between bathroom trips.
    • Getting home from a walk/errands and having to rush to the bathroom so you don’t pee your pants.
    • Feeling like you really have to go but then there’s only a dribble there.
    • Having to pee 4 times before finally going to bed. As you try to relax to fall asleep it constantly feels like you have a full bladder still.
    • Waking up at night to pee.
    • Having to go to the bathroom at every opportunity, so you aren't stuck somewhere with the urge to pee with no bathroom in site. (before you leave the house, while shopping, etc…)
Want to learn more? Check out these videos on postpartum urinary urgency.

Prolapse

A very common pelvic floor symptom postpartum is prolapse. To some degree, it is not always something to worry about, especially in those first few weeks postpartum. However, it never hurts to be proactive!

Prolapse means that either the bladder, uterus, or rectum has fallen a bit and you feel the pressure of that in your vaginal canal. We expect a bit of laxity in the pelvic floor postpartum, but we don't want prolapse symptoms to linger. Common pelvic floor prolapse symptoms include : heaviness in your pelvic floor, dragging sensation, and pelvic floor fullness. Some postpartum women will say it feels like they are wearing a tampon when they aren't. 

These symptoms may come on more after being on your feet for a long period of time. This could be after going on a longer walk, or after lifting (like lifting your toddler). Postpartum pelvic floor therapy can help reduce or resolve these symptom so that you can go back to doing all the things you want to do without symptoms.

Want to learn more? Check out these videos on postpartum prolapse.

Abdominal Separation | Diastasis Recti 

Diastasis recti is a common concern that women have postpartum. Diastasis recti is a fancy way of talking about abdominal separation. With diastasis recti, there is thining of the abdominal wall in the space between the rectus abdominal muscles (your 6- pack muscles). The thinning causes a space or a separation in your abdominal muscles.

The first thing to know is that basically all pregnant people will experience this to some degree. There is no reason to panic! Abdominal separation is a normal adaptation from our body to make space for the baby (thank goodness!). What we care about is how this tissue heals by 12 weeks postpartum. 

 

 

Any abdominal separation that is greater than two finger widths in distance is clinically considered a diastasis (see more about how to measure in the video above). More important than the actual space itself, is the firmness of that space. If you have a two finger-width space, but it is firm and doesn’t dome with activity, than your abdominal separation is less concerning. However, if you have a space that is two finger widths, really squishy, and domes when you do a sit up or roll over in bed, than your diastasis  might be more of a concern. If the latter sounds like you, then you might want to be prudent and get checked out by a pelvic floor physical therapist. There is likely always some way you will be able to optimize your body for healing.

Painful Intercourse

Painful intercourse is another symptom that many women experience postpartum. Unforatunately, women can be given some very poor advice by medical professionals in regards to managing these symptoms. Like, “drink some wine and use some lube!” Although we do want those muscles to be able to relax a little more, wine is not the way to do it. Lubrication is also helpful, especially in your are breastfeeding, but that shouldn't be the only way you are addressing your symptoms. 

Scar tissue and muscle tension of the small muscles at the vaginal opening can cause symptoms like sharp, burning, stabbing pain with penetration. Tension in the deeper layers of pelvic floor muscles can cause a deep aching pain with deeper penetration as well as a feeling of hitting a wall with penetration and it feels like you can’t go any deeper. Postpartum pelvic floor therapy can help address muscle tension as well as scar tissue. It will help make intercourse more comfortable in a more permanent way that a glass of wine!

Want to learn more? Check out these videos on painful intercourse!!

Postpartum Low Back Pain | SI Joint Pain | Pubic Pain

Pain around your pelvis can be a common complaint postpartum. You may have pain in your low back, sacroiliac joints [back side of your pelvis], and/or your pubic region [front side].  Why is pelvic pain so common postpartum? Because of all the adaptations that occur during pregnancy, including the changes in posture and core strength. These changes make injuries more likely to occur postpartum! Not to mention all of the bending, lifting, and carrying in awkward positions of a newborn. Its a wonder we can function at all!

Pelvic floor therapy postpartum, especially in conjunction with chiropractic care, can be a huge help here. First we want to look at mobility and alignment of the muscles and joints in that area of the body. If there are mobility or alignment concerns, we want to make sure to address that first before jumping into a ton of strength training. Then we want to build that deep core strength again, optimize posture, and create strength in all the muscle groups around and attaching to the pelvis. This will help you create a really stable base of support. Back pain can be common but that doesn’t mean it is normal or just something you have to live with because you are postpartum.

Postpartum pelvic floor pt

If any of these symptoms sound familiar, it is always worth reaching out for help. It might be as simple as a few visits to teach you some things to work on at home. Sometimes people notice huge change in their symptoms in only 1-2 visits! It is always worth getting the help because if we don’t take care of momma, who will take care of baby? You are worth the effort!


Medical Disclaimer:

All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider.*


As always, don’t hesitate to reach out with questions//thoughts surrounding this topic!