I've been a physical therapist for over 20 years and spent many of those working in spine rehabilitation, sports medicine, and general orthopedics. However, when I had my first baby (13+ years ago now!), I discovered the gap in care for postpartum women as I learned how to reconnect with and rehab my own body back into the high level of activity I loved. It was then that I shifted my focus to core and pelvic health, the foundations of postpartum physical therapy.
Since then, I’ve had two more babies, and my passion for working with other moms continues. My personal and professional experience fuel that passion for helping guide women through their healing and return to activity throughout pregnancy, postpartum, and the entire journey of motherhood. It is my belief that understanding how to reconnect with, rebalance, and re-pattern our core and stability system is the key to effective pain-free and leak-free movement.
Today, let’s take an in-depth look at the importance of why considering physical therapy during the postpartum months/years is important. I’ll also offer guidance for new mothers considering postpartum PT treatment!
Benefits of Postpartum Physical Therapy
Postpartum physical therapy can offer many benefits for women who have recently given birth. Additionally, it’s my professional opinion that the "early postpartum" period is from birth to 5 years – but really, "postpartum” is forever! Our bodies are always remodeling, healing, and changing and it is never too late to improve your symptoms and function. It is never too late to change your body, improve your symptoms, and improve your function – even if your baby is all grown up! Keep that in mind when considering the following benefits:
Pelvic floor and core rehabilitation
Did you know that your pelvic floor is actually a part of your deep core? (Explore my other blog posts for more information on this!) The process of pregnancy and childbirth naturally has an effect on our core and pelvic floor as this area of our body needs to adapt to a growing baby, and then needs to work hard to bring that baby into the world, whether via vaginal birth or cesarean section! Issues that can arise that are commonly associated with the pelvic floor and deep core are urinary/gas/bowel incontinence (leaking), pelvic pain, sexual dysfunction, prolapse, and diastasis recti. Sometimes, these symptoms can be a result of the system being weak, or “quiet”, sometimes these symptoms can be due to a tension or tightness in the system, and sometimes they can just be due to needing to find ways to reconnect and get everything back “online.” There is no one-size-fits-all approach. Postpartum physical therapy can help to rehabilitate this muscle system and improve function.
Improved stability
Pregnancy can cause changes in our stabilizing muscles (think core, hips, shoulders, glutes), contributing to pain and poor posture. Postpartum physical therapy can help improve strength and coordination of these muscles and improve stability. And, improved stability in our center leads to improved ability to strengthen the rest of our body effectively without pain.
Pain relief
Postpartum physical therapy can help to alleviate pain associated with childbirth, including back pain, neck pain, pelvic pain, and joint pain.
Improved posture and body mechanics
Pregnancy and childbirth can lead to changes in posture and body mechanics, contributing to back and neck pain. Postpartum physical therapy can help to address these issues and improve overall body movement ability.
Faster recovery
Postpartum physical therapy can help you recover more quickly from childbirth and return to the activities you love.
Prevention of future issues
Addressing pelvic floor and core dysfunction and imbalance early on can help to prevent future issues such as prolapse, incontinence, diastasis recti (abdominal separation), pain with intercourse, and chronic pain.
Regained sense of control
Postpartum physical therapy can go beyond resolving physical symptoms and health issues! By reconnecting with their body’s core, many women report feeling more grounded, powerful, and in control – of their bodies and life.
Common Issues Addressed in Postpartum Physical Therapy
Postpartum physical therapy can address a number of issues that you may experience after childbirth. And remember: “after childbirth” doesn’t just mean after recent childbirth. I guarantee you’ve heard moms of all ages talk about issues on this list. Some of the most common issues addressed in postpartum physical therapy include:
Diastasis Recti
Diastasis Recti is a separation of the abdominal muscles that can occur during pregnancy. Postpartum physical therapy can help to address this issue through targeted movement, exercise patterning, and manual therapy.. (You can also check out this blog post where I debunk 10 common myths about Diastasis Recti. You’ve likely heard - and believed - most of them!)
Pelvic floor dysfunction
Pregnancy and childbirth can lead to dysfunction of the pelvic floor muscles (weakness, stiffness, or tension), leading to issues such as urinary/bowel/gas incontinence, pelvic pain, and sexual dysfunction. Postpartum physical therapy can help to rehabilitate these muscles and improve pelvic floor function.
Back pain
Many women experience back pain (upper and lower) during pregnancy and after childbirth due to changes in posture and the strain placed on the back during pregnancy and childbirth. Postpartum physical therapy can help to alleviate this pain and improve posture.
Core weakness
Pregnancy can cause weakness in the core muscles as they stretch to accommodate a growing baby, leading to issues such as back and hip pain and poor posture. Postpartum physical therapy can help to strengthen these muscles and improve core stability.
Scar tissue
Cesarean sections, perineal tearing, and episiotomies can lead to scar tissue formation, which can contribute to pain and dysfunction. Postpartum physical therapy can help to address scar tissue and improve mobility and function.
Joint pain
Pregnancy and childbirth can lead to joint pain, particularly in the hips, shoulders, and pelvis. Postpartum physical therapy can help to alleviate this pain and improve joint function.
Overall, postpartum physical therapy can address a wide range of issues you may experience after giving birth, whether months or years later. You can recover and regain your strength, function, and quality of life!
When to Seek Postpartum Physical Therapy
While I believe that all women can benefit from pelvic floor physical therapy, I want to highlight a few signs or symptoms that may indicate that you should seek postpartum physical therapy. Be aware of the following indicators during your postpartum recovery, and specifically your return to exercise after childbirth:
Pain or discomfort in the pelvic region, lower back, or hips during exercise.
Urinary incontinence or leakage during exercise.
A feeling of heaviness or pressure in the pelvic area.
A bulge or protrusion in the vaginal or rectal area.
Difficulty controlling bowel movements.
Difficulty engaging the core or feeling weakness in the abdominal muscles.
Pain or discomfort during sexual activity.
Doming abdomen or continued separation of the abdominal muscles (diastasis recti).
Experiencing pain, discomfort or stiffness during activities of daily living like lifting, bending or carrying your baby.
If you experience any of these signs or symptoms during your return to exercise after childbirth, consider seeking postpartum physical therapy treatment! A physical therapist can evaluate and address these issues through targeted exercises and other therapies, helping you safely recover and regain strength and function.
The ideal timeline for starting physical therapy will vary depending on the individual's specific needs. There is a benefit to seeking physical therapy treatment during pregnancy to help prevent some of these issues, and to deal with any pain that may be arising. Also, getting in for at least one visit very early in the postpartum period can be very helpful - learning about things like healing concepts, breath patterns, how to hold and lift your baby, feeding positions, and basic core/pelvic floor connection as early as possible can improve your recovery. However, for targeted exercise and exercise progression, it is generally recommended to wait until after the postpartum bleeding has stopped and you have been cleared by your healthcare provider to begin exercising again. This is typically around 6-8 weeks after vaginal delivery or 8-10 weeks after cesarean delivery.
Ultimately, you should determine when to start postpartum physical therapy in consultation with a healthcare provider or physical therapist who can assess your needs and develop a personalized treatment plan. If you’re local to the Charlotte area, check out this page for a peek at what my Postpartum Assessments include. I also have an online video education series to go through my “ABCs of PostPartum Healing” workshop and give you the foundational concepts of healing after baby. You can also read my blog post on this topic. Have questions? Schedule a free phone consultation with me anytime. I would love to help you on your journey toward healing and strength!