If you are reading this and weren’t even aware that physical therapy exists for the pelvic floor you are not alone! As a pelvic floor physical therapist, my job is to help bridge the gap between being told to do nothing for the first six weeks after your delivery and then suddenly being cleared for return to all activities but having no clue where to start and feeling lost in your postpartum body.
In a perfect world, it is my (clearly biased) opinion that every woman should have access to an evaluation by a pelvic floor physical therapist sometime around 6-8 weeks postpartum at least to check the state of the pelvic floor after both C-section and vaginal deliveries as well as provide tips regarding nursing positioning, proper lifting and carrying mechanics, and a stepwise exercise progression for return to activity safely. There are however some signs that you should definitely see a pelvic floor physical therapist for more individualized help.
1. You are having accidental urinary or fecal incontinence (leakage) that continues to occur beyond six weeks after delivery. This could be happening during a cough, laugh, or sneeze or during activities such as walking, stairs, bending over, running, or jumping. It could also occur due to a strong overwhelming urge that is difficult to control or without you realizing that leakage is happening. Even if the amount of leakage is just a couple drops, it is still beneficial to address it sooner rather than later, as it is a sign of a larger weakness in the core muscle system. Leakage doesn’t have to be something to laugh off or that is “just part of being a mom”; it is something that can typically be completely resolved.
2. You have a feeling of increased pelvic heaviness/pressure or the sensation of pelvic organs falling down. This is a sensation related to pelvic organ prolapse, which occurs when the bladder, urethra, vaginal wall, uterus, small bowel or rectum is collapsing downward. You can have a greater risk of developing a prolapse after childbirth just due to the amount of pushing and pressure down on your pelvic floor during delivery, as well as some of the hormonal changes that contribute to increased ligament laxity during pregnancy to allow for birth. The good news is that you can learn strategies to help protect your pelvic floor as it is healing in order to avoid continued excess pressure on the pelvic organs. A pelvic floor physical therapist can also teach you how to strengthen the muscles in the pelvic floor and in the core in order to help better support the pelvic organs as well.
3. You are having pain or discomfort when returning to sexual intercourse with your partner. Sometimes this discomfort can be due to scar tissue from perineal tearing or an episiotomy or even C-section incision. Sometimes the discomfort can be due to extra tension in the muscles of the pelvic floor- remember these muscles had to work extra hard all throughout your pregnancy to help hold the baby up- so sometimes they need to be retrained how to relax again. Whatever the cause of the pain, your pelvic floor PT can help figure out the reason behind why the pain is occurring and develop a plan to be able to be intimate with your partner without pain.
Of course, there are other issues postpartum such as diastasis recti (abdominal muscle separation or “mommy tummy”), symphysis pubis dysfunction (SPD), and coccyx (tailbone) pain including other joint pains that can develop due to the repetitive activities you are now performing on an hourly basis as a new mom (think feeding, lifting, carrying) as your body is still healing. A pelvic floor physical therapist can help you address any and all of these potential issues that arise throughout the fourth trimester and the postpartum period. Luckily, even if your medical provider doesn’t refer you to a pelvic floor PT, you can seek out a pelvic floor PT on your own in New York State without a referral. To get started with a free consultation or to book an initial evaluation, contact email@example.com.
Dr. Julie Berube is a pelvic floor physical therapist who is on a mission to revolutionize the standard of healthcare for women in Central New York. She is the owner and founder at LiveWell CNY Physical Therapy, LLC in Syracuse, NY.
Dr. Julie Berube is a pelvic floor physical therapist who is on a mission to revolutionize the standard of healthcare for women in Central New York and the Syracuse area.