Pregnancy and Postpartum

Pregnancy and childbirth put a lot of stress on the core and pelvic floor, causing pain and dysfunction to muscles and tissues in the region.

Pelvic floor muscles extend between the pubic and tailbone, supporting your uterus, bladder, and bowel. These muscles play an essential role in bladder and bowel health, sexual function, and pelvic stability. When pelvic muscles are tight or weak, they can cause a variety of symptoms or pain:

• Stress incontinence: Leaking with impact. Stress incontinence may occur from weakened pelvic muscles that support the bladder.

• Urinary urgency: A sudden, compelling urge to urinate even when the bladder is not full. Urinary urgency can caused by overly tight pelvic muscles.

• Urinary hesitancy: Difficulty starting the flow of urine. Also typically due to overly tight pelvic muscles.

• Bowel incontinence: Difficulty controlling gas and/or bowel movements, often the result of injury during the birthing process. Manual therapy together with neuromuscular re-education can be highly effective.

• Diastasis Recti: The separation of the linea alba, which connect the two sides of the abdominal muscles. Physical therapy can be highly effective in non-severe cases.

• Perineal pain: Pain in the area between vagina and rectum, can last post childbirth even after wounds have healed. Perineal pain can be the result of a tear, episiotomy, or tight muscles in the region. The perineum plays an essential function during vaginal childbirth, making it prone to injury.

• Pain with intercourse: Many women experience pain during sex (dyspareunia) for months or even years after childbirth. This is typically caused by muscle injury during the birthing process and can be effectively treated with physical therapy intervention.

• Pubic symphysis, or pubic pain: The pubic bones can become misaligned during pregnancy or childbirth. Sometimes women will even hear a pop when the pubis comes out of alignment (pubic symphysis diastasis), which can create pain with sitting, standing, and other functional movement, and can be very debilitating. PT helps align the bones/joints and create dynamic stability with muscle support.

• Pelvic organ prolapse (POP): Pelvic organ prolapse can occur when the muscles and ligaments supporting a woman's pelvic organs weaken, and the pelvic organs slip out of place. This doesn’t usually happen immediately after childbirth but symptoms can arise down the road. There is also a significant genetic component to the condition. POP typically doesn’t involve pain but can lead to functional problems such as leaking or a “pressure” discomfort as the tissue loses elasticity and starts to fall down. There are three main types of prolapse: cystocele (vagina), rectocele (rectum) and enterocele (uterus). Physical therapy improves the muscular support of and blood flow to the pelvis, which may result in reduced symptoms and prevents the organs from slipping further out of place.

How we can help

Pelvic floor physical therapy is an effective treatment of a variety of pregnancy and postpartum pelvic issues. If you're dealing with weak muscles leading to conditions like stress incontinence or prolapse, physical therapists can offer neuromuscular rehabilitation. This approach focuses on retraining your vaginal muscles to contract and relax correctly. For those with overly tight pelvic floor muscles, therapists can apply manual therapy techniques to alleviate trigger points and address any muscle impairments. During your initial evaluation, we will assess your condition and then develop a personalized treatment plan that aligns with your specific needs.

What to expect

At your initial appointment, we will start by taking your medical history, followed by a comprehensive musculoskeletal examination of your pelvic area. This will include assessing your posture, joint alignment, any muscle restrictions or trigger points, the health of your connective tissue, and muscular strength. An internal examination is often part of this process, but it's entirely optional and will only be conducted if you feel completely comfortable with it. This exam is much more relaxed and comfortable compared to a typical ob/gyn visit, and it provides essential information about your pelvic muscle tone, strength, and coordination. If impairments are found during the exam, the physical therapist can treat the problems with manual therapy techniques resulting in pain relief and improved function. Following the exam, we'll discuss our findings with you and outline a personalized treatment plan aimed at achieving the best results. Most patients start feeling better after their first session and see significant improvement by their third visit.