It is recommended that all postpartum women come for a full assessment. Some problems may be hidden and not cause issues in the beginning, but if caught early on, many symptoms can be prevented.
Why is it recommended to see a physiotherapist after the 6 week doctor’s check up?
Your obstetrician-gynecologist will determine whether the tissues are healing properly, deal with stitches and make sure there aren’t any postnatal complications. However, only specialized obstetrician-gynecologists/urogynecologists check the function of the muscles. Physiotherapists in this field are specialized in assessing strength, endurance, coordination, correct activation and isolation of these muscles. Knowing all this about your pelvic floor function is essential for safe return to everyday activities and sports.
Some women are more worried than necessary about their symptoms, in which case a little encouragement following the assessment can make a big difference. Based on the findings and the type of birth you had, we discuss the plan, with graded exercise to return to the activities you enjoy. For some mothers, it may mean I give detailed advice and they can exercise and progress on their own. The timescales are very different for everyone. One postpartum mom might feel up to starting appropriate breathing and deep abdominal activation exercises on day 1. Others might find it difficult to find the time and energy to even think about their own needs for months, maybe years. It doesn’t matter where you are in the process or how long ago you are postpartum; it is never too late to seek help and start your regeneration journey.
What can I expect from physiotherapy? What will it help me with?
The initial assessment consists of pelvic floor muscle testing for both those who gave birth vaginally and those who gave birth via cesarean section. Perineal scar tissue mobilization, correct muscle activation practice, and strength training is most commonly needed after vaginal delivery. Learning to relax the muscles, stretching and exercising with the aim to create more elasticity in the muscles is often more useful post cesarean deliveries.
Treatment of cesarean scars should commence early on, initially only with gentle, superficial touch and mobilization. After the 12th week, we can start deep scar tissue mobilization, doing big stretches, lifting heavier weights than your baby and more difficult abdominal exercises.
During pregnancy, the abdominal muscles must stretch and so does the connective tissue between the muscle bellies in the middle, called linea alba. This can create rectus diastasis, where the distance between the outer (‘6 pack’) layer of muscles increases. For some women, it is not the distance between muscles that is bothersome, but generally a feeling that they can not get rid of the ‘belly’. When this is still the case after the womb contracts back to its original size, and despite lack of abdominal fat, learning to activate the transversus abdominis (deepest layer of the abdominals) is essential. It can also be helpful in case of postpartum low back pain.
It is not uncommon to have upper back and shoulder pain from breastfeeding. We treat these issues, to help you with your everyday activities.
Read the following blog if you are interested in tips on returning to sports safely.
You can learn more about treatment techniques here.
Women’s Health Physiotherapy assists women through different cycles of life