Pelvic Therapy for Postpartum Problems

What is Pelvic Therapy?

Pelvic Therapy is a type of physical therapy that can be very helpful for postpartum moms. Pregnancy and childbirth can damage both the muscles and connective tissue of the pelvic floor and abdominal wall, which causes inconvenient and uncomfortable symptoms for women after they give birth.

When pelvic floor muscles are too tight or weak, they can cause annoying symptoms or pain. A pelvic floor physical therapist (PT) can evaluate these muscles and determine whether they’re contributing to the symptoms. If they are, the PT can work to release trigger points – areas where the tissues are stuck together rather than sliding easily against each other. PTs also teach you how to do exercises at home to help relax muscles that are tight and strengthen muscles that are weak.

Which postpartum problems can be helped by Pelvic Therapy?

Various conditions can be related to problems with the pelvic floor. These problems are particularly common in postpartum moms, but they can last beyond the first six months or surface later for some women.

  • Urinary difficulties: Women with urinary incontinence leak urine when they sneeze, cough, or run. Some women feel a frequent or sudden compelling urge to pee, even when their bladder isn’t full. Others are unable to start the flow of urine at will or empty their bladder completely when urinating.
  • Anal Incontinence: Many postpartum women have trouble controlling gas or bowel movements.
  • Perineal Pain: This is common in postpartum women, especially those who had a tear during childbirth or are recovering from an episiotomy. A tight pelvic floor causes some new moms to experience persistent perineal pain, even after their wound heals.
  • Pelvic pain. Some women have pain during sex for many months or even years after childbirth. And some have chronic pain, itching, or burning in their vulva – the tissue surrounding the opening of the vagina. This can make it hard to tolerate wearing tight clothing and underwear. Others have pain during bowel movements. These symptoms are often caused by tight pelvic floor muscles, which can lead to inflamed tissue and nerve endings.
  • Pelvic organ prolapse: When pregnancy and childbirth weaken the pelvic floor muscles, one or more of the organs they support – the uterus, bladder, and bowel – can slip out of place. Rehabilitating these muscles can help prevent or improve this condition.
  • Diastasis Recti: Women lose a lot of tone in their abdominal muscles during pregnancy. About two-thirds develop what’s known as diastasis recti, a separation of the rectus abdominis muscle along the center of the belly. This condition can contribute to lower back pain, constipation, and urine leaks, as well as that stubborn postpartum stomach pooch that may last for months to years.  Diastasis recti cannot be fixed with crunches or sit ups. In fact, these exercises can make the problem worse. Instead, the condition requires special strengthening exercises that focus on the deeper transverse abdominal muscles. Your therapist can teach you how to do these exercises at home.

What Techniques do PTs use for Pelvic Therapy?

Physical therapy for pelvic rehabilitation involves several different kinds of techniques that focus on the muscles and connective tissue of your pelvic floor and abdomen.

  • Education and Exercise: Your therapist will teach you to identify various muscles, so you can strengthen or release them. All of the muscles in this area work together to help you maintain your core strength and prevent incontinence.
  • Relaxation Techniques: Should all women be prescribed Kegels?  Not necessarily.  Kegels are great to do if a woman is dealing with stress incontinence due to weak muscles. But if the pelvic floor muscles are really tight or weak, contracting the muscles further will only make the problem worse.  Teaching a woman to contract the muscles and then relax them to a full resting position is important for healthy pelvic floor muscles.
  • Manual Therapy: Your therapist will also use her fingers to massage your thighs, buttocks, and the tissue inside your vagina. The goal is to gently stretch this area and release trigger points that are causing pain. This can be uncomfortable, particularly if you have chronic pain or are reluctant to allow probing inside your vagina.  Manual therapy to the pelvic floor muscles is similar to regular massage.  There is discomfort when tight muscles are pressed, but then a sense of release and relief is experienced as muscle tension reduces.

Pelvic Therapy at Blue Sky Physical Therapy

Blue Sky has one physical therapist on staff who specializes in Pelvic Therapy – Karen Lewis, PT, MPT. Karen has specialized training and experience to treat pelvic floor pain and dysfunction or diastasis recti.  With manual therapy, she can also help reduce scar tissue formation from episiotomy, c-section or other surgeries in the abdominal region.  If you have any further questions, please contact our office to learn more about how Pelvic Therapy can benefit you!