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Physiotherapy & Rehabilitation

Post-Partum Physiotherapy

Post-Partum Physiotherapy

What is Post-Partum Physiotherapy?

Regardless of the type of delivery, the abdominal and pelvic floor muscles can be affected.  The pelvic floor plays an important role in birthing, and like any muscle, the pelvic floor can experience injury under extreme circumstances. Up to 80% of women who have given birth vaginally cannot effectively contract their pelvic floor muscles. The abdominal muscles, lengthened during pregnancy, are weakened and may even separate.  This is termed diastasis recti.  An assessment 6-8 weeks postpartum will examine the abdominal wall and pelvic floor looking at muscle contraction and relaxation, scar mobility, and any other issues that may have occurred in delivery. Early intervention can encourage faster recovery of the abdominal wall and pelvic floor, reduce long term complications, and enable a safe and timely return to daily activities including exercise and sport.

Common Post-Partum Complaints:

  • Incontinence of bladder and/or bowel
  • Inability to control the passage of gas
  • Feeling of instability in the pelvis, low back, pubic bone, or sacroiliac joints, especially with physical activity like lifting, carrying, walking, coughing, or bowel movements
  • Hip, pelvis, or low back pain and stiffness
  • Pressure or heaviness in the perineum or vaginal region
  • Pelvic organ prolapse
  • Perineal pain
  • Pain at the site of episiotomy, tear or c-section scar
  • Decreased sensation
  • Decreased desire or sexual appreciation
  • Pain in the pelvis or low back with intercourse

How Can Donna Sarna Physiotherapy Help?

At Donna Sarna Physiotherapy & Rehabilitation, the post-partum assessment is a two-part process with a global approach taken both with assessment and with treatment. During the assessment process, a detailed history as well as an internal and external evaluation will occur incorporating not just the pelvic floor, but also assessment of posture, as well as range of motion and strength  of the torso, back, hips, pelvis and extremities. An  examination of the associated musculature and fascia as well as the nerves and joints will also be included.  Diastasis recti (abdominal separation) will also be assessed for as well as trigger points within the abdominal wall.  The pelvic floor component will include an external evaluation of the skin and connective tissue in the perineal and genital area as well as an internal examination of the vagina and possibly the anal canal if indicated. The pelvic floor muscles and sphincters are tested for muscle tone and  tightness, strength, endurance, trigger points, and tissue integrity. The pelvic floor is also assessed in conjunction with the rest of the core to ensure that timing of activation  and sequencing of  the muscles is optimal. Position of the pelvic organs and integrity of their supporting ligaments and fasciae are also evaluated.  You are always welcome to have a trusted individual present during assessment or treatment.

An individualized treatment plan is developed based on the assessment findings and may include education regarding posture, breathing, proper toileting techniques, bladder training/urge delay techniques, prolapse reduction techniques, bladder irritants, perineum care, perineum support and evacuation techniques and abdominal massage. Manual techniques to address adhesions and scar tissue that may occur with episiotomies, tears, or C-section scars are a key component of treatment.  Techniques that are utilized include myofascial release, mobilizations, visceral manipulation and biofeedback.  An individualized home exercise program will also be provided to release and/or strengthen with a whole body approach to include the pelvic floor, but not specific to.  Other modalities such as electrical  muscle stimulation (EMS), transcutaneous electrical nerve stimulation (TENS), mechanical biofeedback, ultrasound and acupuncture may also be included as components of the treatment plan.