Every woman should see a pelvic health physical therapist after having a baby. It doesn’t matter if you gave birth via c-section or vaginally, you most likely need the assistance of a pelvic health PT to help your body recover. The American College of Obstetrics and Gynecology now recommends a routine physical therapy consult after 6 weeks post-partum, but unfortunately, this is not yet the norm. We want to change that!
During pregnancy and delivery, our bodies go through a lot. Muscles are stretched, joints are strained, scar tissue is made, and our bodies physically change. Areas of our body most affected include the pelvic floor, the joint in our pelvis and lower back, and abdominal/core muscles.
Unfortunately, our bodies can sustain these permanent changes that can alter our normal function if it isn’t addressed.
One of the primary functions of the pelvic floor muscles is to support all the organs in the pelvis and up into the abdomen. Yes, this includes your uterus and growing baby! This means throughout the progression of your pregnancy, more and more pressure is placed down onto your pelvic floor muscles. This can lead to stretching of the muscles causing them to be weak, or, in some cases, the muscles react by over-contracting and becoming tense. So, despite the method of delivery, pregnancy itself can lead to pelvic floor dysfunction.
During a vaginal delivery, a newborn will need to pass through an opening in the pelvic floor. This can lead to tears in the muscle itself which can cause scar tissue. Also, during a vaginal delivery the pelvic floor can stretch up to 3x it’s normal resting length. Think about this: if you stretch any muscle in your body up to 3x it’s normal length, do you think that would cause some problems? The same is true for your pelvic floor muscles!
What does that mean? Well, pregnancy and childbirth are both common risk-factors for pelvic floor dysfunction! With this, we will often see problems including urinary incontinence, urinary frequency and urgency, pelvic pain, and prolapse.
Pelvis and Lower Back
As pregnancy progresses and the belly grows, most moms will experience a change in their posture. There is an increase in the arch of your lower back as the weight of the growing belly pulls it forward. When this happens, you may experience increased strain on the joints of your spine, along with the muscles and ligaments that support it. This can lead to problems such as lower back pain. For a majority of women, this pain will subside a few weeks after delivery. However, there are those who continue to struggle with chronic back pain following pregnancy.
Throughout pregnancy, increased levels of the hormones estrogen and relaxin are released into the body. These hormones have a relaxing effect to both joints and ligaments. The purpose of this is to allow the pelvic outlet to widen during delivery. However, the increased laxity in these joints and ligaments can lead to increased joint pain, especially in the pelvis and sacroiliac (SI) joints.
As your baby and belly grow throughout your pregnancy, your abdominal muscles accommodate to this by stretching to allow for more room in your abdomen. This stretching can result in core muscle weakness which can contribute to back pain.
The stretching of your abdominal muscles can also lead to a diastasis rectus abdominus, or DRA. This is otherwise known as the “mommy belly” or “spit in the belly muscles”. Although a DRA is primarily considered a cosmetic problem, for up to 50% of patients it can also lead to back or pelvic pain. Why is this? Well, your other core muscles attach to the tissue that is stretched with a DRA. When this tissue is stretched, the muscle attachment isn’t as strong we would like, which can contribute to core muscle weakness. A common side-effect of a weak core is lower back and pelvic pain! Your pelvic floor and core muscles also work together, so it is common to see pelvic floor dysfunction when a DRA is present.
Why You Should See a Pelvic Health PT
Now that I’ve explained some of the changes your body goes through during pregnancy and delivery, let me explain why seeing a pelvic health PT at 6-weeks post-partum is so important!
A pelvic health PT has specialized training in assessment and treatment of post-partum women. She will provide a thorough assessment of your pelvic floor muscles, pelvis and lower back, as well as core/DRA. Your PT will then be able to guide you through an exercise program that will safely help restore your core and pelvic floor! Even if you aren’t experiencing any urinary incontinence or pain, it is still beneficial to work with a pelvic health PT to learn how to correctly restore your muscles to avoid any future problems. Issues such as urinary incontinence don’t always occur right after having a baby, however, childbirth is a risk factor for incontinence throughout your lifetime. By rehabbing your muscles in the early stages, you can help prevent future problems!
A pelvic health physical therapist can also help you safely return to your post-partum fitness goals. If done too early or improperly, certain exercises may worsen issues such as DRA or prolapse. A pelvic health PT can help coach you through the safest exercises for your body to allow you to return to what you love doing!
As you can see, working with a pelvic health physical therapist is so important!
We can help you safely restore your core and pelvic floor to keep your body functioning in the best way possible, in order to take care of and keep loving your new bundle of joy!