Postpartum Pain, Dysfunctions, and Safe Return to Exercise

Congratulations! The baby is here, and the focus is all on the baby but what about the mom who just gave birth?  

In our experience, most people do not realize that pelvic health/floor physical therapy is an option for them or know that treatment could be beneficial. We recommend that 6 weeks after pregnancy, you should schedule an appointment with one of our pelvic health/floor physical therapists.

This session can be done in person or remotely. The body was designed to give birth; however, we want to give you the opportunity to ask questions, teach you exercises to protect and restore your body, assess for a diastasis recti, and if needed, assess the pelvic floor muscles.

Many women experience pain following childbirth. Oftentimes, pain will resolve over the first 3 months after childbirth, but pain should not keep you from completing daily activities such as walking, lifting, child care, or exercise.

Some women with back and/or pelvic pain continue to have pain for months (~20% of women had pain at 14 months) or years following pregnancy (8% of women experienced pain 2 years following pregnancy). Studies have shown that a personalized rehabilitation program can be helpful for managing this pain.

Caring for baby AND yourself after surgery?

You’re one tough Mama! A C-section causes significant damage to the abdomen and underlying tissues.

We recommend seeking treatment once the incision is healed (about 6-8 weeks), to reduce restrictions from scar tissue not only in your skin, but also in the deeper tissues and muscles. Also, it is very important to restore the strength of the abdominal muscles following c-section for daily repetitive activities such as lifting, carrying, reaching and more! 

Check yourself before you wreck yourself! How to manage and exercise with a DRA.

A DRA is a stretch of the tendon between your abdominal muscles that can occur due to the growth of the abdomen during pregnancy.

It presents as feeling a separation between the abdominal muscles and possible bulging through the separation. This is common following pregnancy; however, it can contribute to other pains and difficulties following pregnancy. Studies show that improving the strength of the abdominal muscles to restore trunk support can reduce dysfunctions; however, it is best when these exercises are personalized to you and your needs.

Do you wet yourself when you sneeze, cough, run, jump, or hike? We can help so you can do the activities you enjoy.

Incontinence is uncontrolled leakage from the bladder (urinary incontinence) or the bowels (fecal incontinence). It can be caused by dysfunctions of the pelvic floor muscles, including weakness, muscle stiffness, or impaired coordination.

There are several types of urinary incontinence, including stress incontinence, urgency incontinence, and mixed incontinence. Fecal incontinence can be the involuntary loss of stool or gas and have similar causative factors as urinary incontinence. Often, incontinence can be lessened or treated with specialized physical therapy interventions. 

Stress incontinence is most common following pregnancy. Incontinence can occur when you sneeze, cough, or exercise. While this may be considered ‘normal’  among women, in most cases, it is not how your body is supposed to function normally. In many cases, this can be reduced or resolved with a personalized rehabilitation program.

Do you feel a “falling out” sensation “down there”?

A prolapse is the downward movement of the pelvic organs into or through the vagina. It can occur at the uterus, bladder, urethra, or rectum.

Frequently, prolapse is associated with a sensation of heaviness in the bottom of the pelvis. Sometimes, a bulge or protrusion can be seen or felt in the vagina. Studies have shown that a specialized pelvic rehabilitation program can reduce prolapse. It is best addressed using a multidisciplinary approach. 

Feeling frustrated by sluggish pipes? Do more than consult the internet, and we have tips and tools to assist you.

Constipation occurs when a person has three or fewer bowel movements a week or has bowel movements that are difficult or painful to pass. A normal frequency of bowel movements can range from three times a week to three times a day depending on factors, such as diet, hydration, medication, or exercise. The pelvic floor muscles are important as they also contain the anal sphincters that must relax to allow for a full evacuation. 

Do frequent urges to run to the restroom interfere with your life?

Overactive bladder causes sudden strong urgency and a need to urinate, even when there is a small amount of urine in the bladder. This results in urinary frequency and can negatively impact a person’s quality of life. 

Do your muscles need to get it together? Let us help you properly train your pelvic floor.

Pelvic Floor Dyssynergia is impaired coordination of the pelvic floor muscles. This means you have a difficult time relaxing or contracting these muscles and may have difficulty telling what these muscles are doing. It can be a contributing factor in many pelvic dysfunctions including pelvic pain, incontinence, sexual dysfunctions, and constipation. 

Does it feel like a UTI, but it’s not a UTI?

Bladder pain syndrome (interstitial cystitis) is characterized by pressure or pain in the bladder, frequent urination, and urgency. It is commonly mistaken for a UTI due to the similarities in symptoms. Evaluation of these symptoms should be completed by a qualified specialist such as a urologist or urogynecologist for proper diagnosis. Physical therapy has shown to be helpful with managing symptoms. 

Pain here, pain there, pain everywhere, down there!

Some examples of perineal pain in women include vulvodynia, vestibulitis, pelvic inflammatory disease, and pudendal neuralgia. In men, pelvic pain can be due to prostatitis. Other potential causes of pelvic pain can include muscle and myofascial pain, urinary tract infections, cystitis, IBS, and many others. Pelvic and perineal pain should be evaluated by a physician for any necessary additional testing and to rule out infections. 

Pudendal neuralgia is pain caused by damage or irritation of the pudendal nerve which is very important to the functions of the pelvic floor. It can occur in all people and can cause intermittent burning, sharp pain, aching, itching, or a raw sensation in the genitals and buttock area. It can be chronic, severe, and seriously negatively impact the quality of life. 

Embarrassed to talk about it? You can’t surprise us!

Sexual dysfunction can occur in all genders. Irregularity can include arousal disorders, orgasmic and ejaculatory disorders, dyspareunia (pain with intercourse), low libido, and many other complications. The best approach to treat sexual dysfunctions is utilizing a multidisciplinary team including your physician, physical therapy, sexual therapist, and other specialists as needed.

It’s a pain in the butt!

Coccydynia is pain in the coccyx (tail bone). It can cause pain with sitting, prolonged standing, and difficulty with bowel movements. Depending on the causes of coccydynia, physical therapy can be helpful in reducing pain and restoring function. 

Well, that’s embarrassing!

Incontinence is uncontrolled leakage from the bladder (urinary incontinence) or the bowels (fecal incontinence). Incontinence can be caused by dysfunctions of the pelvic floor muscles including weakness, muscle stiffness, or impaired coordination.

There are several types of urinary incontinence, including stress incontinence, urgency incontinence, and mixed incontinence. Fecal incontinence can be the involuntary loss of stool or gas and have similar causative factors as urinary incontinence. Often, incontinence can be lessened or treated with specialized physical therapy interventions.

Check yourself before you wreck yourself! How to manage and exercise with a DRA.

A DRA is an expansion of the linea alba that occurs when the abdomen is stretched and can occur with weight gain. It presents as a separation of the abdominal muscles and possible bulging noticed in the abdomen (hernia). This can commonly occur with the growth of the abdomen and can contribute to other pains and dysfunctions.

There is evidence to support improving the abdominal muscles’ strength to restore trunk support can reduce dysfunctions. However, it is most effective when the exercises are tailored to your personal needs.

We want you to be you and do the things you love!

Pre and post-operative rehab and pain management following surgeries, often people require rehabilitation to restore strength and function. This can include addressing myofascial pain and restrictions, joint mobility, muscle pain, and exercise to restore and maintain full mobility and function. 

Pain concerns regarding gender-affirming interventions, including garments, braces, wraps, etc.