“The weeks following birth are a critical period for a woman and her infant, setting the stage for long-term health and well-being”
- American College of Obstetricians and Gynecologists, 2018 “Optimizing Postpartum Care”.
Postpartum Rehab
Whether you are a first-time mom or mom of multiples, every pregnancy, and postpartum experience is different (just like every birth experience is different).
Our bodies go through significant changes, very rapidly throughout pregnancy and again during the birthing process. Regardless of whether you’ve had a vaginal birth or a cesarean section, childbirth is considered a physical trauma to your core and pelvic floor.
Birth injuries, scar tissue, abdominal weakness, bladder leakage, bowel issues, painful intercourse, and pain in the back, hips, or pelvis are just some of the many issues women can experience after birth, which is why it’s so critical to see a pelvic floor physiotherapist before and after childbirth.
There is no timeline. Although we recommend women come to see us 6 weeks after birth, there is no time limit or expiration date. Life is busy, especially while trying to navigate life as a new mom and especially if you’ve got multiple children at home. If you’re 6 months or 16 years postpartum, this is still appropriate for you.
Reasons to see a pelvic floor physiotherapist after birth;
A thorough assessment of body mechanics, posture, balance, core and pelvic floor muscle recovery, strength, and function.
Treatment for any pelvic health concerns such as urinary incontinence, painful intercourse, pressure/heaviness, or bulging sensations (this may indicate a prolapse), diastasis recti (abdominal separation), and any scar tissue restrictions.
Progressive individualized core and pelvic floor rehabilitation is designed to get you back to the movements and activities you love safely.
Postpartum Conditions We Treat.
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Commonly known as the separation or “gap” in the abdominal muscles after birth.
During pregnancy the tissue that holds your rectus abdominis (six pack muscle) together stretches and thins to accommodate your growing belly. Research has shown that by 35 weeks into pregnancy, 100% of women have some degree of separation. However, in roughly 40% of women this separation persists into their postpartum period and requires more targeted exercise to help correct or heal.
Most women with diastasis report tissue laxity, softness or “pooching” that is localized to the abdomen. They may experience more obvious abdominal distention with gas or bloating and have a difficult time “using their core” during their activities. There are different severities of Diastasis, based on how wide and deep the separation is and your physiotherapist will work with you to design a core rehab program that works for your specific presentation and your specific goals.
Have questions about Diastasis Recti or want to book an assessment?
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No amount of urinary leakage is normal but it can be a common symptom during pregnancy and after birth. Bladder leakage can range from small dribbles to big gushes and can often be downplayed by healthcare providers or even joked about by your mom friends, but peeing your pants isn’t funny. It can be embarrassing and frustrating, especially if you find it is limiting the activities you like to do. Ignoring bladder leakage is not the answer, in fact it tends to worsen over time.
Research has shown that 92% of women who are still incontinent 12 weeks postpartum will remain so 5 years later. Research has also shown that moms who leak have an increased risk of postpartum depression.
The causes of leakage after birth can vary widely, and are not always associated with “weak” pelvic floor muscles. In fact, leakage can be caused by muscles that are too tense (too tight), which is why traditional “kegels” aren’t always appropriate or effective. Leakage can also occur from other factors such as; scar tissue dysfunction, poor core activation, constipation, and even your running form.
During your postpartum appointment, your physiotherapist will perform a thorough assessment to find the driver behind your leakage.
Let us help you run again without leaking and sneeze again without crossing your legs.
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Pain that persists beyond the first few weeks after birth is not normal. Although some discomfort may be expected in the first few weeks of your recovery, pain that persists is not something that you should have to deal with. Pain can be a direct result of trauma during birth (scar tissue, torn muscles, birth positions), as a result of muscle weakness or muscle tension, or movement strategies; including how you lift, carry, and feed your little one. If you’re experiencing pain, please reach out.
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It’s common to be nervous about the first time having sex with your partner after baby arrives, especially if you’ve had any tearing or trauma during birth. Factors such as changing hormones, fatigue and emotions, scar tissue dysfunction and pelvic floor muscle tension can all contribute to sex being uncomfortable or even painful after birth.
Pain should not only be comfortable but it should be enjoyable. Please don’t push through it.
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Scar tissue dysfunction (Abdominal or Perineum)
Scar tissue is an important part of your recovery. If you’ve had an abdominal incision, an episiotomy or perineal tear during birth, scar tissue is a necessary and normal part of your recovery.
The problem with scar tissue is that it is a less flexible and more rigid tissue. When a scar isn’t moving well, it can result in adhesions and lead to altered sensations (numbness, tingling, sensitivity) and even pain. Because of where the scar tissue is forming, it can also be associated with bladder leakage, pelvic pain, painful intercourse and even back or hip pain.
During your postnatal visit your physiotherapist will assess your scar and if appropriate teach you exercises to improve its mobility and appearance.
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The term “prolapse” is used to describe the descent of one or more of the pelvic organs (uterus, bladder, bowels) down into the vaginal canal. There are different severities of prolapse, based on how far down the vagina the pelvic organ has descended, with grade 1 being the least severe and grade 4 being the most.
There is a misconception that prolapse only happens to women of a certain age. In fact, having some degree of prolapse can be especially common in the postpartum period, as your body is recovering from birth.
Signs of pelvic organ prolapse are: heaviness, pressure, and bulging sensations in the vagina. You may also experience incomplete bladder or bowel emptying, discomfort with intercourse or urinary and fecal leakage.
If you’re experiencing any signs or symptoms of prolapse, please see a pelvic floor physiotherapist as soon as possible as the severity and symptoms of prolapse can worsen over time without treatment. (BOOK HERE).
If you’d like to learn more about pelvic organ prolapse, check out our blog post :
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Unfortunately, women are left to navigate their return to exercise after birth with very little support or guidance. They are often given vague recommendations like “go slow” or are given the green light to “do anything” after their six week appointment. This can set moms up for disappointment and even injury as they start becoming more active.
Here at Collingwood Pelvic Health, we are passionate about supporting moms with evidence-based and progressive rehab programs to get them back to the activities they love, without injury, and with special consideration for their long-term pelvic health.
Whether you are a weekend warrior, a long-distance runner or a crossfit athlete, your physiotherapist will work with you to build a program that is individualized to your body and your goals.
Are you ready to get started? Book here.