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physical therapy after cesarean section

What Pelvic Floor Physical Therapy after Cesarean Section Can Do For You

Physical therapy after cesarean section can help you in your recovery by giving you skills to regain optimal body function and help you get back on your feet, doing the activities you value in addition to taking care of your new little one. In this article we review some ways that a therapist at Femina Physical Therapy can help you through your recovery. You can see a trained therapist as soon as you have the energy to do so.

Scar management and desensitization

Pelvic floor physical therapists are trained in soft tissue mobilization techniques to help soften and flatten scar tissue after your cesarean incision is healed. As a part of your treatment, your therapist will teach you techniques such as scar massage to help prevent scar tissue build up and puckering. Check out our full article on scar tissue management here.

Additional benefits of scar tissue management:

  • Soften and flatten scar tissue by promoting collagen remodeling
  • Decrease itching
  • Provide moisture and flexibility to the scar
  • Desensitize the scar tissue

Diastasis recti recovery

Diastasis recti, or diastasis rectus abdominis (DRA) is a condition in which the 2 sides of the “six-pack” muscle (A.K.A. rectus abdominis) separate.

This typically happens during and following pregnancy because of the stretching that happens to the belly as the uterus expands to carry the growing baby. Scar tissue from the incision site of a cesarean may complicate the healing of a DRA.

Those with diastasis recti may experience some of the following symptoms:

  • A gap in “six-pack” muscle above or below the belly button that you can touch or see
  • Feeling “flabby” in the abdominal muscles
  • Urinary problems (frequency, urgency, leakage)
  • Bowel problems (constipation, pain with bowel movements)
  • Low back pain
  • Pelvic pain
  • Hip pain
  • Poor posture
  • Weakness of the core muscles
  • Pain with sex

A trained physical therapist providing physical therapy after cesarean section will provide you with corrective exercises to help stabilize your core and to help the abdominal separation to come back together partially or completely. They will also evaluate you to be sure your muscles are creating enough tenstion across the midline of your body.

Posture and body mechanics training

After the birth of a baby, it is important to restore healthy posture to protect your spine and reduce neck, shoulder, and back pain. A physical therapist will help you restore your postural mechanics to optimally support you.

During pregnancy, a mother’s center of gravity moves forward as the uterus and baby grow. Many mothers compensate for this shift by slumping their posture forward, causing shoulders to roll forward and increasing stress on the muscles of the neck, shoulders, and back. The low back curve can increase or decrease significantly, depending on the mother. Ribs can flare up to 6 cm to accommodate shifting organs and the growing belly. Some women will even have a permanent change in shoe size after pregnancy. This is all to say that your body changes after pregnancy and a physical therapist can help you regain function of your body.

Pelvic Floor Dysfunction

43% of those who deliver via cesarean section have pelvic floor dysfunction (compared with 58% of women who deliver vaginally) (MacLennan ,Taylor ,Wilson, et al., 2000). Pelvic floor dysfunction can cause:

  • Urinary problems (frequency, urgency, leakage, straining)
  • Bowel problems (constipation, pain with bowel movements, urgency and incontinence with gas or bowels)
  • Pelvic organ prolapse (feeling a bulge, pressure, or “falling out feeling”)
  • Painful sex
  • Perineal pain
  • Low back pain
  • Pelvic pain
  • Hip pain

A trained pelvic floor therapist will help return strength, function, and flexibility to the pelvic floor to help you regain control.

Regain core control

During pregnancy, all abdominal muscles will lengthen and weaken. A functional core is essential to all functions of the body: walking, bending, lifting, running, even sitting with good body mechanics requires a functional core. Physical therapy can help you regain strength and support through your core muscles to help you get back to the activities you want to do.

Return to exercise training

Along with regaining your core control, physical therapy after cesarean section can help you return to the exercise you love after pregnancy. Whether you are a marathon runner, swimmer, boxer, yogi, or any other kind of jock- you want to return back to the activities you love in a safe way.

Pain management

Therapy can help an achy and painful body. An physical therapist can create a treatment plan that matches your needs while working on typical triggers of pain:

  • posture
  • joint alignment
  • muscle strength
  • flexibility
  • nerve involvement

It’s all tied together

Weight gain, bad posture, life stress, core control, and the pelvic floor are all interconnected--they are all a part of your body. Changes in your posture can make your muscles work harder. Believe it or not, dysfunction of the pelvic floor can lead to back pain, neck pain, and even jaw pain. A trained physical therapist can help you heal the whole body and help you feel like you again. To get started with physical therapy after cesarean section, use this simple form to schedule an appointment with one of our therapists.

 

Resources

American Physical Therapist Association. (2018). Physical Therapist's Guide to Diastasis Rectus Abdominis https://www.moveforwardpt.com/SymptomsConditionsDetail.aspx?cid=f8a7ad12-eadf-4f42-9537-e00a399c6a03#top

Iverson, C. (2017). Postpartum Physical Therapy: An Orthopedic Perspective. Newgradphysicaltherapy.com

MacLennan AH, Taylor AW, Wilson DH, Wilson D. (2000). The prevalence of pelvic floor disorders and their relationship to gender, age, parity and mode of delivery. Br. J. Obstet. Gynaecol. 107:1460–1470.[PubMed]

Memon, H. U., & Handa, V. L. (2013). Vaginal childbirth and pelvic floor disorders. Women’s Health (London, England), 9(3), 10.2217/whe.13.17. https://doi.org/10.2217/whe.13.17

Moffitt Cancer Center. (2006). Managing Your Scar. https://moffitt.org/media/1086/managing_your_scar.pdf

 

**This information is for educational purposes only and is not intended to replace the advice of your doctor.

What Our Patients Have to Say

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Testimonial by Carolina J.

I had tried Pelvic Floor Physical Therapy before (with another PT) and I had a really bad (painful) experience. A friend of mine and fellow patient, told me about Heather, Laureen and Femina PT (née Fusion Wellness & Physical Therapy) and I decided to try again. I am so happy I did! Femina PT have, literally, changed my life. I was able to do again things I couldn't do for over 10 years!! Their bedside manners are impeccable, their knowledge and understanding make me feel comfortable to recommend this place to anyone in pain. Specially if you have Endometriosis. 100% recommended!!

-- Carolina J., 12/28/16 via Yelp!

Testimonial by S.B.

As someone who suffered the debilitating physical and emotional effects of vaginismus (as well as a complicated history of back injuries) for more than 15 years, I thought a "normal" life was just a fantasy. Then I found Heather.

Read more: Testimonial by S.B.

Testimonial by R.H.

No one could tell me why I was having pain during sex--sharp pain, not just uncomfortable, pain. I was referred to Heather Jeffcoat after researching several different options. I had seen a specialist who told me physical therapy would not help and my only option was surgery. I really didn't want to go that route, so when we got a referral, I decided to try it--it can't hurt, I thought. I am so glad I did. She diagnosed the problem right away, which was a relief in itself.

To know why I was having pain eased my mind immensely. And to hear that she could fix it without surgery was another relief. She said she could fix the problem in 6 weeks. I think it was actually 4 for me. She was very methodical, and treated me as an intelligent human being capable of participating in my own recovery. I would absolutely recommend her to anyone. She did not try to prolong my session numbers, she worked hard to accommodate my schedule (and the fact that I had to bring a baby to sessions), and she was completely honest the entire time. It is so hard to find someone with these characteristics, much less a professional who is so good at what she does. She has my highest respect.

-- R.H.

Testimonial by Fritzette H.

I went to Heather after the birth of my third child. It was lucky, really, that I was referred to her, because my doctor had referred me to a surgeon for a possible hysterectomy or pelvic wall rebuild. Thankfully, I went to Heather before undergoing either surgery, she was able to fix the problem. She has studied extensively in women's health--even written a book about it--and was able to diagnose my problem, suggest a course of treatment (6 weeks), and then follow through with said treatment. By the end, as she said, I was as good as gold. Boy, was it worth it! Though uncomfortable to talk about, much less write about, it is worth getting the word out there. If you have painful intercourse, especially after birth or other trauma, the treatment may be as simple as Physical Therapy (with Heather, of course). I highly recommend her.

-- Fritzette H., 3/24/16 via Yelp!

Testimonial by Jamie M.

I have been going to see Heather for a while now, and I can't tell you enough how much she has improved my quality of life. Heather specializes in issues like pelvic floor, but I see her for other orthopedic issues.

I have a lot of chronic joint pain and dysfunction issues (back, hips, neck) that require that have ongoing physical therapy maintenance. The effects of my problem joints/areas overlap and interconnect with each other in complex ways, so helping me requires really having a complete understanding of the entire skeletal and muscular system. Pain does not always appear where the problem actually is, the human body is a twisty, many-layered puzzle. I have an exercise program I do at home and I am very functional, but there are just something things I need a PT to help me out with.

Read more: Testimonial by Jamie M.

Testimonial by S.P., Age 26

I would like to start off by thanking Heather Jeffcoat for educating me and curing me of Vaginismus. I had been married for almost three years before I was referred to Heather. I never knew about Vaginismus until almost three years into my marriage. I knew something was wrong when I went on my honeymoon and came back a Virgin. I had always imagined how magical my first night would be but boy was I wrong.

Read more: Testimonial by S.P., Age 26

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