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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.

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What Our Patients Have to Say

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Testimonial by Jackie W.

I was in multiple car accidents a decade ago, and I have been to many physical therapists through the years without success. They found the root of my lower back pain problems and after nearly a decade of barely being able to walk I finally can again without pain. They are also the best pelvic floor pts and the only ones who found the connection between my pelvic floor and lower back problems. If you need help with physical pain, they are your answer.

-- Jackie W., 1/19/17 via Yelp!

Testimonial by A.W., age 32

I wanted to let you know that my pelvic floor held strong and gave me no trouble whatsoever in my trail race this morning (12 miles)! In a way, I felt like I ran better than ever because my core feels so rock solid from all the exercises you have me doing. That was especially valuable on the technical downhill - I just flew down the trail because I had confidence in my balance and form. Thank you for helping me get back to doing what I love.

-- A.W., age 32
(completed Post-partum Renewal Program using the InTone biofeedback/stim unit)

Testimonial by Alexandra B.

Heather is without exaggerating AMAZING! After years of trouble with a certain part of my body, in no time, she made everything change back to equilibrium and to what would be considered normal. She explains everything in detail and therefore gives you a better understanding of why things are the way they are, and how you can work towards turning things around. I would highly recommend Heather for any type of Physical Therapy. She has created her own "Method/Therapy" through years of studying (with some of the greatest practitioners), practice and breaking down the issues of her past patients, enabling her to fine tune her own system. I'm so thankful to have found her, and I'm especially grateful for the quick recovery I've achieved, after years of distress. If you cannot afford her, I recommend you purchase her book. Although it may not be Heather in person, it can still help you to get on the right path to recovery!

-- Alexandra B., 5/20/2015 via Yelp!

Testimonial by R.M., Age 40

I can’t speak highly enough of the theapists at Femina Physical Therapy and how much they have helped me grow, discover, and love my body. I had had painful sex for my entire life, and didn’t know that there was anything that could be done about it. It was at the point where my husband and I were not having sex for MONTHs, because it was just too frustrating, and I hated feeling like I was the ONLY woman out there who had this problem, especially at my age. I finally brought it up to my doctor because I was turning 40 and my husband and I were barely having enough sex to conceive. And she brought up pelvic floor, PT. I didn’t even know this was a “thing”.

Read more: Testimonial by R.M., Age 40

Testimonial by S.H., age 24

I just wanted to thank you for everything you've done for me for the past 19 months. I literally could not have reached my goals without you and your practice. You gave me the courage to keep moving forth with my treatment no matter how afraid and anxious I was. You were always there to answer questions and made this whole process so much easier than I expected it to be.

It's because of you that my marriage is on the right track, that I can get pregnant and that this part of my life is finally over. I really feel that Fusion Wellness is a team of people you can call family and are there to root for you and cheer you on until you reach your goals. There is nothing better than knowing I accomplished this with you guys by my side and as calmly and patiently as I needed. Thank you from the bottom of my heart for always being there and helping me reach my goals.

S.H., age 24

Testimonial by Amanda W.

Heather's unique physical therapy program literally changed my life! After years of struggling with vaginismus, a condition that made it impossible for me to have intercourse and very difficult to use tampons without pain, a gynecologist referred me to Heather. I was nervous for my first appointment, but Heather's professional and friendly demeanor put me at ease. She did a great job explaining each technique she was using to help my muscles relax. Heather uses a combination of internal and external stretches and exercises to relax the pelvic floor and build muscle strength. Her specially developed home program helped me quickly recover from an issue that seemed insurmountable before meeting Heather. She was optimistic about my progress and incredibly encouraging. Less than 6 months after my first session, I was able to have pain-free sex for the first time in my life! If you are suffering from vaginismus or any other pelvic floor issues, I highly recommend making an appointment with Heather and reading her book!

-- Amanda W., 2/15/16 via Yelp!

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