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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 M.M.

My husband and I were married for 5 years and unable to have intercourse, but I never knew why. After numerous awful experiences at doctor’s offices (where many doctors told me I “just needed to relax”), a surgery that didn’t fix the problem, and a year of owning dilators that didn’t get me anywhere, someone finally referred me to Heather for Physical Therapy. I finally had answers and information from someone who knew exactly what I was dealing with!

Read more: Testimonial by M.M.

Testimonial by Julie T.

Femina PT (née Fusion Wellness & Physical Therapy) has honestly changed my life. Before receiving treatment at Femina, I was going doctor to doctor to try and find the answer to my pelvic pain. It has taken me YEARS to find someone that can help fix this. It wasn't until my gynecologist recommended your clinic that I finally felt relief. My pelvic pain is almost gone, and granted I still have a lot more to work on with Laureen (my PT), my original problem is nearly cured. I am so grateful to her.

What is even better is she gave me practical exercises to do at home that were not tedious and provided instant (and lasting) relief. Although I mainly work with Laureen, my interaction with the owner (Heather) has been great. She is very generous, kind, and committed to her business.

It hurts to know there are women out there suffering who will never know or have the opportunity to work with women like Laureen and Heather because this issue is hardly talked about and this field is so rare. I hope more doctors and physical therapists see the value in this work and can relieve more woman of their pain.

-- Julie T., 12/4/16 via Yelp!

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

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 Julie T.

Femina PT (née Fusion Wellness & Physical Therapy) has honestly changed my life. Before receiving treatment at Femina, I was going doctor to doctor to try and find the answer to my pelvic pain. It has taken me YEARS to find someone that can help fix this. It wasn't until my gynecologist recommended your clinic that I finally felt relief. My pelvic pain is almost gone, and granted I still have a lot more to work on with Laureen (my PT), my original problem is nearly cured. I am so grateful to her.

What is even better is she gave me practical exercises to do at home that were not tedious and provided instant (and lasting) relief. Although I mainly work with Laureen, my interaction with the owner (Heather) has been great. She is very generous, kind, and committed to her business.

It hurts to know there are women out there suffering who will never know or have the opportunity to work with women like Laureen and Heather because this issue is hardly talked about and this field is so rare. I hope more doctors and physical therapists see the value in this work and can relieve more woman of their pain.

-- Julie T., 12/4/16 via Yelp!

Testimonial by A.B.

Before I was referred to Heather Jeffcoat I was living in a nightmare. I had been married to my husband for three years and I was suffering from Vaginismus. That all changed when I visited my OBGYN and she said she knew of someone with a great success rate. To be honest I was hesitant at first because my first doctor had already told me that all I needed to do was order dilators from the internet and I should overcome my problem. She was wrong because I had followed the book on how to use the dilators with absolutely no advancements in my condition. However, that all changed when I went in for my first visit and Heather took the time to explain my condition and how we were going to work together to overcome it.

I remember leaving her office with a glimmer of hope that I could live a normal life. As my sessions continued I began to see immediate results. With only four sessions and a strict dedication to my home programs I was cured of Vaginismus. In the beginning of this process I was made aware that my health insurance company might not cover the costs, which was disappointing but today I can say one hundred percent that it was the best money I ever spent. Now thanks to Heather I am finally enjoying my life to the fullest with my husband. Thank you Heather, I can’t begin to tell you how much I appreciate all that you have done for me. I will never forget it. Those who are suffering from these types of conditions don’t be afraid because she makes you feel so comfortable and the end result is worth it. Good luck to you all and I hope you experience the success I have.
-- A.B.

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