Physical and Occupational Therapy after Cesarean Section
- Written by Nancy Hoi Wong OTD, OTR/L, RYT200
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Physical and occupational therapy can help you in your recovery after a C-section 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
Physical and occupational 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 or occupational therapist 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 or occupational 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 or occupational 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 and occupational 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 and occupational therapy 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.
Therapy can help an achy and painful body. An occupational or physical therapist can create a treatment plan that matches your needs while working on typical triggers of pain:
- joint alignment
- muscle strength
- 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 or occupational therapist can help you heal the whole body and help you feel like you again.
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 https://newgradphysicaltherapy.com/postpartum-physical-therapy/
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. http://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.