Pregnancy and Postpartum

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Pelvic floor physical therapy can be very helpful to postpartum mothers. Pregnancy and childbirth can be a traumatic event to a woman’s pelvic floor, causing pain and dysfunction to muscles and tissues in the region. Pelvic floor muscles extend between the pubic and tailbone, supporting your uterus, bladder, and bowel. As such, they play an essential role in bladder and bowel health, sexual functioning, and pelvic stability. When pelvic muscles are tight or weak, they can cause a variety of symptoms or even pain.

Pelvic floor physical therapists can evaluate your pelvic floor to determine if musculoskeletal factors are causing or contributing to the condition. If they are, physical therapists can then provide manual therapy to address any underlying impairments. Physical therapists can also create tailored exercise programs for each patient to either strengthen weak muscles or help relax tight/short muscles.

Pelvic floor physical therapy can help with many common postpartum issues:

  • Urinary issues
    • Stress incontinence: Leaking with impact. Stress incontinence may occur from weakened pelvic muscles that support the bladder.
    • Urinary urgency: A sudden, compelling urge to urinate even when the bladder is not full. Urinary urgency can caused by overly tight pelvic muscles.
    • Urinary hesitancy: Difficulty starting the flow of urine. Also typically due to overly tight pelvic muscles.
  • Bowel incontinence: Difficulty controlling gas and/or bowel movements, often the result of injury during the birthing process. Manual therapy together with neuromuscular re-education can be highly effective.
  • Diastasis Recti: The separation of the linea alba, which connect the two sides of the abdominal muscles. Physical therapy can be highly effective in non-severe cases.
  • Perineal pain: Pain in the area between vagina and rectum, can last post childbirth even after wounds have healed. Perineal pain can be the result of a tear, episiotomy, or tight muscles in the region. The perineum plays an essential function during vaginal childbirth, making it prone to injury.
  • Pain with intercourse: Many women experience pain during sex (dyspareunia) for months or even years after childbirth. This is typically caused by muscle injury during the birthing process and can be effectively treated with physical therapy intervention.
  • Pubic symphysis, or pubic pain: The pubic bones can become misaligned during pregnancy or childbirth. Sometimes women will even hear a pop when the pubis comes out of alignment (pubic symphysis diastasis), which can create pain with sitting, standing, and other functional movement, and can be very debilitating. PT helps align the bones/joints and create dynamic stability with muscle support.
  • Pelvic organ prolapse (POP):  Pelvic organ prolapse (POP) can occur when the muscles and ligaments supporting a woman's pelvic organs weaken, and the pelvic organs slip out of place (prolapse). This doesn’t usually happen immediately after childbirth but symptoms can arise down the road. There is also a significant genetic component to the condition. POP typically doesn’t involve pain but can lead to functional problems such as leaking or a “pressure” discomfort as the tissue loses elasticity and starts to fall down. There are three main types of prolapse: cystocele (vagina), rectocele (rectum) and enterocele (uterus). Physical therapy improves the muscular support of and blood flow to the pelvis, which may result in reduced symptoms and prevents the organs from slipping further out of place.

How can Tanya help?

Pelvic floor physical therapy can help with all of the above pre/post partum pelvic symptoms. For issues related to weak muscles (e.g., stress incontinence, prolapse), PTs can provide neuromuscular rehabilitation, which involves re-teaching your vaginal muscles to properly contract and relax on command. For overly tight pelvic floor muscles, physical therapists can perform manual therapy to release trigger points and break up any impairments. With Tanya Goodrich PT, DPT you will get a full hour of hands-on care by a doctor of physical therapy without the use of an assistant or machines, providing you with highest quality of care.

Treatment/What To Expect

During your first appointment, Tanya will take your medical history, and then provide a thorough musculoskeletal exam of your pelvic region, evaluating posture, joint alignment, muscle restrictions or “trigger points,” connective tissue health, muscular strength, and typically an internal examination. The internal exam is performed in a relaxed, comfortable setting, and provides important information to the physical therapist about your condition. After the exam, she will explain all of her findings and provide a treatment plan to get you better. Treatment typically consist of 6-12 follow up visits, with patients usually feeling better after the first visit, and showing significant improvement over the course of full treatment.

 

Tanya is accepting new patients at her practice in Belmont, CA.

To schedule an appointment, please email tanya@healthypelvis.com or fill out the form below. Please note any information you provide is entirely confidential.

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