Your main focus throughout the post-partum period should be protecting your body. In general, this includes but is not limited to your pelvic organs, pelvic floor musculature, fascia surround pelvic inlet, and abdominal wall/cavity. Pelvic floor dysfunction is common postpartum. Signs and symptoms that need to be addressed include: urinary or fecal incontinence, pelvic pain, diastasis recti, pelvic organ prolapse. Whether you had a vaginal or cesarean birth pelvic floor dysfunction can occur. If you experience any of the above symptoms do not hesitate to contact a pelvic floor physical therapist.
It is fair to guess that you’ll probably have so many other things on your mind that protecting these body parts won’t be high on your list of priorities. Here are some very minor changes you can make to your daily activities and habits that will have a big pay-off down the road.
- Wear high-waisted compression throughout the day while doing activity. This will reduce the stress your organs place on your abdomen and pelvic floor, and may lead to a reduction in diastasis recti. You can wear high-waisted leggings, a compression tank top (such as Blanqi), or an abdomial binder (such as Belly Bandit). When wearing an abdominal binder or compression garement make sure that you wrap it upwards or put on bottom to top so that pressure is not exerted towards pelvic floor.
- Be mindful of your posture by sitting on your ‘sitz bones’ instead of rolling back onto your tailbone and sacrum. You may consider buying a breastfeeding pillow such as My Breast Friend to help keep you from slouching while nursing in a big chair or on a couch.
- Avoid ‘crunches’ in your daily activities. Crunches can increase the separation between your rectus abdominus, which leads to the post-pregnancy ‘pooch’ or mommy tummy. When getting out of bed, don’t sit straight up. Instead, be sure to roll to your side and push up with your arm.
- Lift and lower objects properly by engaging your transversus abdominus (or TA) before moving a load. You can engage your TA by imagining pulling your hip bones together, toward the midline of your body.
- Avoid constipation through your diet and water intake. You may consider adding a natural supplement to your diet if you’ve discussed it with your provider. It is important to avoid constipation because straining to make a bowel movement puts additional pressure in your abdomen, and ultimately your pelvic floor. Self massage can help move bowels.
- Drink plenty of H2O: Try to drink as much water as you can throughout the day (at least half your body weight in ounces).
Postpartum physical therapy can address a wide array of these issues, such as:
- Diastasis Recti
- Rib pain
- Back pain
- Hip pain
- Neck pain
- Pubic bone pain
- Incisional pain from C-section
- Episiotomy pain
- Painful sex
- Urinary/fecal incontinence
- Urination frequency
- Pelvic organ prolapse
- Pressure/heaviness in vagina
Treatment may include, but not be limited to:
- Postural restoration
- Proper body mechanics for lifting
- Trigger point release and scar tissue mobilization
- Individualized program for safe return to exercise
- Education on breast feeding positioning and posture
- Pelvic floor strengthening and core strengthening
When should you initiate physical therapy post-partum?
- According to the American College of Obstetrics and Gynecology it is best to initiate physical therapy at 6 weeks post partum if vaginal delivery and 8-10 weeks if C-section
Merci Ortenzi Treaster is a pelvic health therapist at Functionize Health & Physical Therapy. She treats prenatal and postpartum clients, pelvic pain, urinary/fecal incontinence, constipation/ IBS, diastasis recti, and supportive dysfunctions. Merci received her Doctor of Physical Therapy degree from Mercer University.