Postpartum

After 6 weeks, you can start gradually progressing your exercises, but it’s important to avoid high-impact activities that might set back your healing. This is the perfect time to see a pelvic floor PT for a full postpartum assessment if you haven’t already. We’ll check your posture, movement patterns, abdominals, spine, pelvis, and pelvic floor muscles.

Many women continue to hold onto patterns from pregnancy into postpartum, which can lead to long-term issues like chronic pain, leakage, pressure, and discomfort. A thorough evaluation with a pelvic floor PT will help you safely rebuild strength and prevent these problems as you continue your recovery. 

At your 6-week follow-up, your OBGYN checks for signs of infection and ensures you aren’t at risk for any serious medical complications. However, they do not assess your abdominal or pelvic floor muscles or screen for pelvic floor dysfunction.

Only a pelvic floor PT can thoroughly examine your pelvic floor and provide a personalized treatment plan for common postpartum issues like urinary or fecal incontinence, pressure or prolapse, diastasis, pelvic pain, pain with sex, hip or back pain, and tailbone pain. While your OBGYN is there to ensure your overall medical health, your pelvic PT focuses on helping you regain strength, comfort, and confidence so you can live your life and spend time with your family without worry.

It’s best to wait until 12 weeks postpartum before returning to high-impact activities. 

Why? Jumping back into intense exercise too early without building back your foundation can lead to postpartum issues like leakage, prolapse, diastasis, and pain in the future– especially after multiple pregnancies. 

But don’t worry, this doesn’t mean you have to be sedentary for 12 weeks. During this time, you’ll focus on rebuilding your foundation and gradually strengthening your body with progressive exercises to challenge your body. This way, when you do return to high-level exercise, you can do so confidently, without fear of setbacks.However, patients who come in for prenatal PT often recover smoother and can safely return to higher-impact and intensity exercises even sooner under supervised postpartum rehab. By preparing their bodies during pregnancy, they set themselves up for a faster, more confident postpartum recovery.

Some signs that your body might not be tolerating exercise include an increase in vaginal bleeding, leakage, pressure, or pain. These symptoms suggest you may have over-exerted yourself and need to scale back.

For example, if you’re two weeks postpartum and go for a 1-mile walk, but then notice heavier bleeding afterward, it’s a sign that 1 mile might be too much for now. In this case, reducing the distance is more appropriate at this time.

Remember, every individual is different, so it’s important to listen to your body and adjust as needed.

Yes, you can do sit-ups again, but timing and technique are key. Before returning to sit-ups, it’s important to first rebuild your foundational core strength. Once you’ve built up to the point where sit-ups are safe, you need to make sure you’re not putting extra pressure on your pelvic floor and core while performing them.

Poor form and technique during sit-ups can potentially worsen pelvic floor symptoms. Consulting with a pelvic floor physical therapist will help ensure your form is correct and safe.

No, you don’t need an abdominal binder. In fact, for some people, an abdominal binder can increase pressure on the pelvic floor and delay healing, potentially raising the risk of leakage and prolapse.

Instead, we recommend wearing comfy clothing and compression leggings or shorts to support blood flow and lymphatic drainage after birth. If you’ve had a c-section, try to avoid clothing with a waistband at the incision level—high-waisted options are usually more comfortable. One of our favorite brands is Bao Bei!

Once your OBGYN clears you to resume intercourse, it’s normal to experience some initial discomfort, but this should quickly resolve. If pain persists, it may be a sign of either scar tissue from a healing perineal tear or stitches or overuse of the pelvic floor muscles due to pregnancy, labor, or delivery.

This can happen even for women who had a C-section. Pain with sex is one of the top complaints we treat for C-section mamas! If the pain continues, it’s a good idea to consult with a pelvic floor physical therapist to address the root cause and help you feel more comfortable.

It’s unlikely that postpartum pelvic floor dysfunction will heal on its own. Many women dismiss pelvic floor issues until they become major problems, but waiting often means more time and visits are needed to resolve them. If you’re planning on future pregnancies, these conditions can worsen over time. Early intervention with pelvic floor therapy can help you address the problem before it becomes more severe.

Pelvic floor PT awareness has only started to grow in the last 5-10 years, thanks to more women advocating for themselves. The lack of awareness or skepticism around pelvic floor therapy might be why it wasn’t mentioned to you. Many of our postpartum patients ask the same question!

This is why we’re committed to spreading awareness and letting people know that help is available. You’re not alone, and we’re here to support you on your journey.

If you had a c-section, you might actually need pelvic floor therapy even more than someone who had a vaginal birth!

Here’s why: Many postpartum problems stem from the physical demands of pregnancy itself. During pregnancy, your joints and pelvic floor muscles are under constant strain from carrying your baby. This can weaken or overly tense the pelvic floor, potentially leading to issues like urinary or fecal leakage, pelvic organ prolapse, diastasis recti, pelvic pain, pain with intercourse, pelvic girdle pain, tailbone pain, and hip or back pain. If you had an unplanned C-section and labored before the surgery, your pelvic floor muscles were likely impacted by the labor itself as well.

Additionally, c-sections often leave behind significant scar tissue, which can create a “shelf-like” appearance and may pull on joints and fascia, causing tailbone, hip, back, or abdominal pain. Pelvic PT can help address and treat this scar tissue to alleviate these symptoms.

Lastly, remember that a c-section is major abdominal surgery. After any major surgery, physical therapy is key for full recovery and a return to normal activity. During a c-section, seven layers of tissue are cut or pulled apart. Without proper pelvic PT, these muscles may not heal to their fullest capacity, leading to pain and limited activity for years to come. Pelvic PT will guide you in retraining your abdominals from the inside out for complete healing.