• Katie Moise PT, DPT

Top 10 Reasons To See A Pelvic Floor Physical Therapist After Cesarean Birth

There is a common misconception that you don't need to see a pelvic floor physical therapist if you had a cesarean birth. Most women think if they didn't have a vaginal delivery then their pelvic floor muscles were not affected so there is little benefit in seeing a pelvic floor PT. However, this is farther from the truth! Pelvic floor PT can be beneficial to educate on bed mobility, bladder and bowel habits, tips to reduce pain, address scar tissue mobility as well as how to safely regain core strength and improve overall function. Here are the top 10 reasons you should see a pelvic floor PT after cesarean birth:

1. Bed Mobility

Unfortunately, after cesarean birth, there is not much guidance given to new moms about how to move safely without causing more pain or increased tension on their abdominal wall. One of the first things I like to teach patients is how to get out of bed without straining your abdominals. The best way to do this is to use a log roll technique. First, start lying on your back and bend your knees. Then, roll onto your side. Next, swing your legs off the side of the bed. Leverage the weight of your legs as well as your top arm to help push you up into a sitting position. Make sure you aren't holding your breath as you come into sitting.

2. Gut Function

Pelvic floor physical therapists can educate you on how to improve your gut motility and bowel health. Hydration is key. I like to tell patients to aim for drinking half your body weight in fluid ounces. It also can be helpful to start taking some stool softeners or magnesium to keep stools soft and easy to eliminate. We also focus on nutrition and fiber to make sure you are getting the nutrients you need to heal and keep your gut optimally working.

3. Breathing

Diaphragmatic breathing is an integral part of your core function. Learning how to properly breath is so important for the health of your pelvic floor and core. Your pelvic floor physical therapist can guide you on how to improve your breathing patterns in a variety of positions.

4. Posture

Whether you are breast or bottle feeding, it is important to pay attention to your posture to avoid aches and pains in the future. We can educate you on how to improve positioning with pillows as well as different mobility stretches and exercises to reduce tension in your neck, shoulders and mid-back. After cesarean birth, I recommend sitting up tall rather than spending too much time bent over looking at your baby while feeding (I know this is hard to avoid, especially with a cute little one!)

5. Pelvic Floor Assessment

Evan after a cesarean birth, you may experience changes to your pelvic floor function that can result in urinary leakage, constipation or pain. Your pelvic floor supported your growing baby for 10 months; therefore, it has undergone changes and most likely those muscles have been lengthened and weakened. It is important to be assessed by a pelvic floor physical therapist to understand how well your muscles are able to contract and relax as well as if there are any areas of tenderness or tightness in the muscles. Understanding the function of your pelvic floor will help you optimize your bladder, bowel and sexual function.

Pelvic floor physical therapist and patient

6. Diastasis Recti Assessment

Pelvic floor physical therapists are trained in assessing for diastasis recti abdominus (DRA). This is when there is separation of your abdominal wall (the 6 pack ab muscles). Restoring core function is crucial to allow you to return to day to day activities as well as help you reach any fitness related goals you may have. We can teach you how to properly engage your deeper core muscles and to manage your abdominal pressures as your tissues continue to heal from surgery.

Pelvic floor physical therapist checking for Diastasis Recti Abdominus

7. Scar mobilization

Many women have an aversion to touching their scar after cesarean birth. However, it is so important for us to mobilize this tissue so that adhesions or excessive scar tissue does not build up. The scar that you see on your skin is about 10% of what is actually there. Therefore, it is easy for scar tissue to build up underneath the surface. Restrictions in your scar tissue mobility can lead to abdominal pain, pain with sex or other pelvic floor dysfunction. A pelvic floor PT can guide you on appropriate ways to begin stimulating the scar with light touch and then progressing to variety of textures as the scar tissue has healed. We can also instruct you on ways to perform scar massage to make sure the scar moves well in all directions. It is important to make sure your scar has healed and there are no signs of infection before starting to mobilize your scar. Check with your pelvic floor PT on when to begin this process!

8. Pain Free Sex

Did you know it is more common for women to have pain with sex following cesarean birth compared to vaginal birth? There are a multitude of reasons why, including poor scar mobility or restrictions in your abdominal wall. A pelvic floor physical therapist can do a thorough assessment of your movement patterns, check your pelvic floor and abdominal wall to get to the root cause of your symptoms. It is great to be proactive with this assessment to mitigate pain with sex.

9. Lifting Mechanics

Once you are cleared by your provider to begin lifting light weights, a pelvic floor PT can guide you on the best body mechanics and breathing strategies to lift your baby, car seat, stroller, groceries, etc off the floor. In reality, it is hard to avoid lifting in our daily life. The best way to protect your body from future injury is to learn how to lift correctly.

10. Return to Exercise

When is it safe to run again? Can I go back to my Crossfit gym? How should I modify certain ab exercises? There is so much information on online about exercises you should do or avoid after baby. It can be overwhelming for some people and they feel stuck on where to even begin. Everyone's fitness goals or exercise routines can be different, but a pelvic floor physical therapist can guide you on the best exercises for you to start building a strong foundation. This will allow you to return to the activities you love without abdominal pain or pelvic floor dysfunction.

Do you still have more questions or want to see if pelvic floor physical therapy is right for you? Schedule your discovery call with us today!

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