Postpartum physical therapy: a guide to recovery from pelvic floor physical therapists

Welcoming a baby is an exciting and joyous time. It can also be challenging to recover from delivery while dealing with physical and emotional demands of caring for a newborn. 

The first few months after your baby is born are sometimes known as the “fourth trimester.” It’s a time when your body is recovering and you are navigating all the changes that come with the new addition to your family. Along with joy and excitement, you may also feel overwhelmed, vulnerable, or sad. Movement and exercise can be a great way to help feel better, reduce stress, and improve sleep, but it’s important to start moving safely. 

Postpartum physical therapy can help address common postpartum conditions you may experience.

Here, you’ll learn how pregnancy and birth affect your pelvic floor, the benefits of pelvic floor physical therapy for postpartum recovery, and how to safely get back to movement after having a baby.

Pregnancy, birth, and your pelvic floor

Your pelvic floor is a bowl-shaped group of muscles that stretches like a hammock at the bottom of your pelvis. During pregnancy, these muscles experience additional strain, which can impact their function during daily activities, exercise, or toileting (urination and bowel movements). 

During labor and vaginal delivery, the muscles of the pelvic floor need to relax and stretch to allow your baby to pass through the vaginal canal. If you delivered by C-section, your abdominal incision may affect the support and function of your pelvic floor muscles. 

Physical therapy and exercise for postpartum recovery

Postpartum physical therapy (aka postnatal physiotherapy) and exercise can improve muscle coordination, strength, and flexibility, and help address postpartum symptoms. While your provider typically recommends waiting six weeks after delivery to resume activities like sex and exercise, there are many steps you can take during this period to help with your recovery.

Pelvic floor physical therapy and exercises can help you:

• Improve the strength and mobility of your pelvic floor

• Develop a personalized exercise program to progress safely

• Learn healthy ways to move your body during childcare activities and lifting/carrying your baby

• Find breastfeeding positions that decrease strain on your back and neck

• Adopt good toileting habits to manage leakage and pelvic pain

• Understand recovery expectations after vaginal and C-section delivery

• Manage pressure on your abdomen during daily activities to reduce strain on your pelvic floor and re-engage your abdominal muscles

• Identify postpartum mood issues and when to seek additional help for postpartum depression and/or anxiety

When to try pelvic floor physical therapy 

Many common conditions can occur during or after pregnancy, even with a healthy pregnancy and delivery. Pelvic floor physical therapy may help if you have any of these treatable symptoms: 

• Back, hip, or pelvic pain  

• Pain in the front of your pelvis (over your pubic bone), such as when standing on one leg, putting on or taking off your pants, or getting in or out of bed 

• Leaking urine or bladder incontinence 

• Leaking feces or bowel incontinence (even staining your underwear) 

• Constipation or pain with voiding or bowel movements

• Pain during or after sexual activity

• Pelvic pressure or a feeling of bulging or heaviness in your vagina

• Diastasis recti (doming, separation, or a gap between your abdominal muscles near your belly button)

Getting back to exercise

In addition to doing exercises that target the pelvic floor muscles, you may be eager to get back to activities like running, gym workouts, and sports. Many people are able to resume exercise six weeks after giving birth (get clearance from your provider first). The amount of recovery time you need postpartum can vary depending on any health issues you experienced during pregnancy and birth, your pre-pregnancy fitness level, and the types of exercise you want to do. 

When you resume regular exercise, it’s best to start gradually and ease back in. A pelvic floor physical therapist can help you develop a personalized exercise program to meet you where you are and teach you how to progress safely.

You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit. 

How Hinge Health can help you

If you have pelvic pain, bladder, bowel, or other pelvic symptoms that are affecting your quality of life, you can get the relief you've been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

1. Goldfarb, I. T. (2021, April 6). The fourth trimester: What you should know. Harvard Health Blog. Retrieved from https://www.health.harvard.edu/blog/the-fourth-trimester-what-you-should-know-2019071617314

2. Patel, S. (2017, September 17). The “fourth trimester”: Why women need health care after delivery. UT Southwestern Medical Center. Retrieved from https://utswmed.org/medblog/fourth-trimester-primary-care/

3. Postpartum exercise: How to get started. (2021, November 24). Mayo Clinic. Retrieved from https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth/exercise-after-pregnancy/art-20044596