Postpartum Physical Therapy

Giving birth and being pregnant can be an emotionally satisfying and beautiful time in a woman’s life. This time can be difficult for some.

Many women suffer from musculoskeletal problems as a result of pregnancy and birth.

There may be an effective solution. A physical therapist can help with many postpartum conditions.

This article will discuss postpartum conditions and physical therapy options.

Postpartum Conditions

A woman’s body experiences many stresses during pregnancy. These include:

  • Weight gain: Progressive weight gain over nine months places more load on your spine, pelvis and legs. This can also alter your posture and place new stress on these muscles.
  • Pregnancy can also cause changes in the ligaments. In preparation for giving birth, hormones are released that make the ligaments stretchier and more flexible.
  • Pelvic problems: During birth, significant trauma can happen in the pelvic and reproductive areas. Because a child’s head must leave the mother’s body via a narrow anatomical space, this is why it can cause significant trauma to their torso and pelvis.

Below are some of the most common diagnoses for postpartum women:

Urinary Incontinence

Many women experience urinary incontinence (or leakage) during and after pregnancy. Some estimates indicate that as many as 30% of women experience this condition within six months after giving birth.

This is believed to be because the pelvic floor muscles become weaker during pregnancy. Even though the uterus shrinks to its normal size, these muscles remain weaker than when it was bigger.

Low back pain

Your abdominal muscles become less effective as your baby grows and your stomach becomes larger. Your low back muscles will become shorter as your lumbar curve (also called lordosis of lumbar curve) becomes more prominent.

These changes can make your core muscles less capable of supporting the spine, which can cause back pain in pregnancy and after birth.

Diastasis Recti

Your abdominal muscles, specifically the rectus abdominis, can stretch during the second and the third trimesters. The tendinous structure running down the middle of the muscle (called linea alba), can begin to separate and widen.

The condition is called diastasis recti and can be found in as many as 59% of women who have given birth within the first 24 hours. This fibrous area becomes thinner and wider, and can even tear. This is when a lumpy feeling appears in the middle or back of your abdomen.

Pelvic Dysfunction or Pain 

The pelvic floor is an important group of muscles that support the pelvis of women and the bladder.

The growing weight of a child during pregnancy can put excessive pressure on the muscles, making them lax and ineffective. These structures can also be torn or laxened by the trauma of childbirth.

There are many potential problems after your baby is born. Possible issues include pelvic pain or sexual dysfunction, pain during sex, pelvic pain, separation or bulging of pelvic organs via the vagina.

Options for Physical Therapy 

PT may be an option for you if you have any of these pregnancy-related issues. First, speak to your doctor about your symptoms. Your doctor may recommend therapy if you feel it is necessary.

This specialization allows physical therapists to help you regain strength and learn how to use your pelvic floor muscles correctly. Each woman’s postpartum condition will be different so they can tailor a treatment plan to suit your needs based on what you tell them and the results of their examination.

When should you seek care?

Talk to your doctor if you feel pain in your pelvic, groin or hip after giving birth.

If you have incontinence or bladder problems, a bumpy stomach (especially if your abdominal muscles are clenched), or if you experience difficulty or pain during sexual activity, the same applies. Women who feel fullness or heavy sensations in their pelvis, or bulging around the vaginal region, should consult their doctor.

Most Frequently Asked Questions


What should you expect from a session of physical therapy?

A comprehensive evaluation is usually performed on the first visit to your therapist. Your therapist will conduct a thorough evaluation of your condition and assess your core, abdominal, and pelvic floor muscles. Your PT will then work with you to develop a customized treatment plan.

A home program that focuses on strengthening and coordination of the above-mentioned muscles is usually created after your evaluation. As you gain strength, coordination, this program can be continued in your subsequent therapy visits. To help you activate your muscles properly and reduce pain, manual techniques can also be used.

What exercises can be used to treat pelvic floor dysfunction (PFD)?

Exercises that train the pelvic floor muscles are a good option for treating many symptoms of pelvic floor dysfunction (PFD), such as urinary incontinence, difficulty with sexual desire, and pelvic pain.

This training focuses on Kegel exercises. These are meant to help you activate and strengthen important muscles under your bladder, large intestinale, and uterus. A biofeedback machine may be used by your physical therapist to visualize muscle contractions and help you turn these structures on.

Pelvic floor therapy often targets structures that are too tight/constantly contracted in pelvic floor. It’s not always about contracting muscles. Sometimes, it’s all about learning to relax the muscles.

What length should postpartum physical therapy be?

It may take a while before your postpartum symptoms start to improve depending on how severe they are. However, some problems such as pelvic pain can be treated with physical therapy in as little as five to seven weeks. Some issues like pelvic floor prolapse or urinary incontinence may require several months of treatment before noticeable improvement can be seen.

Your PT can provide a more precise estimate of your recovery time frame after a thorough evaluation.