The Benefits of Pelvic Floor Physical Therapy After C-Section

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Our postpartum bodies may look and feel different than they did before pregnancy – even if you had a cesarean delivery. The pelvic floor plays an important role in both vaginal and c-section births, and is affected by the changes that occur throughout the duration of pregnancy. Postpartum recovery isn’t just about getting back into pre-baby shape. 

A cesarean delivery bypasses the need for the baby to pass through the vaginal canal, but even so, a woman’s pelvic floor muscles, vaginal tissues, and vulvar structures can still experience significant strain during pregnancy. This tension can lead to postpartum issues related to urinary control, bowel function, and sexual activity. It is important. 

Patients who have had a cesarean delivery may find that the tissue around their healing incision has become restricted, leading to pain and difficulty with functional movement. Postpartum bodies are unique and can require special attention when it comes to recovery and restoring function. 

What to expect in a pelvic health assessment after cesarean

The connective tissue of the abdomen may be one of the first places a pelvic physical therapist will assess for postpartum mothers who have had a cesarean section. This is due to the numbness, pain, tightness, and mobility restriction that may occur in this area from scarring. Additionally, many women find it difficult to activate their abdominal muscles, which can make physical activities more challenging. It is important for postpartum mothers to speak with their physical therapist about any issues that may be occurring in this area, and ask what exercises or treatments may help them regain full mobility and strength.

The pain a patient may experience after a cesarean delivery can be quite varied. It could manifest in the form of diffuse abdominal pain, localized discomfort at the incision site, and/or muscular pain or tightness during physical activity. Additionally, patients may feel sensitivity to touch around the scar as well as numbness.

Pelvic floor assessment via internal exam
 A pelvic floor physical therapist can assess your postpartum body through an internal vaginal exam (with consent). This helps identify if there are any areas of tightness and determine how well the pelvic floor muscles can contract and relax. This level of examination allows for more precise treatment that is tailored to your unique needs, increasing the chances for successful recovery from childbirth.
The pelvic floor muscles are incredibly important for postpartum bodies, and should be a focus when it comes to regaining strength after pregnancy. Not only do they help with controlling bladder and bowel movements, but they are also critical for supporting the internal organs during daily activities or exercise. And of course, these muscles are an essential part of good sexual function too!
Tissue restriction from cesarean scar
he effects of postpartum scarring can be far-reaching. Scar tissue restriction from an abdominal or cesarean scar can include the following:
  • Cesarean shelf 
  • Painful sex
  • Pelvic pain
  • Back pain
  • Painful ovulation and menstruation
  • Straining during bowel movements
  • Unable to empty bladder
  • Section incision site feels numb, fuzzy, painful or sensitive 

What you can do to help your cesarean shelf

After childbirth, the area around your scar will likely feel numb. It is important to start lightly massaging your abdominal area within 2-3 inches of the scar in order to help it heal and restore blood flow and sensation. This massage should be gentle, as too much pressure can cause discomfort.

 Following the postpartum period, it is important to care for your scar. After six weeks, you can start massaging it gently with slow and gentle movements. Move the scar up and down and from side to side in a circular motion. Spend more time on areas that are harder or tighter to move around. It’s okay if these areas take longer – be patient and consistent, as regular massage can help to reduce the appearance of your scar.

Spending 2-3 minutes a few times a week on scar management will help improve its appearance, making it softer, flatter, and less purple.

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