New moms sometimes don't know that the physical changes their bodies went through during pregnancy and childbirth are normal, and that help is available for overcoming the discomfort. Here are 5 things women often don't know can be successfully addressed postpartum by a physical therapist:
1. Vaginal Pain
I often hear, “I just don’t feel right down there, “ from my new moms. This is most often caused by a healing episiotomy or tear that required stitches, hormonal changes, pH imbalances, and dryness. There is not much you can do in the form of medication or supplements that can address this issue when you are breastfeeding, so physical therapy offers a conservative way to treat these symptoms as soon as you are aware of them.
2. Adhesion/Scar Tissue Management
Not many people are told about how scar tissue or adhesions formed as a result of an episiotomy or C-section can contribute to pain with intercourse, abdominal or low back pain, GI dysfunction, or sexual dysfunction. In 2007, it was estimated that 32% of women delivered by Cesarean section, and in 2002, that 11% of all vaginal deliveries utilized an episiotomy. Scar tissue will form after any traumatic injury or cut to soft tissue. Scar tissue has a tendency to be very messy and unorganized, forming layers of tissue that can attach to surrounding muscles, nerves, and fascia, creating a painful lump. While you are healing, a physical therapist can help the scar tissue lay down in a more organized manner, prevent adhesions to surrounding tissues, and prevent pain.
3. Mastitis or blocked ducts
Mastitis is a breast infection that often occurs when a blocked duct cannot clear or when there has been trauma to the breast when breastfeeding. Since this infection develops very quickly, the first line of defense is usually to speed to the emergency room and get on antibiotics, which is a heartbreaker for any new mom. This can be avoided if you contact a physical therapist at the first sign of infection or if you have a persistent blockage that you are unable to clear on your own. Mastitis symptoms can usually be cleared in 1-2 sessions.
4. Abdominal /GI issues
Have you thought about where all of your abdominal organs get pushed to as the baby grows? Possibly not, but your GI system and urogenital system were greatly stressed during this time. Many new moms notice a change in their digestion and bowel habits following delivery. A skilled women’s health physical therapist can help you restore GI motility and mobility to ease your abdominal and digestive changes.
5. Overall pelvic health
In France, women are offered perineal and abdominal reeducation sessions following delivery. Their women have significantly less reported incontinence or pain in the first year following childbirth. Since we do not have any government mandated program for pelvic rehabilitation, we must advocate for ourselves. Please mention any of the above symptoms to your physician at your 6 week follow-up, or sooner, and ask if they work with a women’s health PT or pelvic PT in the area. Many states allow direct access to a physical therapist, so a prescription is not always needed.
EA McDonald, D Gartland, R Small, SJ Brown. Dyspareunia and childbirth: a prospective cohort study. BJOG: An International Journal of Obstetrics & Gynaecology, 2015; DOI: 10.1111/1471-0528.13263
Menacker, Fay, Dr. P.H., and Hamilton, Brady, PhD. Recent Trends in Cesarean Delivery in the United States. NCHS Data Brief. Number 35. March 2010.