Is Postpartum Physical Therapy Right for Me?
Body After Baby: How Postpartum PT Can Help
Feeling Strong and Pain-Free After Childbirth
Whether giving birth for the first time or fifth, by vaginal delivery or cesarean section, bringing that new little bundle of joy into the world can take a toll on mom’s body. It may be challenging to find time to prioritize your physical recovery from pregnancy and childbirth or to address any new aches and pains that develop as you care for your little one but doing so is an important part of what has been termed the “fourth trimester”. This fourth trimester is a concept that emphasizes the need to address lingering health concerns in postpartum women and physical therapists play an essential role during this time.
WHAT POSTNATAL CONDITIONS CAN PHYSICAL THERAPISTS TREAT?
In this section we will take a look at some of the conditions that can develop before, during, and after childbirth that when lingering, should be evaluated by a physical therapist with experience in postnatal care or pelvic health.
Ligament laxity and joint pain: Many women are familiar with the discomfort in their joints that can develop during pregnancy. Throughout pregnancy a woman’s body is changing proportions and size to accommodate the growing fetus and the onset of pregnancy-related hormones leads to increased laxity in tissues and joints. Some women may experience discomfort or pain in their legs, arms, back, neck, or pelvis as the pregnancy progresses. These hormones can persist for several months after delivery, even for a short while after breastfeeding stops.
While joint pain that occurs in response to carrying the weight of a growing fetus may disappear upon delivery, parenting an infant often includes repetitive movements that can lead to new pain or injuries.
Back pain: Can you imagine how many times in a day, an hour, or a week, you are bending down to pick up your growing baby from the bassinet, the floor, the carseat? Persisting ligament laxity, weakened core muscles, and use of poor biomechanics can lead to back pain that can interfere with your ability to care for your little one and yourself.
Wrist pain: without thinking, most of us will automatically cock our wrist to the side and stretch open our thumbs while bottle feeding a baby or supporting their head. Over time, this repetitive motion can cause inflammation to develop in the tendons of the thumb that run along the inside of the wrist. This condition, called De Quervain’s Tenosynovitis, or “mother’s thumb” can cause mild to severe pain at the base of the thumb along the inside of the wrist.
Neck Pain: Sitting in prolonged positions while breastfeeding or holding your baby while they sleep can cause neck pain to develop. Even falling asleep in uncomfortable positions or holding your baby on one side of your body more than the other can cause uncomfortable neck pain to develop.
Diastasis Rectus Abdominis: A diastasis rectus abdominus is a separation of the left and right outermost abdominal muscles known as the rectus abdominis. It most commonly occurs as a result of pregnancy. As the fetus grows, increased pressure is placed on the connective tissue between the two sides of abdominal muscles causing separation. It commonly develops during the second or third trimester and often will resolve on its own in the first few postpartum months. Sometimes, however, it will persist and can cause discomfort, feelings of weakness in the abdominals, low back, hip, or pelvic pain, and feelings of “flabbiness” in the abdominals
Pelvic Floor Dysfunction: Carrying a growing fetus and the process of giving birth vaginally can lead to postpartum pelvic floor dysfunction. Pelvic organ prolapse, pelvic pain, and incontinence are the most common conditions.
Pelvic organ prolapse occurs when the muscles and tissues of the pelvic floor that support the organs of the pelvis–the bladder, uterus, and rectum–become weakened causing the organs to descend out of position into our out of the vagina. This can happen soon after giving birth or years later. The pressure from the descended organs can sometimes be felt or seen in the vagina and women may experience uncomfortable sensations of pressure during physical activity or sex. Aside from feeling increasing pelvic pressure, urinary incontinence or problems having bowel movements can also be signs of pelvic organ prolapse.
Women can experience issues with fecal or urinary incontinence after childbirth in the absence of pelvic organ prolapse. Weakness or impairments in the muscle control of the pelvic floor may be the cause of incontinence and while you may hear other moms joking about “peeing a little” when they laugh, cough, or exercise, it is not considered a “normal” side effect of pregnancy or delivery and should be addressed by a pelvic health physical therapist.
HOW WILL POSTPARTUM PT HELP ME?
While the lack of sleep and never ending diaper changes may be out of your control for a while, living with postpartum pain, discomfort. or pelvic floor issues are not. A consultation with a physical therapist knowledgeable about pre- and postpartum conditions and treatments should be a priority within the first few months after giving birth. Here are some of the ways physical therapy can help:
Education: While you may not feel you have the time to begin new exercises right now, there are likely very simple changes and modifications you can make to the routines you already have in place that can relieve some of your symptoms. For example, if you are experiencing back, neck, or wrist/thumb pain, your physical therapist can suggest ways of lifting your baby, feeding your baby, and holding your baby that will keep them comfortable while reducing irritation and discomfort in your own body.
Pelvic floor physical therapy: if you are experiencing pelvic pain, incontinence, pelvic organ prolapse or other problems with your pelvic floor, it is important to see a specialist in pelvic health to begin to address these issues early on. To learn more about what to expect during pelvic floor physical therapy, check out this article on our site (I thought we could link to the pelvic floor PT article I wrote)
Manual therapy techniques: Hands on techniques such as joint mobilization, soft tissue mobilization and myofascial release may be applied to improve joint and tissue mobility to reduce symptoms of pain and tightness.
Strength and flexibility training: Strengthening and stretching or mobility exercises to optimize strength and flexibility can help improve conditions such as back pain and prevent their recurrence in the future. It can also be used to treat a diastasis rectus abdominis.
Modalities: The application of modalities such as ice and heat, ultrasound, or electrical stimulation may be used to address pain and inflammation.
If you are experiencing any of the conditions described in this article, don’t put off getting the help you need and deserve. Addressing postpartum concerns early will allow you to focus on the joy of raising your child and the physical therapists at Evolve are here to support you. Call us today and let postpartum physical therapy be the answer to getting your strong and resilient post-baby body.
Click here for more information on post partum physical therapy in Brooklyn
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Brooklyn's Premier Holistic Physical Therapy Clinics- There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better!
First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.
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