Pelvic Floor Physical Therapy

Pelvic Floor Physical Therapy

As I mentioned in my Postpartum Recovery post, I had to do Pelvic Floor Physical therapy. Today I wanted to share about my experience with it as I had never heard of it before I needed it. I hope that this becomes more well-known to women as it really aided in my recovery. In many other countries, this kind of therapy is the norm after a woman gives birth, but sadly the US has not widely accepted this. After 3 or 4 months of still having pain in my episiotomy area, I went back to the doctor. She referred me to a pelvic floor physical therapist and I made my first appointment. 

The First Appointment

My first appointment was an initial evaluation to see what was wrong, what needed to be done, and also to talk to me about my pregnancy, labor and delivery, and recovery so far. The evaluation was 60 minutes and began with just talking. After taking notes on our conversation, my physical therapist had me hold some poses and took notes on how things looked. After our discussion, we did an internal exam. I was nervous about this but it turned out to be not too bad. It’s never comfortable to get an exam like that, but she was very gentle and professional and made me feel comfortable. She told me she recommended 4-6 sessions with her and in that time, she was pretty confident my pain would be gone. I scheduled a few sessions in advance, and left to return the next week to begin our sessions.

What Were the Sessions Like?

Internal Work

Each appointment began with internal work. The physical therapist gently massages internal and external scar tissue. This helps to loosen and flatten the build up that causes women pain after delivery. During the internal exam, a physical therapist also applies pressure to different areas of muscle to check for spasms and places of stress. This portion usually lasts anywhere from 10-20 minutes of the 60 minute session. My first two sessions were very uncomfortable and I felt a good deal of pain during the internal work, but after that the pain began to lessen. During the exam, she would ask how things were feeling and was very gentle and professional. Nothing was ever over-worked or forced where things felt unbearable. 

External Exercises

After completing the internal work, I got dressed again for some external exercises. It’s important after delivery to restrengthen your pelvic floor even if you aren’t still having pain. We worked on some strengthening exercises for the hips, legs, pelvis, core, and back. Most women experience some kind of discomfort after a vaginal delivery in the pelvis, especially if they choose to breastfeed. Breastfeeding hormones make your joints very loose and lax which causes lots of general discomfort in all joints. We focused on moves to help take pressure off tired joints and moves to strengthen the entire pelvic floor. Exercises that we focused on during our session are also meant to be done daily at home in order to speed up your recovery. I did exercises whenever I had a few moments at home. We worked on exercises for about 15-20 minutes of the session and took pictures of the poses so that I could look at them for reference while at home.

Breathing Exercises

Another really important aspect of my recovery was learning breathing techniques. We focused on different types of breathing techniques that relax the pelvic floor. After 1 week of mindfully breathing and doing the techniques multiple times a day, my pelvic muscles began to spasm less. I was very surprised at how important this aspect was for recovery for me. We usually began the session with breathing work while she worked internally and ended the session with some relaxation breathing for about 5 minutes or so. We also focused on breathing that engaged the core and back and breathing to work on while feeling the extra joint pain.

6.5 Months Postpartum Update:

Now at 6.5 months postpartum, I’m feeling very good. The physical therapy was so helpful to me and I now do not have any internal or external pain or muscle spams. I still have joint pain which will most likely continue until I stop breastfeeding, but it is now a bit more manageable with my new exercises and breathing techniques. I would highly recommend any woman to at least see a pelvic floor physical therapist after having a baby even if they aren’t having pain. They can really help you know how to ease back in to working out in a safe way depending on how your joints and body are postpartum. For me, it meant that I couldn’t really work out much besides walking for the first 6 months. When I tried to do more than that, my body didn’t feel right. Listen to your body and don’t push yourself when things don’t feel normal. It can be tempting to push yourself when you want to lose the baby weight or bounce back to your old self, but in the end it just does more damage. It really can take 1 full year for things to feel good and normal again for many women

Exercise & Weight:

I’m now cleared for low impact exercises and yoga. I’m hoping to start with light yoga 3 times per week or so and see how that goes for me for a while. After that, I hope to begin incorporating low impact cardio and strength training in the mix.  It’s been frustrating to not be able to see much tone and muscle like I used to have, but I’m just happy things are feeling healed up for me now.

As far as the number on the scale, I’ve been at my pre-pregnancy number since about 3 or 4 months postpartum. I know that with time, things will begin to tone again and I’m just not stressing about it. Rather than obsessing over tone and muscle, I’ve been focused on eating healthy filling foods for my milk supply. I’m giving my body as long as it needs, even if that means not feeling as toned right now. For now, keeping up my milk supply, eating healthfully so that I’m satisfied, and moving my body gently are my priorities. Losing fat and gaining muscle tone will come in time.I’ll check back in with you all somewhere between 9-12 months postpartum with any updates. Mamas, be kind to yourself and give your body the time it needs! 

Any recovery or physical therapy questions? How long did you give yourself postpartum?

Tell me in the comments below!

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8 thoughts on “Pelvic Floor Physical Therapy

  1. I’m proud of you for taking the initiative to go and do physical therapy! And this was really interesting to read – I have no idea what all it would entail. I’m so glad you are feeling better, and it sounds like you’re only going to continue to feel good from here on out! Good job, mama!

    • Thanks, Christina! Yes, most countries do it as the norm regardless of any underlying issues. It helps speed recovery for both c section and vaginal deliveries. I learned so much. If/when baby number 2 comes along, I will definitely plan to go even if I don’t have the same postpartum pain.

    • I know…most drs don’t even recommend it and that makes me so sad because without it I’d still be in pain all the time.

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