Taking Care of Your Body

Taking Care of Your Body Pregnancy

and Postpartum

WRITTEN BY KELLEY KOONTZ

The process of going through pregnancy, labor and postpartum is a beautiful thing. It’s also a marathon for your body. From conception, it seems your body is all about preparing for the baby and, after labor, taking care of the baby. But it’s also time to take care of yourself. Did you know physical therapy can help during pregnancy and after? From low back pain, to incontinence, to pelvic organ prolapse and so much more, there are so many benefits to seeing a pelvic health physical therapist during these times.

Not sure what a pelvic health physical therapist is? Pelvic health physical therapists focus on the pelvic region, specifically the pelvic floor muscle group and treat many diagnoses related to this region. The pelvic floor is a muscle group that lives in your pelvis and helps with functions such as having continence with our bladder and bowels, supporting pelvic organs, aiding with sexual function and stability of the pelvis and spine.

Pregnancy and Postpartum Physical Therapy

During pregnancy, your body is continually changing and adapting to growing a human. Your abdominal muscles are adapting to an expanding belly, pelvic floor muscles are helping support a growing baby and most people aren’t sure what exercises are safe. Not to mention, it’s possible your low back and hips may be speaking to you more.

The postpartum period has just as many changes to work through as your body heals and recovers from pregnancy and labor. Depending on whether you gave birth vaginally or had a C-section, they can both come with their own unique set of challenges (or what I like to call opportunities of growth). The biggest thing to remember: It took nine months to grow a baby, it’ll take at least that long to recover.

A physical therapist that specializes in pelvic health can help in the following ways throughout your pregnancy and after child birth:

Low-back, hip and pelvic girdle pain

No, you don’t have to suffer through back, hip or pelvic girdle pain just because you are pregnant or had a baby. Physical therapists can help reduce pain through a variety of techniques including manual therapy and exercise to get you moving better with less pain.

Diastasis Recti Abdominis

Do not fear diastasis recti abdominis. It is completely normal in 100% of women in the third trimester of pregnancy. What is diastasis recti? It is a stretching of connective tissue that runs from your breastbone to your pubic bone that is called the linea alba and it stretches out to accommodate a growing baby. Physical therapy can help manage diastasis recti before and after pregnancy.

Exercise during pregnancy and the postpartum period

There is so much you can do for exercise and there are many benefits of exercising during pregnancy (especially if you have a low-risk pregnancy) including: reduced risk of gestational diabetes, less likely to need a C-section, less likely to have a larger fetal birth weight, reduced risk of postpartum depression and potential reduction of the length of first and second stages of labor. Pelvic health therapists can help guide you through the unknowns of exercise during pregnancy, and they are the experts of knowing what’s going on with the pelvic floor and core. Physical therapists can help give you guidance throughout your pregnancy for when and IF you need to modify exercises. In the postpartum period, it can be difficult to know what you can do to get back to exercise. Physical therapists are the experts at helping and guiding you back to your pre-pregnancy level of fitness.

Incontinence (Urinary Leakage)

This can be common, but not normal. Maybe you have heard of Kegels for pelvic floor strengthening, but not everyone needs to do them and those who do benefit from instruction in doing them correctly. It has been estimated that about 30% of women perform Kegels incorrectly. Pelvic health therapy can help figure out if your pelvic floor is tight or weak and prescribe an individual plan for you. Post pregnancy, many moms will say they can’t jump on a trampoline anymore or have certain exercises they can’t do because they might leak, a pelvic health therapist can help prevent this.

C-section, episiotomy or perineal tear care

A C-section is a major abdominal surgery. You would expect to see a physical therapist after knee, hip or shoulder surgery, why not after a C-section? With incision sites or tearing, you may need help to reduce scar tissue and get either your abdominal muscles or pelvic floor muscles working correctly during the healing process.

Pelvic organ prolapse

Pelvic organ prolapse is when one or more of your pelvic organs descends into the vaginal canal. This is common after giving birth and physical therapy can help reduce and manage symptoms.

These are the most common things seen in the clinic during the pregnancy and postpartum periods, and the list doesn’t end there. Pelvic health physical therapy can help with even more than was mentioned here. Even if you don’t have concerns about these symptoms, or have them at all, it’s a good idea to check in with a pelvic health physical therapist. Your body went through a lot of hard work and needs some time to rehabilitate your abdominal and pelvic floor muscles. Whether you just had a baby or are 20 years postpartum, it is never too late to get the care you need.

Kelley Koontz is a physical therapist that specializes in orthopedics and pelvic health at APRS Physical Therapy. She enjoys treating conditions of the spine, pelvis and lower extremities, persistent pain and pelvic health conditions. She has taken multiple courses to further her education including the pelvic floor continuing education series through the Herman and Wallace Pelvic Rehabilitation Institute. She is certified in Functional Dry Needling and a certified Pregnancy and Postpartum Corrective Exercise Specialist. She enjoys exercising in her free time, going on adventures in the great outdoors of Montana, and is a coach at Orangetheory Fitness.