Pregnancy and childbirth bring numerous changes that impact the pelvic floor muscles, nerves, and connective tissues. Pelvic floor therapy helps reduce or eliminate symptoms of pelvic floor dysfunction (PFD), significantly improving the quality of life.
The Pelvic Floor
Everyone has a pelvic floor, a group of muscles that support the urinary and reproductive systems and control the bladder and bowels. It’s important for women, especially those who are pregnant, to understand the importance of pelvic floor muscles and how to prevent pelvic organ prolapse, as childbirth and labor are significant risk factors.
The changes that occur during pregnancy and childbirth can impact the nerves, muscles, and connective tissues of the pelvic floor. The pressure, stretching, or tearing often associated with these processes can result in pelvic floor weakness or dysfunction (PFD).
Pelvic floor dysfunction (PFD)
PFD is the inability to properly control and coordinate the muscles of the pelvic floor.
Postpartum PFD symptoms might include low back pain, pelvic girdle discomfort, prolapse, fecal incontinence, and urine incontinence since the pelvic floor muscles support the uterus, bladder, and rectum.
Some people see a gradual resolution of postpartum PFD symptoms following delivery. These issues and symptoms, however, can last for many years and affect a person’s physical, social, emotional, and sexual well-being, among other aspects of their quality of life.
Pelvic floor dysfunction occurs when your pelvic muscles are unable to relax or function properly as a team. If these muscles remain tight and fail to relax, it can result in:
- Constipation
- Frequent urination
- Difficulty controlling bowel or bladder movements, causing leaks
- Pain during sexual activity in women
What is Pelvic floor therapy?
Pelvic floor therapy is a type of physical therapy that helps strengthen and improve the coordination of pelvic floor muscles.
Pelvic floor physical therapy (PFPT), also referred to as pelvic floor muscle training (PFMT), is a conservative, first-line treatment for many pelvic floor disorders.
PFPT is a general term for the instruction of pelvic muscle strengthening, relaxation, and coordination exercises by a trained physical therapist. PFPT may involve manual therapy, biofeedback or electrical stimulation, behavioral education, and the creation of home exercise programs.
The goal of pelvic floor physical therapy is to ease your symptoms, aiding in postpartum recovery, so that you can get back to your daily routine.
What Conditions Can Pelvic Floor Physical Therapy Treat?
Pelvic floor physical therapy is effective in managing various conditions that lead to pelvic floor dysfunction.
Bladder issues such as Urinary incontinence, Urinary frequency, Urinary urgency, Frequent urinary tract infections (UTIs).
Bowel problems such as Constipation, Diarrhea, Irritable bowel syndrome (IBS), Fecal incontinence etc.
Pelvic floor physical therapy can help with sex-related pain or dysfunction, including:
Vaginismus (involuntary contractions of the vagina).
Dyspareunia (pain during intercourse).
Anorgasmia (delayed or absent orgasms).
Additional conditions that may benefit from pelvic floor physical therapy include:
Endometriosis
Post-prostatectomy
Peyronie’s Disease
Antepartum and postpartum conditions.
Pelvic pain.
Diastasis recti (separation of the large abdominal muscles).
Pelvic organ prolapse.
Techniques and Exercises
Pelvic floor physical therapy may involve various techniques or exercises, such as:
Trigger Point Therapy: This method applies pressure to specific trigger points in the body, either internally or externally. In some cases, a doctor or therapist may inject anesthesia into the area to provide relief. This technique is often part of postpartum recovery to address muscle tension and improve pelvic health.
Kegels: These pelvic health exercises involve strengthening pelvic floor muscles by repeatedly contracting and relaxing them. Kegels can help alleviate pain during sex, improve control over incontinence, and support postpartum recovery. A physical therapist (PT) can guide you on how to perform Kegels effectively as part of your pelvic health exercises to strengthen the pelvic floor after childbirth.
Electrical Stimulation: This technique reduces pelvic pain and muscle spasms, often aiding in postpartum recovery. Your PT may perform this treatment in-office or teach you how to use specialized equipment at home, helping with pelvic health exercises to address discomfort after childbirth.
Biofeedback: Using devices to monitor pelvic floor muscle contractions, biofeedback helps assess progress and improve pelvic health exercises. Electrodes may be placed externally, such as near the vagina or anus, or an internal probe may be used to measure muscle tension and relaxation. The results are displayed on a computer screen, allowing your PT to guide you in strengthening after childbirth and improving pelvic function.
When is the best time to start pelvic floor physical therapy?
The first month after childbirth, often referred to as the “fourth trimester,” is a critical time for the body’s recovery.
The postpartum period is typically divided into three phases:
Initial/acute phase: This spans the first 6 to 12 hours after childbirth.
Subacute phase: This lasts from two to six weeks following delivery.
Delayed postpartum phase: This begins after the subacute phase and can continue for up to six months or longer.
During these phases, caring for a newborn, along with other children or family responsibilities, can be physically demanding. Many mothers may adopt movement patterns that are less than ideal during the postpartum phase. Recently, the American College of Obstetricians and Gynecologists recognized the need for improved postpartum care and updated its guidelines to include physical therapy as part of maternal recovery. PT is recommended right after childbirth to help address issues like urinary and fecal incontinence, diastasis recti abdominis (DRA), pelvic organ prolapse, and pain.
If you’re experiencing symptoms like pelvic pain or dysfunction that are impacting your quality of life, consult your doctor to determine if pelvic floor physical therapy could be beneficial for your postpartum recovery and overall pelvic health.
FAQs for Understanding Pelvic Floor Therapy as Part of Standard Postpartum Care
Pelvic floor therapy is a type of physical therapy designed to strengthen and improve the coordination of pelvic floor muscles to alleviate dysfunction and enhance postpartum recovery.
Pregnancy and childbirth can weaken or damage pelvic floor muscles, leading to symptoms like incontinence, pelvic pain, and prolapse. Therapy helps restore function and improve quality of life.
Symptoms include urinary or fecal incontinence, pelvic pain, low back pain, pelvic organ prolapse, and difficulty controlling bladder or bowel movements.
Techniques include Kegels, biofeedback, trigger point therapy, electrical stimulation, and tailored exercise programs to strengthen and relax pelvic muscles.
Ideally, therapy should begin during the postpartum “fourth trimester” (within the first month after childbirth) for optimal recovery.
Therapy treats urinary incontinence, constipation, pelvic pain, diastasis recti, pelvic organ prolapse, and postpartum recovery issues.
Biofeedback uses devices to monitor muscle activity, providing real-time feedback to improve muscle control and relaxation.
Yes, therapy addresses pain during intercourse caused by conditions like vaginismus or pelvic muscle tension.
Yes, pelvic floor therapy can strengthen the muscles and tissues that support the pelvic organs, potentially reducing the risk of pelvic organ prolapse.
Recovery time varies, but therapy typically begins within the first few months postpartum and may continue for several months depending on the severity of symptoms.
