Physical Therapy Can Help with THAT? Part 2b: Postpartum Edition

Here’s the (long awaited, sorry guys!) second part of PT Can Help With That? Postpartum Edition

Like I mentioned in the first part of this post a few months ago, postpartum care in the US is in need of a serious upgrade. Unfortunately, this means that all you Mommas out there need to be advocates for yourself. You need to speak up when something is wrong and find someone that can help you. This post is to help you realize that there is much to be done to help these super common postpartum aches and pains. So if you are suffering with any of these, contact me! I’m here to help!

We covered Diastasis Recti, Returning to Exercise Postpartum, Urinary/Fecal Incontinence, and Painful Sex in the first part of this post so read that if you haven’t yet

In this post we’ll cover:

C-section Scar Pain

Pelvic Organ Prolapse

Mommy Thumb

Back Pain (or other aches/pains)

C-section Scar Pain

During a C-Section, multiple layers of skin, connective tissue/fascia, and muscle are cut, held open with tools, and then stitched back up after the baby is out. It is a major abdominal surgery, and should be treated as such. Scar tissue will form, which is normal, but it can limit the mobility of your abdominal fascia and can also be painful with movement or to the touch.

How can PT help?

PTs can perform scar mobilization to help loosen up the restrictive scar tissue and fascia so that it won’t pull or yank when you move. Your PT will also show you how to perform scar mobilization on yourself so you can do it at home too. Performing just a couple minutes per day of scar mobilization can really help symptoms and you should see results fairly quickly.

PT can also help to desensitize the area around the scar so that it isn’t painful when touched. This involves a progression of tactile exercises starting with gentle light touch with your own hand and eventually progressing to rubbing the area with a rougher surface like a towel.

Pelvic Organ Prolapse

Pelvic organ prolapse (POP) is when a pelvic organ, like your bladder, uterus, or rectum, is no longer supported properly by connective tissue and muscle and begins to fall out of its normal place. This isn’t just something that happens to 80-year old grandmas, ladies! This happens fairly frequently in postpartum moms - which makes sense if you think about it. First, your pelvic organs, connective tissue, and pelvic floor muscles had to support the extra weight of a baby and placenta for 40 weeks, and then it had to withstand pushing that baby out! During delivery, it is common to have an injury to the fascia, skin, and/or pelvic floor muscles, which can mean you’re more at risk for a POP.

Some common symptoms of prolapse are a feeling of heaviness or pressure vaginally, difficulty emptying your bladder or rectum fully, or even some low back pain.

What can PT do to help?

A PT can measure your pelvic floor muscle strength, endurance, and coordination via an internal vaginal examination. She will also look at how you are performing those tasks that are the most aggravating, for example, lifting up the heavy car seat or walking. Your PT will come up with a personalized plan of strengthening exercises as well as teach you how to better perform those aggravating tasks so you don’t feel the symptoms as much anymore.

Mommy Thumb

Mommy Thumb (or DeQuervain’s Tenosynovitis) is an inflammation of 2 tendons in your thumb and can occur very commonly in moms because of how they lift their babies. This can be a tricky one to treat because it often occurs on the dominant hand, which you need to use a lot! However, there are plenty of things to be done to help.

How can PT help?

Your PT will tell you to buy a thumb splint to be worn most of the day to allow the tendons to rest as much as possible. You will also be instructed to ice your thumb regularly to help with pain and swelling. Your PT will show you better ways to pick up your baby so as to not aggravate your thumb anymore. Manual therapy to your wrist, thumb, and forearm will also be done so you don’t lose any range of motion.

Back Pain & Other Aches/Pains

Back pain (and other aches and pains) are common postpartum. You are constantly bending over to pick up the baby, bending over to change the baby, bouncing the baby so she’ll go back to sleep, not sleeping...etc etc Your body is doing a lot and it is TIRED. But the good news is, you don’t have to suffer! Just because you delivered a baby, doesn’t mean you are now forced to live in pain. How are you expected to take care of a baby when your body isn’t functioning properly?

What can PT do for you?

Your PT will look at how you are moving, specifically how you are doing those most aggravating tasks. She’ll then teach you how to do them to decrease strain on your painful areas. Your PT will check your muscle strength and flexibility and be able to give you specific exercises and stretches to address your weaknesses. She will also be able to measure if you have a DRA or any pelvic floor muscle weakness that needs to be addressed (yes, your pelvic floor can be implicated in back or hip pain!!).

So, the moral of these posts is to tell you that there is almost always something to be done to help. Gone are the days where women would just suffer in silence - if you are having pain, discomfort, or dysfunction, seek help. Us pelvic floor PTs are here for you!