Written by: Devin Burson, PT, DPT, PCES; MOJO pelvic health physical therapist and a new mom
“My hope is for this blog post to shed more light on what physical therapy intervention looks like during the pregnancy and postpartum seasons of life as well as how amazing and resilient both the spirits and bodies of mothers truly are.” - Devin
1. Better Understand Postpartum Healing “Timelines”
“I am 6 weeks postpartum/past the fourth trimester, I should be able to do everything I did before I was pregnant. How long will it take to heal? Why is my body failing me?”
This is something I hear from many people who have just given birth but to understand the postpartum healing timeline, we must first understand that the body is forever changed after we carry and have a baby and that it’s totally normal!
After pregnancy and birth, the muscles of the pelvic floor and abdomen are lengthened. Some studies have shown that it can even take 9-12 months for the rectus abdominis muscle (the muscle between the ribs and the pubic bone) to return to its previous level of thickness after carrying a child. It takes time for the muscles to return to a less lengthened state, improve their coordination, and become stronger. Beyond this general timeline, we also all heal at different rates depending on factors such as nursing, childcare responsibilities, and any pregnancy and delivery complications (just to name a few!). Your body just went through an amazing process, and now it is learning to be a mother as well. We need to give the body some grace instead of a harsh timeline.
2. Get Pain Relief During Pregnancy
Being a physical therapist does not exclude me from experiencing pain. Some common pregnancy issues include low back, pelvic, and hip pain. I personally experienced pubic symphysis pain or “lightning crotch” and I was so grateful to have an objective perspective from another pelvic floor therapist who helped me receive some pain relief so I could continue to walk, exercise, and do my job without discomfort.
3. Learn to Adjust to the New “Normal”
I want to make the distinction between “normal” and “common.” Some common postpartum complaints include pain at the c-section scar, pain with sex, and urinary incontinence. Although it is common to have these things, it is not normal and something can be done about it! There is no cookie cutter approach to these issues and we love to help moms discover the right exercises and tools for them.
4. Gain Confidence in the Delivery Room
Beyond working with someone that is dealing with pubic symphysis or low back pain, a pelvic floor therapist can help with education on labor positioning, perineal stretching, and pelvic floor muscle coordination during labor and delivery. Knowing that I knew how to relax my pelvic floor muscles in a variety of labor positions helped me feel more confident on delivery day.
5. Know What Is and Isn't Safe in the 4th Trimester
Everyone is different. Some people can start running or doing HIIT workouts at 12 weeks postpartum and some may have more success at 6 months postpartum. Pelvic floor physical therapy can help you determine what your pelvic floor is ready for exercise wise. I personally had more early success with weightlifting and HIIT workouts early on, but had to ease myself back into running.
6. Learn to Adjust Exercises During Pregnancy
We have all been told of the benefits of exercise during pregnancy but what is appropriate for a pregnant body looks different than a non-pregnant body. Physical therapy can give you the tools to ensure correct muscle engagement is occuring to help reduce pressure on the abdominal wall and pelvic floor.
7. Help Return to Activities that You Love
I have been a runner since I was 6 years old. I was so surprised that when I tried to run at 14 weeks postpartum, I really struggled. Instead of panicking or being disheartened, I followed a return to running program and focused on building up my hip, pelvic floor, and leg strength. Almost 11 months later, I can now do the same run I was doing prior to stopping at 22 weeks pregnant….without peeing myself! Sharing a run with my son in his jogging stroller is one of my greatest joys. I am so thankful that I had the knowledge and help to return my body back to running postpartum.
8. Have a Team Behind You
It was so nice knowing that I had my amazing OB/GYN, labor and delivery nurses, birth educator/doula, lactation consultant, and my sweet coworkers (other physical therapists) all helping me and my son have a healthy pregnancy and recovery. Pregnancy can throw us some curveballs as can the postpartum period. I know I had my share! There were scary and confusing moments but I knew I did not have to work through them alone since I had a team behind me.
9. Get Tips for “Mommy and Me” Workouts
This one is just for fun! A lot of the exercises we give you on your postpartum journey include your everyday mom duties but can also sometimes be done with your little one as well. My son and I have shared some sweet moments both doing our “exercises.”
If you’re local to the Memphis area, you can also check out Fit4Mom Memphis for in person exercise sessions, where baby/toddler is included: https://memphis.fit4mom.com/