Healing Beyond the Scar: The Benefits of Pelvic Floor Physical Therapy After C-Section Delivery

Each year, over 1.2 million Women will undergo C-Section (Cesarian Section) Delivery in the United States, making it the most common surgery performed (Wasserman et al 2018).

Many mothers aren't prepared for the unique postpartum challenges that come with it, particulary when it comes to their pelvic health. These mothers are not only recovering from major surgery, but they are also dealing with weakened core muscles, low back pain, hip pain, pelvic pain, and/or unexpected bladder and bowel issues (yes, these are common symptoms post C section delivery as well). You combine these symptoms with caring for a newborn, there is a potential increase of post partum depression and anxiety, especially if the C-section was not planned (Grisbook et al 2022). The combination of these symptoms can make post partum recovery even harder.

Pelvic Floor Physical Therapy offers solutions to these often overlooked issues, helping moms regain strength, reduce pain, and improve bowel and bladder symptoms for a smoother transition into motherhood. Let's explore the many benefits of Pelvic Floor Physical Therapy after a C-section and why it's worth considering for every mother's recovery plan.

4 Key Benefits of Pelvic Floor PT following a C-Section

Helps improve healing and recovery
During the recovery process following a C-section delivery, a Pelvic Floor Physical Therapist utilizes a variety of techniques to promote healing and overall well-being. These techniques include:
- Manual techniques
- Scar tissue mobilization
- Self-care education
- Modalities
- Exercise
By employing a holistic approach, the Pelvic Floor Physical Therapist aims to address physical and emotional aspects of recovery, helping individuals regain strength, mobility, and comfort after a C-section.
Reduces pain and discomfort of the back, hips, neck and pelvis
By addressing C-section scars, you are decreasing tension and pain the the surrounding tissues. This includes connective tissue to the back, hips, abdomen, and pelvic floor.

C-section surgeries are one of the most common causes of built up scar tissue leading to back pain , as well as sciatica, in the post partum woman. What causes this discomfort? Adhesions that develop around organs, nerves, and ligaments/tendons (Wasserman et al 2018)

Many women will also report pelvic pain following C-sections that can affect intimacy with their partner. Through various modalities and manual techniques, the Physical Therapist will address scar tissue, adhesions, and pelvic floor tension to improve sexual health (Wasserman et al 2018)

Bladder pain is another common symptom experienced by mothers. They may describe pain during bladder emptying, urgency, or when the bladder is full. They might also complain of an overactive bladder, which means that they often rush to the restroom because they struggle to hold their urine due to pain and urgency. These symptoms can prompt them to seek assistance for issues resembling UTIs, potentially resulting in unnecessary antibiotic prescriptions. If you have had a C-section and are experiencing these symptoms, Pelvic Floor PT can help!

Pelvic Floor Physical Therapy aims to utilize evidence based techniques to reduce pain and improve quality of life. If not addressed in the post partum period, the mother runs the risksof developing chronic pain.
Strengthens core muscles (including the pelvic floor) weakened during pregnancy and childbirth
Regardless of her level of activity prior to surgery, many women will experience weakened core muscles. It is crucial to keep in mind that being cleared to resume activities after a C-section does not necessarily mean you can exercise at the same intensity as before. Pelvic Floor PT will provide a safe foundation for regaining your core strength for overall stability and decreased risk of injury post partum. By working with a Pelvic Floor PT, you will also improve symptoms of prolapse and diastasis recti, as well as, decrease your risk of developing these problems in the futre.
Improves bladder and bowel function
Many women experience urinary and/or bowel incontinence following surgery. Pelvic Floor PT will aid the mother in eliminating and preventing this debilitating symptom. Through PT, mothers will regain pelvic floor strength and coordination, education on bowel and bladder health, as well as, manual techniques to improve overall heath of the bowel and bladder systems.

Another common problem following C section delivery is constipation. This occurs not only due to pain meds and anesthesia, but also to scar tissue and adhesion development. This can lead to chronic constipation if not addressed early on. Pelvic Floor PT will aim to address this issue early on to improve overall bowel health.

Each woman's recovery journey is unique. Pelvic Floor Physical Therapy offers individualized treatment plans that meet each woman's needs. Your specific symptoms and goals for recovery will be addressed, ensuring effective and comprehensive care.

In summary, Pelvic Floor physical therapy plays a significant role in healing after C-section by restoring function, strength, and comfort, as well as, over all well being. Pelvic PT addresses the multi system challenges that arise post-surgery, promoting a holistic approach to recovery. By participating in pelvic floor PT, women can enhance their recovery experience, regain confidence in their bodies, and enjoy motherhood with greater ease and comfort.

Lena Miquel, MSPT, PRPC

Wasserman, J.B., et al. (2018). Soft Tissue Mobilization Techniques Are Effective in Treating Chronic Pain Following Cesarean Section: A Multicenter Randomized Clinical Trial. Journal of Women's Health Physical Therapy 42(3):p 111-119

Grisbrook, M, et al. (2022). Associations among Caesarean Section Birth, Post-Traumatic Stress, and Postpartum Depression Symptoms. Int J Environ Res Public Health. 18;19(8):4900

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