This post was written by Margaret Bronson, supervisor outpatient therapy, Parkview Therapy Services.
A cesarean section, or C-section, is a surgical procedure in which a baby is delivered through an incision in the mother's abdomen and uterus. Since approximately 1 in 3 babies in Indiana and Ohio are born this way, these procedures may seem routine, but they are major abdominal surgeries with their own risks and complications. One such complication is pelvic floor dysfunction, which you can address by seeing a pelvic physical therapist postpartum.
What is pelvic floor dysfunction?
Pelvic floor dysfunction occurs when the muscles, ligaments and connective tissues that support the pelvic organs weaken or when the pelvic floor and associated muscles develop increased tension. This can cause a range of symptoms, including:
- Pain or discomfort during sex
- Urinary or fecal incontinence
- Pelvic organ prolapse
Risk factors and treatment options
While pelvic floor dysfunction can affect women of all ages, it is particularly common after childbirth and can occur following a C-section. Fortunately, pelvic physical therapy can be an effective way to address these issues. Pelvic physical therapy is a type of physical therapy that focuses on the muscles and tissues of the pelvic floor, as well as other areas of the body that can contribute to pelvic floor dysfunction. Here are a handful of post-op challenges that a pelvic physical therapist can assist with:
Issue: Scar tissue/adhesions
The incision from a C-section can lead to the formation of scar tissue, which can cause pain and/or discomfort. Pelvic physical therapy can help to break up this scar tissue, improving the patient’s range of motion and reducing pain.
Issue: Weakness and muscle imbalances
Pregnancy and childbirth can weaken the pelvic floor muscles, leading to incontinence or prolapse. A pelvic physical therapist can help identify these weaknesses and create a personalized exercise program to strengthen and balance the pelvic floor muscles. Additionally, these therapists will assess for abdominal weakness, diastasis recti and lower back dysfunction that can carry over after pregnancy into the postpartum period.
Many women experience low back or pelvic pain after a C-section. There is a 2 to 5-time increase in the incidence of low back and pelvic girdle pain in patients following cesarean delivery compared to vaginal delivery. This can be due to a variety of factors, including scar tissue, muscle imbalances and nerve damage. Pelvic physical therapy can help to alleviate this pain through manual therapy techniques, stretching and other interventions.
Incontinence is a common problem after childbirth and can be particularly challenging for women who have had a C-section. Pelvic physical therapy can help address this issue by strengthening the pelvic floor muscles and teaching women how to properly engage these muscles while caring for their child and during physical activities to manage intraabdominal pressure and prevent urine leakage.
Pelvic organ prolapse is a condition in which one or more of the pelvic organs (such as the bladder, uterus or rectum) shift out of their normal position. This can cause discomfort, pain and incontinence. Pelvic physical therapy can help address postpartum prolapse by strengthening the pelvic floor muscles and teaching women how to properly support the pelvic organs. These therapists also work closely with PPG – Gynecology and PPG – Urogynecology to determine the most appropriate treatment plan for the prolapse.
Women can improve their quality of life and regain confidence in their bodies after childbirth by working with a pelvic floor specialist. Making an appointment after a C-section can be a valuable way to address pelvic floor dysfunction and other related issues.
Parkview has a specialized Pelvic Physical Therapy Clinic at Parkview Regional Medical Center, and two pelvic therapists at Parkview Huntington Hospital several days a week. If you or a loved one would like more information, please contact Parkview Pelvic Physical Therapy Services at 260-266-4080 or Parkview Huntington Outpatient Therapy at 260-355-3240.