I had a c-section, do I still need PF PT?
The short answer is YES! Having a c-section does not necessarily mean that you are “saving” your pelvic floor. During a c-section your abdominal muscles were cut open, having a big impact on your core and your pelvic floor. There are 3 ways that your pelvic floor can still be affected after a c-section.
Pelvic Floor Tension
During pregnancy your pelvic floor muscles are naturally working hard to accommodate your growing baby. At the end of pregnancy, those muscles are working extra hard and without the natural stretch of a vaginal birth, they can stay tight. The pelvic floor muscles also tense up when you are in pain. A c-section plus nine months of pregnancy can lead to an overly tight pelvic floor. The tightness can lead to urinary incontinence, painful sex, difficulty with starting to pee and urinary urgency.
Scar Tissue Restrictions
There are seven layers of tissue that are cut during a c-section. One of these layers is called Superficial Abdominal Fascia. This layer is directly connected to the tissue around your urethra and scar tissue restrictions can lead to urinary issues including incontinence and pain.
Second Stage C-Section
Typically uncommon and only found in about 2% of births, second stage c-section occurs after the cervix has dilated and pushing has begun. Pushing produces a high amount of stress on the pelvic floor and can lead to pelvic floor issues postpartum, even if the outcome is a c-section.
Follow these steps to reduce the impact of a c-section
Respect your healing time. You might feel better after 2-3 weeks but full healing time can be as long as 6-8 weeks.
Move! Movement is key to recovery and can help improve scar healing. Start with gentle, pain free movements and short walks. Slowly build up your walks over 6-8 weeks.
Breathwork. Breathing is a great way to wake up your core and lengthen your scar from the inside out. Diaphragm breathing helps you reconnect with your body and is the first step to deep core work and pelvic floor strengthening.
Scar massage. Massaging your scar can help relieve tension and pain.
Strengthen. Lifting anything heavier than baby is not recommended but progressive strengthening is important. Start with gentle pelvic floor, core and hip stability exercises that are low impact and low load.