I'm a C-Section Mama.  Why do I need Pelvic Physio?

One of the most common postpartum myths that I hear is that c-section mama’s don’t need pelvic physio.  It sounds like it makes sense right? If you don’t have a vaginal birth why would you be concerned about your pelvic floor? Well even without having a vaginal birth, I still see a lot of c-section mama’s who have concerns like urinary incontinence, pain with sex, constipation, low back pain, hip pain and even sometimes prolapse.  So if you’ve had a c-section and aren’t sure why you might need pelvic floor physiotherapy, here are five reasons! 

You Still Carried the Baby 

Regardless of how the baby comes out, your pelvic floor and core still have to adapt to a pregnancy for nine months.  During pregnancy there is an increased demand on the pelvic floor and inner core tissues because of the biomechanical changes associated with being pregnant.  These can include decreased mobility of the diaphragm, increased pelvic floor tension, increased difficulty engaging the inner core, heaviness and pressure in the pelvis among other things. These changes can contribute to things like urinary incontinence, pelvic pain, low back or hip pain and pain with intercourse.  So even if you don’t have a vaginal birth, pregnancy related changes can cause postpartum symptoms. 

You Have Scar Tissue 

During a c-section, there are many layers of the abdomen that are affected by scar tissue from the surgery.  There are 7 layers of tissue that are impacted during a surgery; skin, adipose (fat) tissue, fascial tissue, rectus sheath, rectus abdominis muscles (separated not cut), parietal peritoneum, loose peritoneum and then the uterus.  All of these layers can develop scar tissue as they heal which can cause adhesions among the layers.  This can create low back pain, difficulty engaging with the core muscles, pain or numbness at the scar tissue site, among other things.  It is important to have the scar tissue assessed to make sure all 7 layers are healing well and that you won’t have issues with pain further down the line! 

Your Core Needs Rehab 

Pelvic floor physiotherapy isn’t just about the pelvic floor! It is also about the inner core unit which consists of the pelvic floor, the diaphragm, the core muscles and the back muscles.  The core muscles, as we just talked about, are largely impacted by pregnancy and c-section surgery and rebuilding the strength in the core is really important after a c-section.

Some important muscle groups to think about postpartum are the obliques (internal and external), the adductor muscles in the thigh, the lower core (transverse abdominis), the diaphragm AND the pelvic floor.  As you can see c-section rehab is much more complex than just the pelvic floor and re-building strength in all of the core muscle groups is important post surgery!

Your Scar Might be Numb

Numbness of the scar tissue is another common concern post c-section and believe it or not this isn’t something that you have to live with! One component of rehab post c-section in pelvic physio is helping heal the superficial nerves in and around the scar tissue to improve any numbness or pain associated.   If you’re having a hard time wearing high waisted jeans or underwear, make sure to book a pelvic physio appointment! 

Proactive Care is the Best Care 

Being proactive about your pelvic health is the best type of care.  I can’t tell you the number of women who come in 10+ years postpartum or during menopause who wish that they’d been more proactive about their pelvic health right after they had their kids.  Even if you don’t have symptoms or concerns, it can be important to come for a general assessment after birth, to get some information and help yourself heal in the best way possible.  And that stands regardless of whether you’ve had a vaginal or a c-section birth! 

There you have it, five reasons it is important to see a pelvic PT after a c-section birth. If you’re looking to schedule an assessment, you can do that here!