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How physical therapy delivers the most effective post-C-section care

April is Cesarean Awareness Month around the world

Closeup of woman belly with a scar from a cesarean section. Woman with baby on her hand
Physical therapy after a C-section can help women gain strength and reduce any long-term issues.
iStock / Special to On the Minds of Moms
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Like after any other major surgery, the post-cesarean-section experience is no walk in the park; you’re talking pain, limited activities and likely scarring, not to mention that recovery takes weeks.

Yet for many women, the surgery can have lasting effects, including loss of core strength, urinary incontinence and back pain. So how can women prevent these issues or effectively treat them once they’ve started happening?

With the right post-C-section care.

“The American College of Gynecology and Obstetrics recently recommended that moms have some sort of follow-up at around three weeks post-partum,” women’s health clinical specialist Jill Ehrmantraut said. “Our local hospitals primarily follow-up around six weeks, but your pelvic floor physical therapist is an appropriate person to see at three weeks post-partum.”

In fact, working with a physical therapist after most major surgeries is a typical part of the care plan, and one that’s critical to helping patients get back to pre-surgery strength and warding off any long-term issues. But post-C-section physical therapy is only now gaining visibility for its huge benefits in this arena.

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Ehrmantraut, who works for Apex Physical Therapy and Wellness Center , added that working with a physical therapist early on after a C-section is the most effective way women can reduce scar pain, as well as improve core and pelvic floor strength to speed up healing and prevent any future issues.

Why it’s important

During pregnancy, women’s core muscles naturally weaken and even more so if they’ve had a C-section, which involves cutting through multiple layers of muscle. These core muscles work alongside the pelvic floor muscles to do many functions; you really can’t separate the two. When your core is weak, your pelvic floor may try to pick up the slack, which can cause issues such as urinary incontinence or pelvic pain. Even the scar itself can contribute to core weakness and eventual back pain.

Women who’ve had a C-section are also at risk for DRA, or diastasis rectus abdominus, the softening or doming up and down the middle of your abdomen, which again can contribute to back pain.

What can women expect when working with a physical therapist? 

A physical therapist will work on the C-section scar to ensure it is moving appropriately and decrease pain as it heals. Therapists also help moms find comfortable body positions and movements while taking care of the baby which will reduce stress to the abdomen and scar as well as decrease pain.

Once more healing has occurred (between 3-6 weeks), guided core and pelvic floor exercises can begin. This will help improve mobility and restore strength to those areas that weaken during pregnancy, helping your body return to “normal” quicker and prevent any long-term issues such as lower back pain and urinary incontinence.

Can physical therapy also help expecting moms achieve a better outcome post-baby?

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Absolutely! Maintaining core and pelvic floor strength is one of the main things a physical therapist will work on with pregnant women. When your core and pelvic floor are conditioned going into delivery, it can make the process a little easier and quicker, for both a C-section or vaginal delivery.

Also, the better those muscle groups are functioning during pregnancy, the better they will function once the baby is here! That will not only assist in the healing process, but also make caring for baby easier as you will have more strength and stamina to do so. A PT will also be able to identify body or muscle imbalances during pregnancy so they will no longer be an issue after you have your baby.

Is there anything unique in terms of post-C-section therapy for women who have had or will have more than one?

There will be more scar tissue when having multiple C-sections. Although they will use the same incision site, each time you have surgery, scar tissue still develops. Multiple C-sections also mean multiple incisions through your core muscles. Because of this, it’s very important to appropriately rehab your core muscles to prevent any long-term weakness, along with good scar tissue releases to reduce restrictions and pain.

Why does physical therapy work? 

There are many musculoskeletal changes during pregnancy. A pelvic floor PT will assess for all of the changes women experience and develop an individualized plan to address the musculoskeletal issues found. This will improve the function of the muscles and joints in your body, which can have profound effects in how we move throughout our life.

Anything else women should know? 

whether you have a C-section or vaginal delivery, your body has gone through some major changes. Even in one visit we will be able to assess how your body is functioning and give recommendations (including exercises) on how to restore your body so you can function at your highest level. Physical therapy is common practice for any other injury or surgery, it needs to be common practice for pregnancy and postpartum as well!

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Melissa Davidson is a mom to three girls and writer for Click Content Studios, a marketing and video production agency. In addition to writing, she’s passionate about health and wellness, wishes she could get through all the non-fiction books out there, and thrives on learning new things, like the cello!
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