By Libby Borman
Women’s Health Physiotherapist Life Ready Physio Yokine

Women’s health physiotherapy can optimise your postnatal recovery and can help women achieve their exercise goals safely.

One of the most vivid memories I have from the first week after giving birth to my son, was the extremely squishy, jelly like feel of my stomach and that it was so difficult to use my tummy muscles. It stands out in my memories, just as much as the painful, engorged breasts and being more tired than I had ever truly imagined possible. I know I am not alone with this memory, as most women I see on the maternity ward or in my physio clinic, frequently express the same observations. And frequently, it is the reason why they have made an appointment to see me.

During pregnancy, the abdominal and pelvic floor muscles are on constant stretch as the baby grows inside the uterus. This is facilitated by the pregnancy hormones that can take six months to leave your body. When you combine the immense changes your body has undergone during pregnancy, with the physical feat of childbirth plus major abdominal surgery (if you underwent a caesarean section), it is quite obvious that it may take your body some time to recover.

Were you surprised at how different your body felt after the birth of your baby?

Are you concerned or frustrated with how long it might take for your body to recover?

Did you know that a women’s health physiotherapist can complete a whole body assessment and help you identify the factors slowing your postnatal recovery?

Once you’ve got the assessment findings, you can then set goals and receive practical advice and support that will help you keep up with the physical demands of parenting AND safely return to exercise.

I’ve had the 6 week checkup with my GP, so why would I need to see a physiotherapist?
Most new mothers are advised to have a 6 week checkup with their obstetrician or GP. This appointment normally includes a quick inspection to check that the perineal or abdominal scar is healing, some questions about how you are coping, a pap smear if it is overdue, and the potential organisation of some contraception.

What does a postnatal appointment with a women’s health physiotherapist include?

1. Pelvic floor muscle check-up: Using a Real Time Ultrasound machine and/or internal vaginal examination the physiotherapist will determine the strength and endurance of your pelvic floor muscles. These muscles are very important as they help you control your bladder and bowel and provide stability to your pelvis.
2. Abdominal muscle separation test: Your physio will gently feel the middle of your tummy to see if you have a gap between the rectus abdominal muscles (a.k.a rectus abdominus diastasis) and to assess your core muscle strength. A large separation and/or weak abdominal muscles will change the appearance of your abdomen and affect their strength and potentially result in a back injury or frustration at a persistent pregnant appearance.
3. Episiotomy and perineal scar observation: Have the episiotomy or stitches healed completely and is there any pain when the area is touched? This will give you some idea of when to try have sex again and if there is anything you need to do to help it heal completely.
4. Caesarean scar observation: Is the abdominal scar healed completely and do you have any change in sensation or numbness? We can teach you to massage the caesarean scar to help these symptoms disappear.
5. Musculoskeletal screening: Especially the areas such as your back, neck and wrist. Pain in these areas are common when looking after a newborn and we can provide treatment or exercises that will help.
6. Pelvic organ prolapse screening: Do you have any vaginal heaviness, lumps or bulges within the vagina that may be a pelvic organ prolapse? Do you want to know how to prevent a prolapse in the future? A women’s health physiotherapist can provide you information on the integrity of your vaginal walls and identify any risk factors of developing a prolapse.
7. Bladder and bowel questions: It is quite common for women to experience concerns with their bladder or bowels after having a baby. It could be urine leakage, unable to control wind or stubborn haemorrhoids. A women’s health physio can ask specific questions to help diagnose the bladder or bowel problems and then help you fix them. Suffering from bladder leakage is not something women should feel they just have to “put up with it”! It is definitely something a women’s health physio can assist you with!
8. Goal setting: We will discuss your exercise goals and come up with a treatment plan that will help you achieve them.

I believe knowledge is power and that all women should be able to get back to exercise which they enjoy. Exercise helps so many aspects of our health -physically, mentally and emotionally. It is important that you understand where your body is at in the postnatal recovery process because this allows you to be guided through appropriate exercises to help the recovery be safe and injury free.

Do you want to participate in a high impact sport such as HIIT, running or basketball?
Then I truly recommend a postnatal assessment so you know that your body has recovered sufficiently to cope with the stresses that you will be putting through it. Preventing urine leakage and pelvic organ prolapse is so much easier than needing surgery later on in life to fix it.

Need more information?
If you want more information please send an enquiry to libbyborman@lifereadyphysio.com.au if you have any questions or learn how we can help optimise your postnatal recovery!