Physiotherapy after childbirth

Pregnancy and childbirth have ended – you are in the postpartum period. Your body is beginning to recover. Postpartum problems such as stress urinary incontinence, lactation problems, rectus abdominis or poor healing of a caesarean scar may occur during this time. Postpartum physiotherapy can help in such cases. It deals with pelvic floor therapy, soft tissue therapy, including caesarean scars, as well as the implementation of physical activity.

Stretch mark of the rectus abdominis muscles

Usually heals spontaneously within 8-24 weeks after delivery. However, this depends on the overall fitness of the woman’s body and the size of the stretch. This complication is best diagnosed about 2 weeks after delivery. In such situations diaphragmatic breathing is recommended. The diaphragm is one of the deep muscles on which the condition of the abdomen and its possible separation depend. The physiotherapist will gradually implement exercises to engage the pelvic floor muscles and the deep abdominal muscles. You must avoid heavy lifting, hunching and excessive pelvic anterior tilt and consciously control smooth muscle tone.

In the case of a scar after a caesarean section

Physiotherapy management should begin about 4-5 weeks after surgery. By this time the scar has healed and direct work on the area can begin. Before that, you can work on the adjacent tissues. The scar therapy consists mainly of manual mobilisations, i.e. massage techniques and muscle and fascial relaxation, which are supported by physical treatments such as biostimulative laser or iontophoresis.

Milk letdown

This is a physiological condition usually occurring 2-6 days after birth when there is an overproduction of milk in the breasts. Here, too, we can help with physiotherapy consisting of the technique of gentle stroking from the top of the breast to the nipple. In the case of an obstructed flow of milk, we can apply warm compresses to the breasts 30 minutes before feeding, and cold compresses after feeding to reduce swelling and pain.

Management of stress urinary incontinence

Kegel exercises are recommended, consisting of deliberate tightening of the pelvic floor muscles, initially at rest and then under stress (coughing, sneezing, or physical activity). They involve activating the perineal muscles, imagining that you are holding back urine output, while trying not to tense the muscles of the buttocks, thighs, or abdomen. Exercises are complemented by physical therapy treatments, which include electrostimulation of the muscles using a vaginal electrode to improve blood circulation and enhance the strength of contraction needed to rebuild the muscle. Biofeedback- which allows you to learn to consciously contract and consciously relax your pelvic floor muscles- is sometimes recommended. Under visual or auditory stimuli the woman learns to recognize her body’s reactions. Both of these methods require concentration and commitment to the therapy.