Pelvic Floor Therapy: What to Expect Postpartum

February 16, 2022

Pelvic floor dysfunction is (for many) an unfortunate consequence of childbirth. The symptoms include pelvic pain, leakage, pelvic organ prolapse, and more. Fortunately, pelvic floor physical therapy can make a world of difference for new moms suffering from the daily complications and discomfort of this disorder. So, we contacted Jordan Mrosewske, PT, DPT, a specialist in postpartum pelvic physical therapy, to learn more about what to expect from pelvic floor therapy. As well as the symptoms associated with weak pelvic floor muscles, when to seek out a therapist, and some at-home tips to help you effectively perform your exercises and strengthen your pelvic floor. 

Do you know what’s going on downstairs? No, not in your basement… your pelvic floor! Throughout life, we experience a wide range of strain on our body: childbirth, cancer, surgery, just to name a few. These strains can impact bladder, bowel, and sexual function, and while it’s common, it doesn’t have to be the new normal. Pelvic health physical therapists specialize in training the pelvic floor muscles.  We help our patients stretch, strengthen, and relax their muscles to alleviate discomfort and symptoms while giving them more control over their bodies.

Pelvic floor therapy, what to expect. Female pelvic floor diagram. Every Mother
Photo c/o OpenStax

When to seek out a pelvic floor physical therapist:

If you are suffering from:

  • Bladder or bowel urgency/frequency
  • Constipation, irritable bowels, leaking stool, straining with bowel movements
  • Diastasis recti
  • Pain in the pelvis, lower abdomen, vagina, rectum- with or without intercourse
  • Painful scars along abdomen or pelvis 
  • Organ prolapse 
  • Urine leakage 
  • Weak pelvic floor

The pelvic floor muscles function as a support, sphincteric, sexual, postural and lymphatic system for our body. For the pelvic floor muscles to function properly, they must be able to contract, relax, and drop. The goal of pelvic floor exercises is to internalize muscle tension differences and feel the recruitment and release of the muscles.

How to find your pelvic floor muscles:

Feel the muscles: You can insert 1 or 2 fingers into the front canal and one at the opening of the anus to feel the contraction and lifting of the muscles. You should feel the sensation of holding back urine and holding back gas.

Watch the muscles: Use a mirror to look at the pelvic openings. Contract your muscles and watch the openings closely and the area between the openings lift. If you see a bulge, this is dropping your muscles.  

*It is not advisable to conduct pelvic floor exercises while urinating daily. Contracting your pelvic floor muscles and cutting off urination can lead to UTI’s and other medical issues.

Tips to strengthen your pelvic floor muscles:

  • Take 3-5 minutes daily to perform your pelvic floor exercises.
  • Perform your exercises in a variety of positions, including standing, walking, and while exercising. This ensures your muscles sustain through every-day activities. 
  • Completely relax the pelvic floor muscles in between squeezes to avoid fatigue and overactive/tight pelvic floor muscles. It’s just as crucial to relax as it is to contract. 
  • Remember, this is a secret exercise. No one should know you’re squeezing your pelvic floor muscles. Keep your abdomen, hips, and legs from assisting. You don’t want the surrounding muscles to help or compensate for the pelvic floor muscles. Common compensations include: bouncing up and down in your chair, curling your toes, or mini crunching with each contraction. 
  • Continue to breathe, don’t hold your breath. You should be exhaling as you contract your pelvic floor muscles. Counting out loud is a great way to know you’re breathing.
  • Don’t think of your pelvic floor muscles as an on and off switch, but more of a light dimmer. You need your muscles to turn on powerfully and quickly, to assist with coughing, laughing, and sneezing. However, you also need your muscles to have the endurance to sustain day to day activities. 
  • Your pelvic floor muscles are just like any other muscle in your body, you must be consistent with your exercises in order to strengthen and/or maintain.

Overactive pelvic floor muscles do not relax. Worse, they contract when full relaxation is necessary. This fatigues the muscles and makes them tight and weak, which can lead to voiding problems like leakage,(frequency and urgency), obstructed or painful defecation, pain with intercourse and/or chronic pain. This pain may not be isolated to just the pelvic floor muscles, but also the lower abdomen, perineum, anus, tailbone or lower back. If you suspect you have any of the above problems, please consult your healthcare provider (OB or midwife),  and ask for a referral to a pelvic physical therapist. 

By performing pelvic floor exercises properly, you can reconnect with your body and take control of your bowel, bladder, posture, and sexuality. It only takes a few minutes a day and the benefits are worth every minute.

To learn more about postpartum pelvic floor dysfunction check out these two articles.

Reviewed by Jordan Mrosewske, PT, DPT in 2019

Jordan Mrosewske, PT, DPT, is a pelvic physical therapist at Advocate Aurora Health (AAH), in Milwaukee, WI. She is passionate about empowering and educating her patients to be in control of their well-being; physically, emotionally, mentally and/or spiritually. She is also part of the Pregnancy committee within AAH and specialized in Pelvic Health for the Tgncnb Community.

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