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They say that running a marathon is like childbirth. So doesn’t it stand to reason that you should go to a physical therapist for childbirth, just like you would after a race? Even more, why do you see a PT leading up to your race but not leading up to your delivery?
Pregnancy and childbirth are tough on the body — leaving many women to feel as if their bodies may never be the same again. But what many new and expectant moms don’t know is that seeing a physical therapist for childbirth and even during pregnancy can make all the difference in their recovery.
Your Pelvic Floor Will Thank You
“Pelvic-floor therapists can help prepare women for the marathon of childbirth by creating exercise programming,” says Kimberly Howell, PT, DPT, OCS, noting that physical therapy for childbirth can play an essential role during labor and the fourth trimester, which is the first 12 weeks after a baby is born. “They are essential in screening for and treating common disorders related to pregnancy and birth, including diastasis recti, pelvic pain or weakness, incontinence and pubic symphysis dysfunction.”
About 33 percent of women still suffer from urinary incontinence six months after birth. While many may leak while jumping rope and chalk it up as “normal,” Howell says that it is treatable. A 2018 study found that aggressive pelvic-floor rehab can significantly improve incontinence and that it should be included as an alternative to surgery. “We can also address the aches and pains that commonly pop up with the new challenges of caring for a newborn, such as neck and upper-back pain during feeding or baby wearing,” Howell says.
You May Have an Easier Recovery
While quite a few surgeries require some sort of physical therapy after, many women aren’t given any advice after a Caesarean section, which is the most common surgical procedure performed on women. This can make the thought of getting back into the gym seem impossible. As many women heal, they may be disheartened by how years of CrossFit classes seem to have gone down the drain. A physical therapist, however, can help them rehab those muscles without fear and injury.
Pubic symphysis dysfunction, or pelvic girdle pain, can occur during pregnancy and continue for years after. A PT can support you through exercises to stabilize the ligaments and reduce stress. They also can do the same for treating diastasis recti, which is a separation in abdominal muscles.
The Role of PT During Active Pregnancies
Many experts say that exercise is OK and even encouraged during pregnancy if you were already active before conception. This isn’t always an easy transition, and you may feel discouraged about your energy levels and needing to lift lighter weight or run a couple of minutes slower. No matter your level of confidence, a physical therapist can help you through your routine.
For one thing, the same relaxin that is secreted to help prevent contractions loosens your ligaments, muscles and bones. This can cause you to overstretch during exercise, or it could cause back pain because of a looser spine. Some activities, like running, may even begin to cause discomfort, and a physical therapist can help you determine what’s normal or even help you adjust so that you can still continue safely.
Why More Women Aren’t Seeking PT Help
Still, surprisingly few women are seeing a PT before or after childbirth. Abby Bales, PT, DPT, owner of Reform Physical Therapy in New York, explains that for many, it boils down to education. “The OB-GYN community is not well-versed in the benefits of pelvic-floor physical therapy, so they often don’t know who to refer the patient to,” she says.
Instead, she believes that conversations around pelvic-floor issues aren’t taken seriously enough and that women are being prescribed treatments that she considers “antiquated.” These include bed rest, pain killers, surgery or adult diapers, all of which may act like a bandage, but they are not solutions-oriented — leaving many women feeling embarrassed and wondering why their Kegels aren’t helping.
When a woman finally turns to the medical community for help, she typically starts with her OB-GYN. “[But] they aren’t trained to assess or treat musculoskeletal injuries of the pelvic floor, and they are often left without a referral source for their patients outside of surgery,” Bales concludes.
When to Seek a PT
Howell recommends forming a relationship with a physical therapist before childbirth because they can help you strategize labor and delivery. She often helps clients create exercise plans based on their previous activity levels. “I aim to incorporate targeted exercises for the hip and thigh muscles for many pregnant persons,” she says. “Each person’s program is tailored to their needs and altered based on tolerance.” She also helps clients make a safe return to exercise post-delivery, in the same way she would for one who had a car accident or fall.
Howell and Bales, who are both moms, hope to normalize physical therapy for childbirth, especially among active people. Whether your chosen workout takes place in a gym or on a field, chances are you’ll end up seeing a PT at some point. You’re already pushing your body to the max, why not treat childbirth like the body-changing event that it is?