Low back, Sacroiliac (SI), and hip pain is extremely common during pregnancy. Many women think that there are few treatment options available to them during pregnancy and “just live with it” Physiotherapy can actually be quite effective in reducing or eliminating back, pelvic, and hip pain, using a combination of education regarding ways to protect your joints as your body changes, and strengthening of the core and pelvic floor.
Abdominal muscle separation (Diastasis Recti Abdominus, DRA) Almost all women experience separation of the abdominal muscles in their third trimester. By 12 weeks post partum most will have come back together. However, in about 25% of women a gap remains. These women may report that they have a “pooch” that they can’t get rid of, or they may see the abdominal muscles “dome” when they do a sit up motion. Some women report that they are having a difficult time regaining their strength and returning to normal activity. We recommend that all post partum women have a health professional check their abdominal muscles at 8 – 10 weeks postpartum to ensure that their abdominal separation is healing well. If they are not, a physiotherapist can provide direction on how best to protect and promote healing.
Although it is ideal to treat DRA early on in the post partum phase, treatment can be started at any time even if your baby is a few years old.
Incontinence: Sometimes it is hard to know what is normal and what is not after childbirth. Leaking urine or stool anytime after the 2-3 few weeks, while common, is not normal. If you are leaking urine when you cough or sneeze, or when you try to return to exercise, you will likely benefit from seeing a pelvic floor physiotherapist.
The medical term for painful intercourse is dyspareunia. It is very common in women, but unfortunately many women go untreated for years.
Post partum dyspareunia: up to 25% of women report persistent dyspareunia after childbirth. You may be more at risk if you have had a sutured tear or episiotomy, caesarean section, or vacuum or forceps extraction. Proper assessment can help determine the cause of your pain and treatment may include learning how to relax and contract the muscles as well as myofascial techniques to stretch scarring and release tight muscles.