Prenatal & Postpartum Physio

Weight gain, postural changes, muscle weakness, and those sneaky hormonal fluctuations are common culprits behind low back pain during pregnancy. If you’re experiencing low back pain in pregnancy, you’re not alone—it’s one of the most common symptoms we hear from our expecting clients. Prenatal physiotherapy can help bring relief through a variety of methods, including:

• Manual therapy and soft tissue work
• Improving your postural alignment
• Assisting with supportive and corrective exercises
• Movement modifications for work or home
• Providing guidance on supportive sleeping positions
• Discussing pelvic braces, belly bands or support options, if needed

Pelvic girdle pain affects the ring of bones in your pelvis and presents as discomfort and/or pain in the pelvic region.  Common symptoms are:

• Pain in the low back, hips, or groin area
• Difficulty walking
• Pain while standing or sitting
• Pain during movement (walking, climbing stairs, rolling over in bed, etc)

By addressing the root causes of pelvic girdle pain and providing personalized care, prenatal physiotherapy can help you manage your symptoms, improve mobility, and, most importantly, enjoy a more comfortable pregnancy (which you deserve!).

Pubic symphysis dysfunction (PSD) refers to pain and discomfort in the pubic symphysis, the joint located at the front of the pelvis where the left and right pubic bones meet.  This condition is common during pregnancy and is a form of pelvic girdle pain. It can occur due to hormonal changes, increased demands on the pelvic region, or due to excessive movement of the pubic symphysis (fibrocartilage disc) at the front of the pelvis, trauma, or other conditions.  Some common symptoms include:

• Sharp or aching pain at the front of the pelvis, often radiating to the hips, lower abdomen, or thighs aka “lightening crotch”
• Difficulty walking
• Increased pain when doing daily activities like getting out of bed, climbing stairs, or rolling over in bed
• Tenderness to the touch around the pubic symphysis joint

Through individualized care, prenatal physiotherapy can help relieve discomfort, improve function, and support a more comfortable daily life.

While pregnant, have you ever felt a sudden, sharp pain on the side of your belly and into your hips and thighs and wondered “what was that?!”?  Round ligament pain might be to blame and prenatal physiotherapy can help!

Round ligament pain is a common prenatal discomfort, oftentimes caused as a result of weak or stretched abdominal muscles.  It occurs due to the stretching and strain of the round ligaments which support the uterus as it expands.  The growing weight and size of your uterus can cause these ligaments to stretch and tighten, causing pain.

Symptoms of round ligament pain can vary but often include:

• Sharp, sudden pain (typically felt on one/both sides of the lower abdomen or groin)
• Pain triggered by sudden movements (such as standing up quickly, coughing, rolling over in bed, etc.)
• Constant, dull ache in the lower abdomen
• Increased discomfort during activities that involve stretching of the abdominal muscles

By targeting the root causes of round ligament pain and offering care tailored to you and your lifestyle, prenatal physiotherapy can help you manage symptoms, enhance mobility, and experience a more comfortable pregnancy.

Scar tissue management is an essential component of C-section recovery.  We also work on vulvar and perineal scars caused by tearing during a vaginal delivery.  This process involves treating and minimizing the effects of scar tissue that forms at the incision site. After a C-section, scar tissue can sometimes lead to discomfort, restricted movement, and other complications.

Common symptoms indicating the need for scar tissue management include:

• Persistent pain around the scar
• Stiffness
• A sensation of pulling or tightness
• Reduced mobility in the abdominal area.
• For perineal scars it can impact pain with sexual activities, incontinence, and prolapse

Postpartum physiotherapy can be highly beneficial in managing scar tissue both proactively (before scar tissue has had a chance to develop) and once scar tissue has formed. Through techniques such as:

• Scar massage
• Mobilization
• Specific exercises

Postpartum physiotherapists can help:

• Break down adhesions
• Improve tissue flexibility
• Restore normal movement

These treatments not only alleviate pain and discomfort but also enhance overall recovery, allowing for a smoother and more comfortable post-C-section and postpartum experience.

Pregnancy is a time of change for your pelvic floor muscles. Prenatal physiotherapy addresses those significant changes. As the body prepares for childbirth, the pelvic floor muscles experience:

• Increased pressure from your growing uterus and baby
• Hormonal fluctuations that cause tissue relaxation
• Structural changes to the muscles/ligaments
• Increased fluid retention
• Additional weight gain

These changes can lead to issues such as bladder leakage, pelvic pain, pain with sexual activity, and a feeling of heaviness or pressure in the pelvic area.

Seeing a prenatal physiotherapist, who specializes in the pelvic floor, can be helpful to alleviate some of these symptoms.  It also provides the opportunity for you to learn to control your pelvic floor muscles to prepare for birth.

Remember, pelvic floor muscle work isn’t always about strengthening.  It’s about learning to lengthen them too, which is essential for your upcoming birth and postpartum recovery.

Research supports better birth outcomes and postpartum recoveries with a strong and healthy pelvic floor.

Please note, that the ideal time to have an internal assessment in pregnancy is after 14 weeks and before 37 weeks. We choose not to perform internal assessments in the first trimester.

Think of this as a private prenatal health class for your pelvic floor!

During your final prenatal physiotherapy visit with us, we focus on equipping you with the knowledge and tools you need to feel empowered, confident, and prepared for your birth. Our comprehensive pelvic health prenatal education session covers essential topics like:

• Perineal stretching
• Bowel care
• Birthing positions
• Breathing techniques
• The effects of medications and epidurals on the pelvic floor
• Instrumentation delivery
• Postpartum recovery basics
• So much more!

You won’t leave this appointment empty-handed. We’ll provide you with a series of educational resources, created exclusively by our team for our prenatal and postpartum physiotherapy clients.  We also include a detailed postpartum recovery plan to take the guesswork out of the early stages of your postpartum journey, regardless of birth outcome.

You’re probably not surprised to hear that the pelvic floor undergoes significant changes after giving birth. These changes can include weakened pelvic floor muscles, stretching of tissues, torn tissues and various pelvic floor injuries.  Common birth injuries that can benefit from postpartum pelvic floor physiotherapy include:

• Intravaginal scar tissue release
• Perineal trauma (tearing or episiotomy)
• Excessive pushing
• Incontinence (bladder, bowel, or gas)
• Pelvic organ prolapse (feelings of heaviness/pressure or a bulge)
• Painful with sexual activity
• Tailbone pain
• Diastasis recti
• Queefing
• Vaginal dryness
• Low libido

Yes, your pelvic floor can change after birth but postpartum physiotherapy can help you navigate any bumps along the way.

It is generally recommended to see a pelvic floor physiotherapist after giving birth as soon as possible, ideally within the first six weeks postpartum, and before you return to sexual activity or an exercise program. This early intervention can help address any immediate issues and start pelvic floor rehabilitation early. Telehealth appointments may be available for those who prefer it or who are unable to access care due to proximity.  However, every individual’s situation is unique, so we recommend consulting with one of our postpartum physiotherapists for personalized guidance based on specific needs and circumstances.

Note: While we don’t perform internal exams until at least 6 weeks post-delivery, we often see clients earlier for external assessments and education.

Diastasis recti is a common condition that occurs when the abdominal muscles are stretched along the midline, often due to the pressure and stretching experienced during pregnancy.  This stretching can lead to a noticeable gap between the right and left sides of the abdominal muscles. This results in a bulge or a dome in the midsection. 

Symptoms of diastasis recti include:

• Lower back pain
• Poor posture
• Abdominal weakness
• Difficulty lifting or carrying objects
• Still “looking” pregnant, even years postpartum

Remember when we said this was a common pregnancy condition?  Well, we meant it! 100% of pregnant people will have some degree of stretching by the end of their pregnancy.  Postpartum physiotherapy can be effective in addressing diastasis recti by utilizing a variety of therapeutic techniques including:

• Breathwork
• Deep core activation exercises
• Correcting any pelvic floor dysfunctions
• Clinical Pilates
• Progressive core strengthening
• Taping techniques
• Evidence-based education

Our physiotherapists can help you retrain your core muscles, improve posture, and improve the gap between the abdominal muscles. Postpartum physiotherapy can help support the recovery of muscle function and stability while alleviating associated pain and discomfort.

Approximately 50% of individuals who give birth via C-section experience some form of pelvic floor dysfunction postpartum. Seeing a pelvic floor physiotherapist after your C-section offers numerous benefits. It helps assess and strengthen the pelvic floor muscles, which can become weakened or compromised during pregnancy and childbirth. This specialized therapy includes:

• Promoting healing of the abdominal muscles and scar tissue
• Assessing for diastasis recti
• Core re-training and strengthening
• Reducing the risk of pelvic floor dysfunction through pelvic floor muscle rehabilitation
• Providing guidance on safe exercises and postural correction
• Sexual health education after a C-section
• Offering strategies for optimal recovery and personalized education
• Clinical Pilates integration (depending on practitioner)

C-section is a major surgery that can affect both pelvic floor and core functioning, highlighting the importance of proactive care and rehabilitation with a postpartum physiotherapist.

It is generally recommended to see a pelvic floor physiotherapist after giving birth as soon as possible, ideally within the first six weeks postpartum, and before you return to sexual activity or an exercise program. This early intervention can help address any immediate issues and start pelvic floor rehabilitation early. Telehealth appointments may be available for those who prefer it or who are unable to access care due to proximity.  However, every individual’s situation is unique, so we recommend consulting with one of our postpartum physiotherapists for personalized guidance based on specific needs and circumstances.

Note: While we don’t perform internal exams until at least 6 weeks post-delivery, we often see clients earlier for external assessments and education.

One of the most common questions we hear after delivery is, “When can I start exercising again?” While we wish we could provide a straightforward answer, the truth is that the appropriate time to return to exercise varies greatly from person to person. Every body and their respective postpartum recovery journeys are beautifully unique.

Before starting (or returning to) an exercise or running program, we strongly recommend coming in for an individualized assessment with one of our postpartum physiotherapists. Based on their evaluation, they will develop a personalized return-to-exercise or return-to-run plan tailored to your specific goals and lifestyle. Our postpartum physiotherapists or registered kinesiologists can oversee your exercise program to ensure effective and appropriate progress.

Caring for a newborn while recovering from even the most straightforward birth can be challenging. Our team provides supportive postpartum physiotherapy to enhance your comfort during the initial recovery period and throughout the postpartum phase, allowing you to focus on healing and bonding with your new family member. We commonly treat conditions such as:

• Alleviating tension in the neck and back, along with headaches, caused by feeding positioning
• Tailbone pain from extended sitting or birthing trauma
• Wrist pain or carpal tunnel syndrome, DeQuervain’s tenosynovitis resulting from holding or carrying your baby
• Hip and low back pain
• Core muscle strengthening for improved stability

Seeking postpartum physiotherapy can help make your recovery journey smoother, enabling you to focus on the joys of life with your new baby. It addresses common post-birth discomforts and supports your body’s healing process, ensuring you can fully embrace this special time