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Integrative Family Health Clinic in Bolton and the Greater Caledon Area
4-22 Simona Drive
Bolton, ON
Physiotherapy for pregnancy and postpartum Wildflower health and wellness clinic

Supporting Changing Bodies: Physiotherapy for Pregnancy and Postpartum

Pregnancy is an exciting period of time that comes with lots of changes to your body. As your baby grows, there are so many noticeable changes that connect you to your growing baby. Your baby bump starts to pop and grow, and eventually, you’ll start to feel your baby kick. With these changes, however, you may also be experiencing some not-so-exciting symptoms.

What body changes happen with pregnancy?

As your baby bump grows beyond your natural frame, your abdominal muscles elongate and your rib cage allows for more room to accommodate. These changes shift the dynamics of how you breathe and how your core muscles — such as your abdominal and pelvic floor muscles — function.

Your pelvic organs and digestive organs accommodate a growing baby by changing positions, which affects how these organs function.

Changes in the abdominal and pelvic organs can lead to a host of unexpected symptoms, for example:

  • low back pain
  • pelvic girdle pain
  • hip pain
  • rib pain
  • shortness of breath
  • constipation
  • increased frequency of urination
  • incontinence (leaking urine) on the way to the bathroom; or when coughing, sneezing, squatting, jumping, or running
  • vaginal heaviness
  • pain during intercourse
  • “lightning” crotch pain
organ changes during pregnancy
Source: Pearson Education

What is prenatal physiotherapy?

Prenatal physiotherapy supports a pregnant person’s body during pregnancy, before baby’s birth. The focus of prenatal physiotherapy is:

1. To maintain a strong core and normal breathing mechanics

Strong core muscles and normal breathing mechanics are supported when physiotherapists assess:

  • how you are holding your rib cage and pelvic when you stand, sit, and move
  • what your breathing pattern is
  • how you activate your core muscles for stability

Together, you and your physiotherapist will work together on rib and hip mobility in addition to abdominal muscle mobility and strength. We will optimize your breathing pattern and ensure you know how to activate your core muscles.

2. To prepare your pelvic floor for labour and delivery

Kegels aren’t appropriate for everyone. Pelvic health physiotherapists can assess your pelvic floor to learn whether your pelvic floor muscles are in a state of tension, whether you are able to relax them, and whether or not you need to be practicing Kegels.

Relaxing and lengthening your pelvic floor muscles is a key function for labour and delivery. Your pelvic health physiotherapist should work on your ability to consciously relax and lengthen your pelvic floor, in addition to treating any tension that exists in the area. Finally, prenatal physiotherapy involves improving the mobility of your perineal membrane, another layer of tissue in the area, which also needs to lengthen and open during labour and delivery.

3. To teach you positions, pain management, and pushing strategies for labour and delivery

Finally, prenatal physiotherapy involves preparing you, not just your muscles, for labour and delivery. Guided by your physiotherapist, you will learn certain positions that support pain management in addition to learning how to push during labour and delivery.

What is postpartum physiotherapy?

Postpartum physiotherapy supports an individual’s body after pregnancy, or after giving birth. During the postpartum period, many of the symptoms experienced during pregnancy may still persist. In addition, the postpartum body may also experience:

  • painful perineal scar
  • painful and immobile C-section scar
  • pelvic organ prolapse (vaginal, uterine, or rectal prolapse)
  • diastasis recti, also known as “mommy pooch” or “mommy tummy”

The focus of postpartum physiotherapy is:

1. To regain a strong core and normal breathing mechanics

In the postpartum phase, your physiotherapist will work with you to ensure that the position of your rib cage and pelvic return to neutral, that your breathing mechanics return to a normal pattern, and that you are able to activate your core muscles in a balanced and coordinated way, without overcompensating muscles that might cause further pain or dysfunction.

2. To regain a strong pelvic floor

Pelvic health physiotherapists will also re-assess how your pelvic floor muscles have responded to labour and delivery and ensure that you regain the full strength and function of y our pelvic floor muscles.

3. To support C-section and perineal scar healing

Births may result in either a C-section scar, perineal tearing or scarring, or pelvic trauma in general. There are many techniques that your pelvic health physiotherapist can use to support healing and improve the mobility of C-section and perineal scars, to prevent future pain and restrictions in the tissue.

Summary

Overall, the goal of prenatal and postpartum physiotherapy is to ensure that you have:

  • a healthy and strong pregnancy
  • a smooth labour and delivery; and
  • a full recovery

in order to return to all the daily activities that you love, pain- and restriction-free, with your new baby.

If you’re ready to get started, our pelvic health physiotherapist accepts patients in the Bolton, Caledon, and Peel regions.

Pelvic Physiotherapy 101

Have you ever wondered what pelvic physiotherapy actually is and how it helps? Our pelvic physiotherapist explains.

What are pelvic floor muscles?

The pelvic floor muscles are a group of muscles found along the base of our pelvis that create the foundation of our trunk and core. They form a hammock and should have the perfect balance of tension and relaxation to be strong and support our body.

The pelvic floor muscles support our low back and hip joints, they are an important member of our core system (you can’t have a strong core without a strong pelvic floor), they support our urinary function, bowel function and sexual function, and they are closely connected to our breathing, our resting state (calm or anxious) and our emotions. 

Because the pelvic floor muscles have many different functions, pelvic floor muscle dysfunction can present in many different ways and affect many different systems. 

What is pelvic floor dysfunction?

Pelvic floor dysfunction is when the pelvic floor muscles cause or contribute to symptoms such as:

  • Leaking on your way to the bathroom
  • Leaking when you sneeze, cough, or laugh
  • Leaking when you run or jump or suddenly change position
  • A feeling of fullness or heaviness in the vaginal area
  • Prolapse/bulging at the vaginal opening
  • Difficulty strengthening your core muscles
  • Diastasis Recti
  • Painful intercourse
  • Constipation
  • A sudden/intense urge to pee and/or difficulty making it to the bathroom
  • Needing to pee often/planning your day around where the bathrooms are.
  • Pelvic pain
  • Tailbone pain

How does pelvic health physiotherapy help?

A pelvic health physiotherapist does a full history and physical assessment to piece together the factors that are contributing to your symptoms. The history will give a clear picture of what your symptoms are and which systems are affected.

The physical assessment will look at all the surrounding factors that impact how your pelvic floor works: from breathing, posture, movement patterns, to core and hip muscle strength and conditioning. It will also include an internal evaluation (based on your consent) to assess the specific function and mobility of your pelvic floor muscles including: pelvic floor muscle strength, tension levels (under-active/hypotonic muscles or over-active/hypertonic muscles), quality of contraction and relaxation,  scar tissue restrictions and fascial restrictions. 

This will enable the physiotherapist to develop a treatment plan with specific mobility and strengthening treatments and exercises to improve your pelvic floor function and relieve your symptoms.

What happens to the pelvic floor during pregnancy and postpartum?

You may experience many of the symptoms above during pregnancy or postpartum as your core and pelvic floor adapt to a changing body.  

For an overview of how pelvic health physiotherapy supports you to have healthy and fit pregnancy, prepares you for labour and delivery and guides your postpartum recovery, click here for our guide:

Graston Technique Wildflower Health and Wellness Osteopathy Pain Scar Tissue

Treating Scar Tissue with the Graston Technique

 

45% of all chronic diseases treated in hospitals are related to fibrosis or scar tissue. Fibrosis occurs when the body’s tissues get damaged, sometimes due to surgery, a disease, or injury. To fill in the tear or cut, thick, healthy tissue made of collagen cells gets created. Although scar tissue is part of the body’s natural regenerative process, it can cause other health issues.

If left unmanaged, scar tissue can restrict movement, cause nerve pain, cause numbness, and lead to joint contractures. To manage scar tissue and prevent these consequences, patients are recommended to see a physical therapist for manual massage therapy. This helps to remodel the scar tissue and realign all the collagen fibres.

 

What is the Graston Technique?

The Graston Technique is a highly effective method of manual therapy for scar tissue. It involves using a stainless-steel instrument that is specifically designed for this purpose. When used by a registered massage therapist or physical therapist, the Graston Technique can help remodel the scar tissue in a pain-free way.

Cross fibre massage for scar tissue is a well-known, evidence-based treatment. The Graston Technique allows the practitioner to gain a better sense where there is resistance in the tissue. They can use the tool’s edges and surfaces to gently massage the tissue from different angles.

Who is the Graston Technique for?

There are numerous conditions that the Graston Technique can help with. Combined with other treatments, it can treat carpal tunnel syndrome, fibromyalgia, tennis elbow, back pain, shin splints, and more. It’s commonly used to address post-surgery scarring, especially in women post-mastectomy or post-Cesarean.

However, it’s rarely a standalone treatment. Your practitioner will also likely use manual therapy with their hands as well as other forms of treatment depending on where your scar tissue is located.

What Happens During a Session?

When you book a scar tissue massage, your appointment will be similar to any other RMT session. You will consult with the practitioner on how your body has been feeling, where it’s sore, and the status of your scar tissue. It’s important not to massage any open scars or unhealed wounds.

Then, you will remove your clothing (if you wish) and lay on the massage table. In addition to traditional manual therapy of the muscles and tissues, the practitioner will use a stainless-steel tool for the Graston Technique. They will gently run the tool across your scar tissue, assessing its tightness and restriction. Cross fibre massage (with an instrument or just the practitioner’s hands) helps break up scar tissue.

How Effective is the Graston Technique?

The Graston Technique has been proven to be effective in breaking down collagen fibres and stretching fibrous tissues. Not only does it increase blood flow to the area, but it also reduces the amount of pain you feel in the area. It can reduce recovery time from injuries and decrease the amount of treatment you need, in addition to other benefits.

You can read more about the empirical and anecdotal evidence on the effectiveness of this treatment on the Graston Technique website.

Where Can I Receive Treatment with the Graston Technique?

Wildflower Health & Wellness is proud to offer registered massage therapy treatments which incorporate the Graston Technique. Our practitioners have completed the accredited Graston Technique training and are fully licensed to provide this service.

Simply call our clinic at 905-951-7134 or book an appointment online here.

 

 

Postpartum Support

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Pelvic Floor Physiotherapy Postpartum

Ever wonder why pelvic floor physiotherapy has stirred up some great conversation topics amongst friends and family with little ones? After giving birth, a woman’s body, in particular her pelvic floor, has gone through an array of changes. Whether you’ve had a vaginal or cesarean birth, the pelvic floor and other soft tissue structures surrounding have been affected. Other determinants that can affect your pelvic floor structures include the size of your baby, the duration of labour, the delivery method used, and the number or pregnancies you’ve had.

Take a look at the statements below, do any of these sound familiar?

“I am peeing my pants when I laugh, cough, sneeze or jump!”

“I am noticing doming of my belly when lifting my child or rolling out of bed”

“I had a c-section and I can’t stand looking at my scar, it also hurts to touch.”

“It hurts to have intercourse.”

“I’m nervous to have intercourse again, I don’t know what it’s like down there after the baby.”

“I feel like there’s a golf ball pushing out of my vagina.”

“I want to get back into the gym, but not sure what exercises to do and not do at this point.”

If any of these statements or thoughts have crossed your mind since having your baby, a visit to see the pelvic floor physiotherapist is a MUST!

Checklist

Here is a simple checklist that you can also use to see whether or not you should pick up the phone and make an appointment with your physiotherapist:

Ο   6 weeks after having a vaginal birth

Ο   8 weeks after having a cesarean section

Ο   Diagnosed with Diastasis Recti or “Mummy Tummy”

Ο   Experiencing urinary or fecal incontinence

Ο   Diagnosed with a POP (pelvic organ prolapse)

Ο   Pelvic pain with or without intercourse

Ο   Getting back to the gym, running, etc.

Ο   Lower back pain, hip pain, shoulder pain

Ο   Episiotomy performed during delivery

Ο   Any grade 1-4 tearing during labour and delivery

If, after having your six-week follow up with your doctor, OBGYN, and/or midwife, any of the above have been mentioned, seeing a pelvic floor physiotherapist can impact the healing and function of your pelvic structures after having your baby. The results of regular physiotherapy treatment for a minimum of an 8-week period have demonstrated positive tissue healing and a strong, functional pelvic floor regardless of complications with birth.

– Nabila Jutha, PT

[/bt_text][bt_hr top_spaced=”topSmallSpaced” bottom_spaced=”bottomSmallSpaced” transparent_border=”noBorder” el_class=”” el_style=”” responsive=””][/bt_hr][bt_row_inner][bt_column_inner width=”1/1″ align=”center” cell_padding=”default” vertical_align=”inherit” highlight=”no_highlight” background_color=”” opacity=”” el_class=”” el_style=””][bt_button text=”Postpartum Recovery Starts Here – Work with WHW!” icon=”” url=”https://wildflowerhw.janeapp.com/” target=”_self” style=”Outline” icon_position=”Inline” color=”Accent” size=”Medium” width=”Normal” el_class=”” el_style=”” responsive=””][/bt_button][/bt_column_inner][/bt_row_inner][bt_hr top_spaced=”topSmallSpaced” bottom_spaced=”bottomSemiSpaced” transparent_border=”noBorder” el_class=”” el_style=”” responsive=””][/bt_hr][bt_dropdown title=”References” dd_content=”Allen, R., Hosker, G., Smith, A. and Warrell, D. (1991). Pelvic Floor Damage and Childbirth. Obstetrical & Gynecological Survey, 46(4), pp.209-210.;#
Handa, V., Blomquist, J., McDermott, K., Friedman, S. and Muñoz, A. (2012). Pelvic Floor Disorders After Childbirth: Effect of Episiotomy, Perineal Laceration, and Operative Birth. Obstetrics & Gynecology, 119(2, Part 1), pp.233-239.;#
Morkved, S. and Bo, K. (2000). Effect of postpartum pelvic floor muscle training in prevention and treatment of urinary incontinence: a one-year follow up. BJOG: An International Journal of Obstetrics and Gynaecology, 107(8), pp.1022-1028.;#” el_class=”” el_style=”” responsive=””][/bt_dropdown][bt_hr top_spaced=”topSmallSpaced” bottom_spaced=”bottomSemiSpaced” transparent_border=”noBorder” el_class=”” el_style=”” responsive=””][/bt_hr][/bt_column][/bt_row][/bt_section]