C-Section and Pelvic Floor PT

Hey there, mama! First off, congratulations on your little one! I know the postpartum period can be a mix of excitement, joy, and yes, a little bit of overwhelm — especially if you had a C-section. While it’s an amazing, and safe option for delivery, a C-section is still a major surgery that requires time, care, and attention as your body heals.One area that might not immediately come to mind when you think of postpartum recovery is your pelvic floor. But trust me, it plays a big role in how you recover from a C-section, and pelvic floor physical therapy (PT) can be a game-changer in helping you feel strong, supported, and comfortable as you heal.

What Is Pelvic Floor Physical Therapy?

Pelvic floor physical therapy focuses on the muscles, ligaments, and tissues that make up your pelvic floor — a group of muscles that support your bladder, uterus, rectum, and help control functions like bladder control and bowel movements. After childbirth (whether vaginal or via C-section), these muscles can become weakened, tight, or even imbalanced, which can affect your day-to-day life.

Pelvic floor PT is designed to help strengthen, relax, and restore function to these muscles, helping you heal after childbirth, improve your mobility, and address common postpartum concerns like incontinence, pelvic pain, and discomfort.

How Can Pelvic Floor PT Help After a C-Section?

You might be wondering, “Why pelvic floor PT after a C-section? Isn’t it just a belly incision?” While your C-section is a surgery that directly impacts your abdominal area, it’s also important to recognize that your pelvic floor muscles and surrounding tissues were still impacted by the pregnancy and delivery process. Here’s how pelvic floor PT can support you on your recovery journey after a C-section:

1. Promoting Healing and Reducing Scar Tissue

C-sections involve a horizontal incision through the abdominal muscles and tissues to deliver your baby. Over time, the scar tissue from the incision heals, but it can sometimes become tight or restricted, leading to discomfort and limited mobility.

In my practice, I use techniques to help with the healing of the C-section scar. This may include scar tissue massage or myofascial release, which can reduce adhesions, improve blood flow, and soften the tissue, promoting a smoother and more comfortable healing process. Plus, when scar tissue is less restrictive, your body can move more freely, which is especially important as you start to regain your strength and mobility.

2. Restoring Core Strength and Function

Even though a C-section doesn’t directly involve pushing during labor, the recovery process can still challenge your core muscles. During pregnancy, your core (including your abdominal muscles and pelvic floor) undergoes significant changes as it stretches and adapts to accommodate your growing baby. After a C-section, the abdominal muscles need time to heal, but they also need retraining to regain their strength and support.

Pelvic floor PT helps restore core function by targeting the deep abdominal muscles, like the transverse abdominis (your body’s natural corset) and diaphragm, which are essential for stability. These exercises are focused on retraining your muscles to work together, supporting your spine and pelvis so you can move with more ease and confidence.

3. Managing Pelvic Floor Dysfunction

While a vaginal delivery often gets more attention for causing pelvic floor issues, a C-section can affect the pelvic floor as well. The pressure of pregnancy, combined with changes in posture, muscle length, and pelvic positioning, can lead to dysfunction in the pelvic floor muscles.

If you’re experiencing symptoms like urinary incontinence, pelvic heaviness, or difficulty with bowel movements, pelvic floor PT can help. We will assess your pelvic floor strength, teach you how to activate and relax the muscles, and provide targeted exercises to improve coordination and control. This is especially helpful in addressing common postpartum issues like urinary urgency, stress incontinence, or pelvic organ prolapse (a feeling of heaviness or pressure in the pelvic area).

4. Addressing Back and Hip Pain

C-sections often result in a shifted posture due to the abdominal incision and healing process. Many women experience discomfort in the lower back, hips, or pelvis as they adjust to these changes. Pelvic floor PT can help address these issues by retraining posture, improving pelvic alignment, and working on hip mobility. Not only will this help alleviate discomfort, but it can also restore more functional movement patterns so you can go about your daily activities with less pain.

5. Improving Posture and Stability

After a C-section, you may find yourself rounding your shoulders or leaning back to avoid pressure on your incision site. This change in posture can affect your pelvic alignment and contribute to lower back pain, neck tension, or even diastasis recti (when the abdominal muscles stretch). Pelvic floor PT will help you regain proper posture and stability, so you’re not compensating in ways that could cause further discomfort or injury. Learning how to properly engage your core muscles will help you carry and care for your baby more comfortably.

6. Supporting All Phases of Healing - Physical and Emotional

It’s so important to recognize that healing after childbirth is not just physical — it’s emotional too. Recovering from a C-section can bring up various feelings both happy and sometimes not. Having a pelvic floor physical therapist who understands the emotional journey of postpartum recovery can be incredibly supportive. We will listen to your concerns, work with you at a pace that feels right for you, and provide encouragement as you regain your strength and confidence.

When Should You Start Pelvic Floor PT After a C-Section?

Every person’s recovery timeline is different, and it’s always important to listen to your body. In the past, it was recommended to wait 6-8 weeks postpartum to start any kind of recovery plan and health professionals were putting multiple restrictions on moms. This was challenging because there is so much unknown in those 0-6 weeks of what you can or cannot, should or should not do. Also, being afraid to carry your baby, car seat or groceries is not ideal and this is where reaching out to your doctor or pelvic floor PT can be very beneficial.

I usually recommend connecting with your pelvic floor PT ~2-3 weeks following delivery. This way, you have your resource to go over how you are feeling, discuss strategies for healing and determine your plan to recover. I personally offer virtual check-ins as I know those first few weeks can be such a whirlwind trying to figure out routine and taking on the role of mom. My 2 week follow-up is essentially checking in on mama to see how you are feeling, addressing any physical or emotional concerns, and discussing how to start calming your body’s nervous system after C-section. We also discuss our plan for recovery that fits in YOUR schedule, whether that be weekly virtual calls, coming into clinic 1x a week or 1x a month. Your care, your way. 

Takeaway: You Don’t Have to Recover Alone

The journey to healing after a C-section is unique for every new mom. While your body is capable of incredible things, sometimes it just needs a little extra support along the way. Physical therapy can provide that support by addressing everything from scar healing to core strength, pelvic floor function, and more.

If you’re struggling with pain, discomfort, or pelvic floor dysfunction after a C-section, know that you don’t have to navigate this recovery on your own. A pelvic floor physical therapist can work with you to create a tailored plan to get you back to feeling like yourself — and more importantly, back to caring for your new baby with comfort and confidence.

Ready to start your postpartum recovery? Feel free to reach out and let’s chat about how pelvic floor PT can help you feel better, stronger, and more connected to your body.