Physiotherapy for postpartum recovery

May is National Physiotherapy Month! In celebration of physiotherapists and all the work they do to improve our overall health, we’ve partnered with Pro Sport Rehab & Fitness to share more about the world of physiotherapy. This week’s article comes from physiotherapist Nichole Miller. Click here to meet Nichole.

The postpartum period is a time of immense change for new mothers. There are so many adjustments that come with having a new baby, a lot of them welcomed and anticipated, but some that can be unexpected and even problematic. Your body goes through a huge amount of change to accommodate your growing baby. The soft tissue structures that support the female body soften and stretch and your center of balance changes; after you birth your baby, your body will change considerably again. It can be challenging to know what’s “normal,” and what might not be.

Physiotherapists are healthcare practitioners that specialize in rehabilitation, the process of improving function and health, through the treatment of the soft tissues of the body, specifically the musculoskeletal system. There are many ways which a physiotherapist can be a part of your healthcare team through the postpartum phase and help you work through painful or problem areas. In fact, even if you are 20 or more years postpartum, you could find value in seeking treatment from a specialized physical therapist. Let’s talk about a few areas of interest.

Pelvic floor

The pelvic floor is a group of muscles that run from the pubic bone at the front to the tail bone at the back and side to side. This sling of muscles makes up the support system for the uterus, bladder, and rectum/intestines. Following the birth of a baby, it is not uncommon to experience changes in pelvic floor function. You may have even experienced some of these changes during pregnancy.  Problems may present in several different ways: urinary incontinence, fecal incontinence or constipation, heaviness in the vagina, prolapse or pain.

It can be a common misconception that because you had a C-section you should not have any issues with your pelvic floor. In fact, you do not have to have had a baby at all to have issues with pelvic floor function!

It is likely that at this point you have heard of a Kegel or have even been told to “do your Kegels!”.  A Kegel describes an exercise which engages and contracts the pelvic floor musculature.  However, simply contracting and relaxing this muscle group will not necessarily address your specific issues. In fact, Kegels for the wrong individual can make symptoms worse! That is why seeing a pelvic floor physiotherapist who is trained to assess and treat this specialized area is so important!

Diastasis recti – hot topic alert!

Diastasis recti is a widening of the soft tissue, the linea alba, between the sides of the abdominal musculature, the rectus abdominus or frequently referred to as the ‘six-pack’ muscle. This is very common and a normal occurrence during pregnancy to accommodate for your growing baby. In the weeks and months following the birth of your baby, this space may return to pre-pregnancy size, or it may not. The size of the gap pre-pregnancy is different on everyone, so while yours may seem large postpartum, it may have been large to begin with.

Dysfunction can present as doming or coning of the abdomen above, at, or below the belly button when the abdominal muscles contract (for example, when sitting up out of bed).  Our abdominal muscles play an important role in postural control, breathing, trunk movement and pelvic stability. Therefore, diastasis recti can be a contributing factor to other issues like low back pain or pelvic floor dysfunction. The width and depth of the separation are important, but the critical component is the coordination of the abdominals, management of intra-abdominal pressures and how these parts are working together during function.

A physiotherapist can diagnose and treat diastasis recti and often further intervention is not needed.

Cesarian section (C-section)

To bring your baby safely into the world you may have undergone a cesarian section, more commonly known as a C-section. A C-section is a major surgery. Rehabilitation plays an important role in recovery from surgical procedures. A physiotherapist can facilitate the healing of the soft tissues including scar massage, desensitization (no, your scar should not hurt to touch) and building foundational strength and coordination of the pelvic and abdominal musculature.

Return to exercise

Six weeks postpartum and your doctor has given you the green light! Yippee!

But wait… What does that mean? You don’t feel ready! How do you start? Maybe you exercised pre-pregnancy, maybe you didn’t. Either way your physiotherapist is a wonderful resource to help guide you in the process from restorative movement and foundational strength to achieving your exercise-based goals!

The other areas

Low back pain, upper back pain, shoulder, wrist, or foot pain are just a few of the other areas that can be symptomatic for a new mother given the changes occurring in her body and the demands of caring for a new baby. Instead of normalizing pain and dysfunction postpartum, let’s start normalizing rehabilitation!

How can you start seeing a physiotherapist?

If you are specifically seeking pre or postnatal care, be sure to look for a practitioner who practices in this area including specialized knowledge of the pelvic floor. Physiotherapists are direct access meaning you do not require a referral from your physician to book an appointment.

Blue Cross Tip: Personal Health Plans offer $400 coverage for physiotherapists and other health practitioners! If you’re already a plan member, you can find your coverage details on your personal member portal and app. Not a member yet? Learn more about available plans here.

As a healthcare provider on your postpartum treatment team, physiotherapists can help you achieve your ideal level of function and live your life to the fullest along – with your cute new sidekick!


Meet Nichole Miller, B.Sc., MPT, CAFCI

About Nichole  |  Originally from Calgary, Nichole moved to Saskatoon to attend the University of Saskatchewan where she completed a Bachelor of Science in Physiology followed by a Master’s Degree in Physical Therapy. Nichole has been working as a physical therapist at Pro Sport Rehab since 2012 and is currently working at the Warman location. She has completed post graduate education in concussion management, acupuncture, and pelvic health.

Nichole enjoys working with people of all ages and fitness levels. She strives to not only facilitate rehabilitation of dysfunction and injuries but also work with her clients to improve their overall wellbeing and quality of life. When not at work, Nichole stays active with her husband, three young children and young at heart dog. She prioritizes family time, enjoys running, and spending time outdoors.

About Pro Sport Rehab and Fitness | Pro Sport Rehab and Fitness is a multidisciplinary rehabilitation clinic located in Saskatoon’s north end, with a second location in Warman.  Pro Sport Rehab applies a sport rehab approach to all injuries.  Our disciplines include Physical therapy, Athletic Therapy, Chiropractic Care, and Massage Therapy.  We also have therapists trained in acupuncture, extra corporeal shockwave therapy and pelvic floor therapy.  Orthopedic braces are also available.