Pregnancy and Postpartum Related Care
Are you experiencing:
Pubic bone pain or “fire crouch” when moving in bed or getting in and out of the car?
Pulling in abdomen when moving?
Skipping your favorite work outs and activities due to fear of abdominal separation?
Struggling to lift your child without symptoms of pelvic organ prolapse or back pain?
Having a hard time sitting due to tailbone pain or pelvic pain?
Common Pregnancy and Postpartum Conditions We Treat
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Birth Preparation — Get Ready for a Smooth Delivery
Preparing for childbirth involves both physical and mental readiness. Whether you plan to deliver vaginally or via C-section, taking steps to prepare your body and mind can make the experience smoother and more manageable.
Birth Prep & Push Training for Vaginal Delivery
Push training and preparing your body for labor can help improve the efficiency and effectiveness of your delivery, reduce the risk of injury, and support a more positive birth experience.
Key Components of Birth Prep and Push Training:
Core Strengthening: Pelvic floor exercises help tone and strengthen the muscles that support the uterus, bladder, and rectum. Strong core muscles can provide better support during pregnancy and increase endurance needed for various birth positions.
Breathing Techniques: Learning how to breathe effectively during contractions and pushing can reduce stress, help you stay focused, and improve your ability to push effectively.
Deep breathing: Practice slow, deep breathing to relax your body, reduce pain, and ensure oxygen supply to both you and the baby.
Pushing Techniques: Push training helps you learn how to use your breath and body mechanics for effective pushing. This training focuses on using your diaphragm and abdominal muscles while avoiding excessive strain on the pelvic floor.
Pelvic floor muscle relaxation needed for birth.
Pelvic Alignment and Mobility: Regular stretching and mobility exercises improve the flexibility of your pelvic region and hips, which can support optimal positioning of the baby during delivery.
Hip openers and squats: Gentle exercises such as pelvic tilts, hip circles, and squats help prepare the pelvic area for the pressures of labor and facilitate a smoother delivery.
Mindfulness and Relaxation: Reducing tension and anxiety can significantly impact your experience during labor. Techniques such as guided meditation, visualization, and relaxation exercises can help you stay calm and focused during the birth process.
C-Section Preparation
A C-section (caesarean delivery) is sometimes necessary for medical reasons or by choice. Preparing for a C-section involves understanding the procedure, setting realistic expectations for recovery, and focusing on your body’s ability to heal post-surgery.
Key Components of C-Section Preparation:
Physical Preparation: Strengthening your core and pelvic floor muscles can support your body during the recovery process and improve post-surgical healing.
Core Strengthening: Exercises that focus on core stability, such as pelvic tilts and gentle abdominal exercises, can help build strength for post-delivery recovery.
Pelvic Floor Health: Strengthening and relaxing the pelvic floor muscles also prepares you for the physical demands of childbirth and helps with a faster recovery after a C-section.
Breathing Techniques: Breathing deeply during labor can support relaxation and reduce the fear and anxiety surrounding the surgery. Post-C-section, focusing on deep breathing helps reduce pain and encourages proper oxygen flow during the healing process.
Postpartum Recovery Plan: C-sections involve a longer recovery time than vaginal births. It's essential to prepare yourself with a recovery plan, including:
Postural Support: Learn how to maintain good posture and avoid straining the abdominal area while moving and caring for your baby in the early days after surgery.
Gentle Movement and Stretching: Post-surgery movement should be gentle at first. After clearance from your healthcare provider, start with light walking and stretching to maintain mobility and improve circulation.
Pain Management: Discuss with your healthcare provider options for managing post-surgical pain, which may include medications, cold compresses, or alternative therapies like massage.
Support System: Having a supportive network of family and friends can help you manage the demands of C-section recovery. Ask for help with baby care, household tasks, and personal recovery needs.
Why Birth Prep and C-Section Preparation Are Important
Proper birth preparation — whether you’re planning a vaginal delivery or C-section — helps you feel more confident, reduce the likelihood of complications, and set yourself up for a smoother recovery.
Confidence: Knowing what to expect and having a plan for both vaginal delivery and C-section makes you feel more in control.
Reduced Anxiety: Preparation helps calm your nerves and enables you to approach your delivery with a positive mindset.
Faster Recovery: Physical preparation, such as strengthening exercises and postural training, helps your body recover more efficiently after delivery, whether vaginal or C-section.
Tips for Success in Birth Prep and C-Section Preparation:
Talk to Your Provider: Discuss your birth plan with your healthcare provider, including your preferences for vaginal delivery or C-section. This open conversation helps ensure your birth experience is as comfortable as possible.
Create a Birth Plan: Whether you plan for a vaginal delivery or a C-section, a birth plan helps outline your goals and preferences.
Stay Active and Mobile: Regular exercise and physical activity (within your comfort range) can prepare your body for childbirth, improve your overall health, and assist in a quicker recovery after delivery.
Stay Flexible: While preparation is key, it’s important to stay flexible, as labor and delivery may not always go as planned. Trust your healthcare team and remain open to the process.
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Pelvic Organ Prolapse (POP)
"Something feels like it’s falling..." — you’re not imagining it.
Pelvic organ prolapse happens when one or more of the pelvic organs — such as the bladder, uterus, rectum, or vaginal wall — drop from their normal position and begin to bulge into the vaginal canal. This occurs when the pelvic floor muscles and connective tissues become weakened or overstretched and can no longer support the organs effectively.
This is a common condition, especially after vaginal childbirth. While prolapse can feel alarming, it is treatable and manageable with the right support.
💬 Common Symptoms:
You may experience:
A feeling of heaviness, pressure, or dragging in the pelvis
Feeling of a “tampon” stuck in vagina
A bulge or lump in or near the vaginal opening
A sensation like something is "falling out" of the vagina
Discomfort or aching that worsens with prolonged standing, lifting, or at the end of the day
Difficulty fully emptying the bladder or bowels
Leaking of urine or stool
Changes in sexual sensation or discomfort with intercourse
Not everyone with prolapse experiences pain — some notice only a mild pressure or internal bulge, while others have more significant symptoms.
Pelvic floor physical therapy (PFPT) is one of the most effective non-surgical treatments for pelvic organ prolapse — especially in mild to moderate cases, or when symptoms are just starting. It focuses on strengthening, coordinating, and relaxing the muscles that support your pelvic organs (bladder, uterus, rectum), helping to reduce symptoms and improve your quality of life.
Here’s how pelvic floor PT can help with prolapse:
🧘♀️ 1. Strengthens the Pelvic Floor Muscles: The pelvic floor acts like a hammock or sling that holds up your pelvic organs. If those muscles are weak, the organs are more likely to shift downward.
Your PT will assess your baseline muscle strength and teach you how to perform the right kind of pelvic floor exercises (like Kegels), customized to your body.
It's not just about doing more reps — it’s about doing them correctly and in coordination with your breathing and core.
🧘♂️ 2. Improves Core and Pressure Management
If your core muscles (abdominals, diaphragm, back muscles) aren’t working in sync, it can increase downward pressure on the pelvic floor — making prolapse symptoms worse.
Your therapist will teach you how to coordinate your breath, core, and pelvic floor to minimize pressure during daily activities like lifting, coughing, or exercising.
This reduces strain and helps prevent further progression of the prolapse.
🔄 3. Addresses Muscle Tension or Imbalances
Sometimes pelvic floor muscles are too tight in certain areas and too weak in others — leading to poor support or discomfort.
A pelvic floor PT can release muscle tension with manual therapy, stretches, or biofeedback and help you retrain balanced, functional movement.
This may help with related symptoms like pain with intercourse, constipation, or urinary leakage that can accompany prolapse.
🚽 4. Improves Bladder and Bowel Function
Prolapse often makes it hard to fully empty your bladder or bowels — or causes leaks and urgency.
PT can help you relearn better voiding mechanics, bowel movement positioning, and strategies to avoid straining, which worsens prolapse.
You'll also learn how to avoid habits (like bearing down or breath-holding) that increase pressure on the pelvic organs.
🩺 5. Fitting or managing of a Pessary, recommendations of external garments or devices.
✅ Bottom Line: PT Helps You Feel Supported — Literally and Physically
Pelvic floor PT doesn’t “fix” prolapse in the way surgery might reposition organs, but it strengthens your body’s natural support system, helping:
Reduce symptoms like heaviness, bulging, leaking
Improve confidence with movement and exercise
Prevent worsening or recurrence
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Pubic Symphysis Dysfunction (PSD) — Understanding and Managing Pain During Pregnancy and Postpartum
Pubic Symphysis Dysfunction (PSD), also known as symphysis pubis dysfunction (SPD), is a condition that causes pain and discomfort in the pelvic area, specifically at the pubic symphysis — the joint where the two halves of the pelvis meet at the front. This joint allows for slight movement during activities like walking, squatting, and labor, but during pregnancy or postpartum, changes in hormones and joint instability can lead to pain, discomfort, and sometimes difficulty with basic movements.
What Causes Pubic Symphysis Dysfunction?
During pregnancy, the body releases the hormone relaxin, which helps to loosen the ligaments around the pelvis in preparation for childbirth. While this is essential for delivery, it can also lead to excess movement at the pubic symphysis joint, which may cause pain or discomfort. The pelvic ligaments, muscles, and tendons can become overstretched or imbalanced, contributing to discomfort.
PSD can also occur after childbirth, especially if the delivery was difficult or involved a prolonged pushing phase. The condition can persist postpartum due to the continuing hormonal effects or from pelvic floor and core imbalances.
Symptoms of Pubic Symphysis Dysfunction:
The primary symptom of PSD is pain in the pubic area, which can vary in severity. Common symptoms include:
Pain or tenderness in the pubic area (located at the front of the pelvis)
Pain during walking, turning in bed, or standing on one leg (e.g., when dressing or climbing stairs)
Pain while getting in and out of the car
A clicking or popping sensation when moving the hips or pelvis
Lower back pain or pain in the groin region that radiates into the legs or pelvis
Difficulty with activities involving movement (e.g., walking, running, bending, or lifting)
Increased pain with specific movements, like opening the legs or pivoting.
Working with a pelvic floor physical therapist can help improve pelvic alignment, strengthen the muscles around the pelvis, and correct imbalances. Physical therapy may involve:
Pelvic stabilization exercises: Exercises that strengthen the pelvic floor, core, and hip muscles can help support the pelvis and reduce joint instability.
Postural training: Learning how to maintain proper posture can reduce unnecessary strain on the pubic symphysis and prevent worsening pain.
Manual therapy: Gentle techniques to relieve tension and realign the pelvis.
Exercise Modifications
Use of a Pelvic Support Belt
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🤰 Diastasis Recti Abdominis (DRA) — What It Is & How Pelvic Floor PT Helps
Diastasis Recti Abdominis (DRA) is a common condition where the left and right abdominal muscles separate along the midline (linea alba), often due to the stretching and pressure from pregnancy, abdominal surgeries, or improper core loading.
While it’s most commonly seen during and after pregnancy, anyone can develop DRA — including athletes or individuals who lift improperly or have chronic abdominal pressure (from coughing, straining, or bloating).
📍 What Is Diastasis Recti?
The rectus abdominis (your “six-pack” muscles) normally meet at the center of your abdomen. During pregnancy or under chronic abdominal pressure, the connective tissue (linea alba) between them can thin and stretch, creating a gap.
DRA is diagnosed when that gap remains widened postpartum (typically >2 cm) or when the connective tissue feels weak or domed during activity.
💬 Common Signs & Symptoms:
A visible bulge, coning, or doming down the center of the abdomen (especially with crunches or getting up from bed)
Feeling of core weakness or instability
Low back pain or poor posture
Pelvic floor issues (like incontinence or prolapse)
Trouble lifting, twisting, or performing core-heavy tasks
A soft “dip” or gap when you press into the center of your belly
🧘♀️ How Pelvic Floor PT Helps with Diastasis Recti:
Pelvic floor physical therapy focuses on healing the gap, restoring function, and improving core strength — not just making the abdomen “look flat.”
✅ 1. Core Retraining
We teach you how to properly activate your deep core muscles, especially the transverse abdominis, which acts like a corset to stabilize the abdomen and spine.
You’ll learn how to engage the core without bulging or bearing down, which is key to healing the midline.
Exercises are progressed based on function, not appearance, to help you move safely and confidently.
✅ 2. Breath and Pressure Control
Breathing patterns and intra-abdominal pressure play a huge role in DRA.
We teach diaphragmatic breathing and how to coordinate breath with core and pelvic floor engagement, especially during lifting or movement.
This helps reduce strain on the midline and prevents worsening of the separation.
✅ 3. Pelvic Floor Integration
The core and pelvic floor work together — if one is off, the other compensates.
Many people with DRA also experience leaking, heaviness, or prolapse, which PFPT addresses in parallel.
Training both systems leads to more sustainable results.
✅ 4. Movement & Posture Coaching
Daily activities (like how you get out of bed, lift your child, or push a stroller) matter.
Your therapist will coach you on body mechanics and posture that protect your healing core.
You’ll also learn how to safely return to workouts, including strength training, yoga, or running.
✅ 5. Manual Therapy & Support
In some cases, gentle hands-on techniques may help release tight tissues around the abdomen or hips that are affecting alignment.
If scar tissue (like from a C-section or abdominal surgery) is contributing to the problem, we can address that too.
🕒 When to Start:
You can begin working on DRA during pregnancy, immediately postpartum with guidance, or years later — it’s never “too late” to start healing your core!
🧠 Final Thought:
Diastasis recti is common but not always normal — especially if it’s affecting your function or how you feel in your body. Pelvic floor and core therapy can help you feel strong, supported, and confident again.
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We love to help our clients feel confident during each phase of pregnancy and postpartum. Using a combination of hands on techniques, exercise modifications during pregnancy and early postpartum, and then help with the return to full activities/sports during the mid/late postpartum period.
Maintaining physical activity during pregnancy and postpartum is beneficial for both your physical and mental well-being. However, it’s important to approach exercise safely and with adjustments based on your changing body. Below, we offer guidance for exercising during pregnancy and the postpartum period, along with safe modifications for each stage.
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Fitting for intravaginal pessary which is a silicone device that can help with symptoms of prolapse and leakage. It can be used short-term or long-term, all the time or just during certain activities.
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🧘♀️ How Pelvic Floor PT Can Support Mechanical Infertility or unexplained fertility.
✅ 1. Releases Muscle Tension or Guarding
Chronic tightness or spasms in the pelvic floor muscles — especially in the deep hip rotators, abdominals, and pelvic floor — can contribute to:
Poor uterine or ovarian mobility
Compression of blood vessels or lymphatic drainage
Pain with intercourse (making conception more difficult)
PT can use manual therapy, stretching, and breathwork to improve muscle relaxation and function.
✅ 2. Improves Pelvic Alignment and Mobility
Pelvic misalignment (from old injuries, posture, or tension) can affect how organs like the uterus or ovaries sit or move within the pelvis.
Techniques like myofascial release, visceral mobilization, and postural retraining can restore space and symmetry — giving reproductive organs room to function optimally.
✅ 3. Enhances Blood Flow and Circulation
Healthy blood flow is critical for:
Ovarian and uterine function
Endometrial lining development
Hormone delivery and waste removal
Pelvic PT uses breathing strategies, mobility work, and positional training to encourage better circulation and reduce congestion in the pelvis.
✅ 4. Reduces Impact of Scar Tissue or Adhesions
Surgical scars (e.g., from C-section, laparoscopy, or abdominal surgery) and internal adhesions can tether organs, limit mobility, and cause pain.
Gentle scar tissue mobilization and fascial work can reduce restrictions, ease tension, and restore more optimal pelvic mechanics.
✅ 5. Supports Emotional Regulation and Stress Reduction
Infertility is emotionally exhausting. Pelvic floor PT often incorporates relaxation techniques, nervous system regulation, and trauma-informed care, which can help reduce cortisol and promote a more balanced body environment.