If you have had a C-section you may have questions about your recovery.   Let’s take a moment to help you understand why your recovery needs some special attention.  

As a specialty pelvic health, pregnancy & postpartum PT clinic, we are devoted to supporting C-section recovery through a holistic, whole-body, personalized physical therapy approach.  

What Should I Expect after a C-section?

Quick question:  what is the most common surgery in the United States that requires an inpatient stay?  Does it surprise you that the answer is a Csection?   And, yet, many women are discharged without guidance or understanding of what to do to support their recovery, in both the acute phase and longterm.   Because we specialize in postpartum recovery, including C-section-specific recovery through personalized physical therapy, we are privy to hearing women’s frustrations following their C-section.  They often are caught off guard to have challenges when recovering from their cesarean birth.   It does not help that culturally we dismiss the fact that this is major abdominal surgery and no one ever suggested they may need physical therapy.   And women are often thinking they should be able to “bounce back” after their C-section, yet don’t know what to expect and what they should be doing or avoiding. 

Following a C-section, our patients commonly report to us:

• Abdominal weakness
• Pelvic floor issues
• Scar tissue pain and adhesions.  Immediately after a C-section it is common to experience pain, however, published research has found that if you had excessive pain immediately after your cesarean birth, you are likely to experience ongoing pain.  Physical therapy can help this!
• A C-section shelf 
• Bladder & bowel symptoms, such as pain with bowel movements, difficulty emptying or urinary frequency & urgency
• Back pain or SI joint pain
• Chronic Pelvic Pain.  This may be vaginismus, tailbone pain, SI joint pain, deep vaginal pain, pelvic floor spasms,hip & pelvic pain, lower abdominal & pelvic pain

We help women who have had a C-section recover from their abdominal weakness, bladder leakage, scar pain, C-section shelf, back & pelvic pain and pelvic floor dysfunction.   We treat women whose C-section surgery was recent and also whose C-section surgery was many years ago and still dealing with C-section scar pain, adhesions, abdominal weakness, constipation, urinary control problems, painful intimacy, back pain or any other pelvic, hip or spine condition.

Our licensed physical therapists specialize in helping moms who have C-sections rehabilitate to their full strength and function so they have confidence in their body. If you are planning a C-section or have already had one or multiple C-sections, know it is never too late to get support from our physical therapists.   We know you may have questions about what to expect in physical therapy for C-section recovery, just reach out to us at (616) 516-4334 or contact us here with your questions and we will be in touch. 

C-section recovery can also have lingering physical, mental and emotional effects.  In fact, an emergency C-section carries a higher incidence of PTSD afterwards compared to both vaginal birth and elective cesarean sections. Risk factors for a mom to develop PTSD after giving birth include mother and baby medical complications, poor social support and any prior mental health history.  Our PTs are here to provide women the support they need to recover.  Our whole body aproach is trauma-informed and gives women the peace of mind and guidance necessary to help them understand what they are experiencing and how to recover from their C-section through physical therapy that is progressive, customized to their needs, addresses their whole body, includes care for their nervous system and is trauma-informed.   

Women who have had a C-section should absolutely have their c-section recovery properly guided through physical therapy.   A supported & progressive recovery, guided in safe rehabilitation principles and personalized to your exact needs optimizes strength, function and longterm health and wellbeing.  

You deserve and need support to get your surgery and postpartum body to recover and get back to moving effectively, so you don’t hurt yourself.  Making the effort to rehabilitate your body makes a huge difference in both the short-term and also for your long-term health and wellbeing.  To learn more about working with our pregnancy & postpartum specialist PTs, call us at (616) 516-4334 or submit your question to use here and we will be in touch.  

Here’s one mom’s recounting of her C-section recovery and how physical therapy helped:

I didn’t know I would need so much help.  I was in a lot of pain and no one told me what to do to help my pain.  My labor was really hard, I had a lot of back labor and then had the emergency C-section.  I also had some back pain when pregnant, but didn’t expect back pain after the pregnancy.  After my baby was born, I was standing to chop vegetables and it so painful, I couldn’t do it.  My whole pelvis hurt and my back and C-section.  My C-section felt pulling and sometimes shooting pain.  I was worried something was tearing or had been torn from pregnancy or my labor or maybe my surgery. I didn’t know.  It was alarming to me to be unable to chop vegetables.  My best advice to other moms is to ask for and accept help. I thought I could chop vegetables and I couldn’t.  I want to be chasing my baby.  I’m young and active and knew that to be able to get back to myself, I needed help.  Physical therapy really helped me, my entire body was “off” and with each appointment I could feel myself coming back from that weakness and pain.  I felt so validated knowing that my body would be able to heal and get strong.  I loved the ultrasound, it really helped my brain figure out how to activate my muscles.  I avoided touching my scar, it was sensitive and painful and I just avoided even looking at it.  But, with PT she worked on my scar with massage, cupping and dry needles and it felt so much better.  It also looked better.  I didn’t have that constant pinching, itching or pulling sensation anymore.  I liked that my appointments would be catered to what I needed that day.  Somedays we did a lot of exercises because I needed to learn how to stand correctly, walk better, strengthen my abs & back and control my bladder.  Most appointments were both hands-on treatments, like my scar massage and neck and back massage, with the ultrasound exercises or the whole body vibration exercises.   She gave me exercises to do at home and I appreciated they were made for me.  When I get pregnant again I don’t want back pain and I hope to have a vaginal birth.  I plan to come to physical therapy during that pregnancy for the birth prep and to make sure my body is feeling good and strong.

The truth is that your C-section recovery takes time, needs to be progressive (meaning steadily building up the rehabilitation program) and must be comprehensive to address all of the changes that occurred in your body related to your pregnancy.

C-section recovery through physical therapy should be standard of care so you are safe, know what you should be doing and should be avoiding and you can feel confident with being an active mom, lifting your kids, getting pregnant again and simply feel good in your body.  If this is ringing your bell of truth and you want help, we are just a phone call away.  Reach out to us at (616) 516-4334 to get your questions answered, or submit your questions here and we will be in touch. 

At Purple Mountain Physical Therapy, we do things differently, precisely because we are established to provide a whole-body, personalized & comprehensive treatment plan for our postpartum patients, especially women who need to recover from C-section.   Our PT treatments are personalized to each person’s unique needs and include manual therapies (such as scar massage, myofascial release, joint mobilization, manual stretching) and also corrective therapeutic exercises.  The treatments we provide address your strength, motor control, movement patterns, fascial restrictions, nerves, scar tissue, pain, balance and postural changes.    

A Physical Therapist’s Insight into What Happens to the Body After a C-Section 

We all know that pregnancy generates massive changes in a woman’s body, including posture changes, tightness in the low back, elongation and weakening of the abdominals, pelvic floor strain, hip changes and often pain or issues in your thumbs, neck, shoulders, wrists, knees, hips or feet.   In addition to these common pregnancy related body changes, a woman who has a Cesarean birth has experienced a major surgical change to her uterus, muscles, fascia, and nerves.  Pregnancy itself changes core strength and pelvic floor connection and then add in a C-section and recovery can be much more challenging to get these muscles working properly.   

Following a C-Section, The Abdominals, Diaphragm and Pelvic Floor Become Weak, Impaired and Discoordinated.  At Purple Mountain PT, we use a whole body framework to address this.

C-section recovery requires extra attention to retraining the core and pelvic floor connection through introducing deep core training, reconnecting with the diaphragm, addressing movement patterns and slowly building back strength to avoid developing patterns to compensate for weakness or pain that lead to further issues down the line.

• Yes, pregnancy disrupted the abdominals.
• Yes, pregnancy changed your pelvic floor.
• Yes, pregnancy altered your ribcage, diaphragm and breathing.
• And, your C-section surgery further changed, in a major way, your abdominal wall and its ability to coordinate with your breathing and your pelvic floor.

Our pregnancy and postpartum physical therapists find that our patients who are going through their C-section recovery require extra guidance and support for retraining their abdominals, pelvic floor and diaphragm.   They, quite literally, often have no idea if they are correctly activating their deep core muscles of their abdominals.  When this is the case, our Rehabilitative Ultrasound Imaging comes in for the Win!

Pelvic Floor Dysfunction can occur. Pregnancy, regardless of mode of delivery, is associated with pelvic floor dysfunction.

Some of our patients mistakenly think that because they had a cesarean birth they should not have any pelvic floor dysfunction. Pelvic floor dysfunction is common after pregnancy and C-section birth.   The signs and symptoms of pelvic floor dysfunction include, but are not limited to: bladder leaking, flatulence (gas) incontinence, needing to wipe excessively after defecating, pelvic pressure or heaviness, pain with intimacy, pelvic muscle spasms, vaginismus or changes in your bladder or bowel function.

If you’re a mom, whether you delivered vaginally or by C-section, if you have noticed any of these symptoms, you are not alone.  Studies show that millions of women experience pelvic floor dysfunction.  In fact, it is common for adolescent athletes to experience stress urinary incontinence, which is involuntary leakage with laughing, coughing, jumping, running, sneezing.   As we go through our lifespan, women have increasing risks of experiencing pelvic floor dysfunction and pregnancy is one risk factor for this.   Nearly 1 in 3 women experience urinary leakage and many other women also have some degree of pelvic organ prolapse as they move from pregnancy, through motherhood, towards perimenopause and beyond.   Pregnancy, vaginal or C-section delivery, prior surgeries, core weakness, aports with jumping & cutting moves and even things like chronic coughing or strained breathing (asthma) or high impact exercise can all play a role in developing pelvic floor dysfunction.

One study identified that higher weight gain during pregnancy was a risk factor for pelvic floor dysfunction.   The study also found that if a women experienced urinary leakage during pregnancy, then this was a risk factor for her to continue experiencing incontinence when the baby is two years old.  Physical therapy helps this! We’re here for you!  What’s holding you back from addressing this?  Our licensed PTs have devoted our entire careers to helping resolve pelvic floor dysfunction.   You can speak with a knowledgable team member and get your questions answered by calling (616) 516-4334 or asking us a question here.  

Pelvic floor dysfunction slows us down, physically.  Research has found that if we leak urine or have pelvic organ prolapse issues, we are less likely to exercise and engage in lifelong heart healthy fitness. We stop running and jumping, for example.  It also can be associated with body image negativity.   After a C-section, because women are usually not expecting to have pelvic floor issues (this is misguided thinking), they often don’t think they should need any physical therapy.   This couldn’t be further from the truth.  If you are having any signs of pelvic floor dysfunction, just living with it and not doing any physical therapy to support your C-section recovery is not the best path forward.  These problems do not improve with age, they get worse.  We need to be strong and healthy throughout our lifespan. Don’t give up on your health and wellbeing!  There is good support for C-section recovery through specialized physical therapy.

So, if you have pelvic floor dysfunction after C-section, what do you need to know about working with our physical therapists for your recovery?

Our PT is completely one-on-one between you and your physical therapist.  We do not use lesser trained aides during your appointments.  We do not treat two patients at one time.  We never leave you alone to do your exercises by yourself during your appointment.  We tailor the appointment to your needs and use detailed methods to effectively guide you to reconnect your core and pelvic floor muscles.  The pelvic floor muscles work as part of a team with the rest of your body, gently supporting the organs that are above them and pairing with your hips and low back muscles.   This is why your treatments will include hands-on therapies such as myofascial release, visceral mobilization, C-section scar massage, joint and pelvic balancing and gentle, therapeutic work to your low back, hips, neck and pelvic floor to restore movement and reduce pain.   By guiding your through personalized exercises to rebuild strength, coordination and function of your pelvic floor, deep core and postural muscles, you will gain confidence in your body.

If you are experiencing pelvic floor dysfunction after your C-section, you are not alone.  You deserve answers.  You have a duty to be strong and to take care of yourself.  You deserve all the support you need to feel at home in your body again.  With the right care, from our specialist PTs, all of this is possible.   Reach out today at (616) 516-4334 or here. 

You may experience Urinary Incontinence after your C-section.   Pregnancy is an established risk factor for incontinence, regardless of mode of delivery.

It is commonly believed that a C-section may have spared your pelvic floor and because of this misconception a lot of our patients who had a C-section are baffled as to why they are experiencing urinary incontinence.  They say to us “I didn’t even push my baby out, why do I have this leakage?”  The rates of leakage of urine are lowest for women who never had a baby at 10.1% and with a C-section incontinence rates increases to 15.9%. Vaginal birth carries the highest rates of incontinence, at 21% of women experiencing it.

Pregnancy itself is a strain on the pelvic floor and many women experience incontinence during pregnancy.  If this was you, know that you have a higher chance of experiencing leakage after the pregnancy, even if you had a C-section.  In fact, 6.2% of women who have a C-section report moderate or severe incontinence.

You may be surprised to learn that Urge Incontinence rates are highest for women who birth via C-section compared to vaginal birth and no births.   Urge incontinence occurs in 2.2% of women after C-section perhaps related to the surgery begin very near the bladder (though the bladder is not cut) and scar tissue possibly impacting the bladder muscles leading to spasms and incontinence.  Following vaginal birth urge incontinence occurs at a rate of 1.8%, only slightly above the 1.6% rate of women who never had a birth.

To put all of this into context, women who had a vaginal delivery are more likely, overall, to experience incontinence compared to women who had a C-section.  In fact, vaginal birth is 70% more likely to have any amount of leakage and over two times more likely to have moderate to severe leakage.   While vaginal delivery can increase the risk of incontinence compared to cesarean birth, any pregnancy and delivery increases your incontinence risk compared to never having a baby.  This is not inevitable and it definitely does not mean it’s something you have to accept and live with.  Incontinence is very treatable with the personalized pelvic health physical therapy we provide.

Key takeaways regarding Incontinence and C-section Recovery through Physical Therapy

Although C-sections are commonly believed to “protect” the pelvic floor, any pregnancy is a risk for developing pelvic floor dysfunction and incontinence.  A C-section does not eliminate the risk of incontinence.

• Women who have had a C-section are more likely to experience leaking than women who have never given birth
• Compared to vaginal birth, C-section has a lower risk of incontinence. However, with C-section the risk of incontinence increases about 40-50% compared to women who have never been pregnant
• The most common types of leakage after a C-section are very treatable through physical therapy. These are:
  • Stress incontinence, which is leaking with coughing, sneezing, laughing, singing, running, jumping
  • Mixed incontinence, which is a combination of both stress incontinence and urge incontinence, which is when you rush to the toilet and lose urine on the way.
• About 1 in 6 women who have a C-section experience some form of incontinence
• About 6% of women who have a C-section experience moderate and bothersome leakage.

What this means for you, if you have incontinence after C-section:

If you’ve had a C-section and are experiencing leaking- even occasionally- this is common and not something you should ignore.  When neglected they tend to get worse with age.  Your core muscles, posture and pelvic floor were all significantly impacted by pregnancy, surgery and your postpartum recovery.  These problems are very treatable with physical therapy.

Many women are dismissed when it comes to having incontinence issues after a C-section.  They may be told “at least you had a C-section” as if it prevents these issues. This is not the case.  Your body has been through a major pregnancy and surgery and you need to be proactive about your C-section recovery to give yourself the best chance of living an active, healthy life.  Your posture, movement patterns, abdominal wall, scar tissue, breathing, pressure control systems, urogenital system and pelvic floor coordination all play a role in your recovery.  Our PTs are here to customize your treatment plan so you can overcome incontinence and also address all of the things your postpartum body needs.   We have a knowledgable team of people who are available to let you know more about working with our PTs and how to get started. Reach out to us today at (616) 516-4334 or submit a question here and we will be in touch.

Your Abdominal Muscles Need Help After a C-section.

After pregnancy and delivery, the muscles of your abdominals become weaker, elongated, thinner and less coordinated. This holds true for both C-section and vaginal births.   However, c-sections demonstrate more complex changes, not just in the muscles, but also in the connective tissues (fascia) and scar tissues that surround and support those muscles.

For moms who had a C-section, research has found the following more complex abdominal muscle changes compared to vaginal birth:

• Thinner and imbalanced core muscles.   A thinner muscle has a harder time generating strength and stability
• A wider separation of the abdominal muscles. This diastasis recti abdominis can often be visualized when you see a doming of your abdominals when you try to do a sit-up.
• Thickened and less mobile scar tissue and fascia, creating stiffness, pulling, tension or pain through the abdomen.   Potentially affecting the bowels, uterus or bladder.
• These changes have been associated with ongoing pain in women who had C-sections, including abdominal, pelvic and low back pain.

For moms who had a vaginal delivery, the abdominal wall changes are also profound, yet different.   In comparison to abdominal wall changes associated with C-section birth, vaginal deliveries have been found to have these abdominal changes:

• Core muscles were also thinner and sometimes right to left sides demonstrate uneven tendencies.
• Deeper tissue restrictions are less prominent in vaginal birth compared to C-section.
• Scarring is less prominent in vaginal birth compared to C-section.

Why these Abdominal Wall Changes Matter for your C-section Recovery:  These altered abdominal muscles, fascia and scar tissue impact how your entire core system works.

If the abdominals are weak and not coordinated with our diaphragm, pelvic floor muscles and low back muscles, we experience myriad symptoms.  Recovery from C-section is not simply about abdominal strength, it is also about how well your muscles and tissue coordinate, support your organs, glide together, stretch and move.  That’s why our patients tell us that they notice things like:

• Weak abdominals.   They have trouble doing planks, sit ups, holding their kids for extended times.
• A persistent belly “pooch”
• A C-section shelf
• Back pain, pelvic pain or pelvic pressure
• “Bad posture”.  Moms consistently tell us they know they slouch, their abdomen pooches and their head is forward.
• Difficulty returning to exercise or higher level activities, often due to being too weak and sometimes because they tend to get hurt.

After Pregnancy and C-section, Women Typically Do Not Know How to Effectively Use Their Weakened, Elongated, Separated and Surgically Disrupted Abdominals.   Your body has not failed!  In fact, it triumphed as it adapted to pregnancy.  Now it just needs the right guidance to recover from your pregnancy and C-section.  Our PTs specialize in abdominal wall and deep core rehabilitation, including your pelvic floor, deep core of your low back and diaphragm muscles.

The encouraging news if you are having abdominal muscle problems after your C-section or vaginal birth:  These are not permanent problems.  They are treatable with the right approach that is customized to your specific needs.  With our specialized pelvic health, postpartum physical therapy you will be able to:

• Retrain your deep core abdominal muscles, pelvic floor muscles, low back muscles and diaphragm.   We are often using real-time ultrasound in our PT session so you can see and connect to these muscles
• Improve scar mobility, reduce adhesions, help flatten your C-section shelf and resolve scar pain. We do this through hands-on treatment and coordinated movement training to get your abdominal wall and scar tissue to move again.
• Restore your postural muscles, from head to toe.  We address your neck strength, your feet and toe mobility, your scapula & shoulder stability and strength and everything else in between.  To have a strong abdominal wall, you also need good postural control.
• Improve your balance, coordination, movement patterns and strength across your entire body.
• Address pain at its root and including the musculoskeletal contributions to your pain, such as posture, pelvic floor tension, shallow breathing, stiffness in your low back.   As well as the nervous system contributions to your pain.

Our clinic is unique in offering Rehabilitative Ultrasound Imaging (rUSI) as standard of care for all of our postpartum women, especially if you are recovering from a C-section.

The rUSI is a special type of Ultrasound specifically calibrated to see your muscles while you exercise.  It is incredible and patients love this.   While your postpartum specialist physical therapist uses ultrasound to your abdominal wall, you are seeing your muscles in real-time.   Our PTs assess and measure each layer of abdominals and your diastasis recti abdominis.  This is very helpful for you to know the extent of your diastasis recti abdominis and your pelvic floor dysfunction.  And, over time we can measure and see progress.  While the ultrasound is imaging your abdominal muscle layers or your pelvic floor muscles and bladder, your PT will guide you to perform specific exercises.  As you breathe, connect with these muscles and watch the ultrasound image, your brain and body are able to better figure out how to bring back the coordination and contraction of these important muscles. Your PT guides you to coordinating the proper muscles to contract and to relax the muscles that are overworking.  Patients tell us this is hugely helpful and seeing their muscles on ultrasound helps their brain figure out what to do.  If you are interested in receiving personalized and comprehensive C-section recovery through physical therapy with one of our specialist PTs, reach out to us at (616) 516-4334 or contact us here and we will be in touch.

Your Scar May Have Chronic Pain, Adhesions or Develop a C-section Shelf.  There is help!  Did you know that research has found that specialized soft tissue mobilization of your C-section scar, by a physical therapist, can reduce your pain and enhance your recovery?

Our PTs assess and treat every abdominal scar, including C-sections and all laparoscopic scars (from surgeries such as gall bladder removal or endometriosis excision).  We support your C-section recovery through physical therapy that includes soft tissue mobilization, visceral mobilization, scar tissue manual therapy and manual therapies to your low back, hips, ribcage and thoracic spine.   Our PTs are trained in myofascial release and we understand the head-to-toe connections of fascia. Because of this, you may be surprised that your C-section scar treatment is directed both to the scar itself and also to your neck, shoulders and sacrum.   Our PTs further enhance your C-section scar development by retraining the deep core and diaphragm and improving your spine and hip mobility.  All of our C-section scar treatments are performed within our Whole-Body framework of treatment. This means, we are treating you as a whole person and addressing your posture, mobility, balance, strength, motor control and movement patterns to optimize your C-section scar, you abdominal wall recovery and your pelvic floor.  If your c-section scar is painful, it is telling you that something is not right and your healing process would benefit from a licensed physical therapist to develop a treatment plan to ease c-section scar pain. To answer your questions about treatment for c-section scars, contact us here.

The C-section Shelf, there’s help for this

If you’re concerned about the tissue above your C-section scar hanging over the scar, this is called a C-section shelf.  It is a common issue and it is not simply a problem related to aesthetics.  A c-section shelf is often a result of how the scar tissue healed underneath the skin.  After surgery, scar tissue grows and responds to the forces your body generates in daily movements.  Sometimes the scar tissue can develop adhesions, become tight, thick or stuck to layers below it, including your fascia and abdominal muscles.  These limit how your skin and tissues move and appear.  While the shelf-like appearance may be visually concerning, you may also experience deeper symptoms such pulling, excess numbness, core weakness, back pain or pelvic floor issues.

We are often asked “will this ever go away?”  The answer is that yes, this can absolutely improve with the right treatment.  This is where our specialized physical therapy makes a big difference.  In our one-on-one appointments, we use gentle, hands-on techniques to perform scar tissue and visceral mobilization, myofascial release and fascial stretching to help the scar and surrounding tissues slide, glide and move more freely.  This isn’t agressive or painful.  It is tailored to your comfort, especially if you have scar sensitivity or are hesitant to touch it.

With our whole body approch, treatment for a C-section shelf goes beyond the scar itself and includes understanding of your body’s head to toe fascia connections, movement patterns, postural habits and strength.  Using tools like rehabilitative ultrasound imaging and whole body vibration, we help you reconnect with your deep core muscles so you can rebuild strength in a way that supports healing. This is important because doing abdominal exercises in a manner that worsens a diastasis recti abdominis can worsen your shelf.  Under the watchful eye of our experienced PT, you’ll learn how to coordinate your breath, core and pelvic floor, which plays a huge role in how your abdomen functions, supports your low back and looks.

Over time, our PT recovery treatments for your Csection shelf can help soften the shelf, improve mobility, restore visceral (organ) normal ability to slide and move, reduce pain and reconnect a stronger core.  More importantly, this care helps you feel more at home in your body again, because what we are achieving together isn’t just cosmetic, it’s functional healing.   To work with one of our specialist PTs, you just need to call us at (616) 516-4334.

What our patients tells us about how PT helped their C-section scar

Patients tell us their C-section scar does not bug them anymore. They say they can touch it without hypersensitivity.  They tell us it lies flatted, their C-section shelf is gone. They can wear pants on their scar without it hurting. And, most importantly, they can reach and twist and turn without an uncomfortable pulling or sharp shooting pain in their scar. Additionally, they notice that their bladder urgency, which may be due to scar tissue near or around their bladder also calms down.  Our gentle and specialized C-section scar treatments give you the TLC you deserve for your C-section recovery.   If you are interested in having your C-section scar assessed for adhesions, pinched nerves, scar tissue, visceral restrictions or hypersensitivity, give us a call at (616) 516-4334 or submit your query here and we will respond to you.

Chronic Pelvic Pain:  The Problem No One Told You About.  Research has found that women who have had C-sections have a 6.1% increased incidence of chronic pelvic pain, compared to women who had vaginal birth.   C-section DOUBLED the odds of experiencing Chronic Pelvic Pain

I wish women were more informed about the fact that chronic pelvic pain may occur after a C-section and that, if this is the case, they should start to work with a specialist PT right away, without delay.  Chronic pelvic pain after a C-section is depressing, fatiguing, very worrisome and often leaves women feeling isolated, anxious and overwhelmed.   Research shows that women who have had a C-section birth have double the odds of experiencing chronic pelvic pain  This pain may involve C-section scar pain, bowel or bladder pain, deep pelvic pain,  pubic pain, vaginal pain, tailbone pain, lower abdominal pain, SI joint pain or pelvic floor pain.  If you are among the moms who is having chronic pelvic pain after C-section, you are not alone.  There is a path forward.

At Purple Mountain PT, our licensed pelvic health physical therapists have advanced training in both chronic pelvic pain and C-section recovery.

We provide one-on-one, highly personalized care that addresses your whole body, not just your pelvic floor or your scar.  Your PT plan of care is tailored to your specific needs and goals and may include hands-on treatement such as gentle and calming manual therapy to your neck, ribs, low back, hips, thighs and pelvic floor, myofascial release, visceral mobilization, scar tissue mobilization, joint mobilization and pelvic balancing to restore alignment, quiet pain and reduce strain on irritated tissues and joints.  To learn more about our personalized and comprehensive C-section recovery through physical therapy, reach out to us at (616) 516-4334 or contact us here and we will be in touch.

As noted above, our personalized PT care includes rehabilitative ultrasound imaging to help you reconnect with and retrain your abdominal and pelvic floor muscles, giving you real-time feedback while you watch your muscles during exercise and our PTs guide you toward restoring their performince and coordination.   Easing pelvic floor tension is a key component of easing pelvic pain and our PTs address this with manual therapies, ultrasound imaging, guided movement, nervous system downtraining and pain neuroscience education.  Women tell us that our treatments relieve their pelvic pain and also give them confidence in knowing they are doing the right things to help themselves.

Your Nervous System Needs Balancing:  Beyond the physical strength & coordination component of C-section recovery, at our clinic we also treat your nervous system.  This is unique at Purple Mountain Physical Therapy.  Our PTs create a treatment plan to calm your chronic pelvic pain, reduce pelvic floor & abdominal muscle spasms, promote a balance between your ability to rest & ability to be focused & productive.  We work to ease irritated nerves and heal pelvic pain so your C-section recovery can be complete and ultimately you will be painfree.

Our whole body approach helps to down-regulate an overactive sympathetic nervous system and recalibrate a central nervous system that is sensitized and causing pain.   Our methods help support true healing. At the end of appointments patients tell us that they feel relaxed, better able to move and have less pain.  When treatment also includes progressive, individualized therapeutic exercise to rebuild strength, enhance your balance & posture, improve coordination, and restore function, our patients can return to the activities they love.

Whether you’re dealing with pudendal neuralgia, SI joint pain, chronic pubic pain, tailbone pain, anal spasms, vaginismus, pelvic congestion syndrome or symptoms you haven’t been able to put a name to, we help women like you every day move from fear and frustration to clarity, strength, and relief.   We are deeply devoted to this work.  Our licensed PTs have extensive experience and are ready to help you.  Your c-section recovery and chronic pelvic pain recovery through physical therapy will serve as a lighthouse for you.  To learn more about working with our PTs, call (616) 516-4334 or contact us here.

One patient this week just emailed us after her appointment saying:

I have to say my PT appointments are a highlight of my weeks. I always leave feeling better than I came!

This is our goal!  We are moms, too.  We have done the hard work of recovering from our own pregnancies. We also have many years of experience, devoted to treating pregnancy and postpartum conditions, including chronic pelvic pain, C-section scar adhesions, low back pain, abdominal weakness, pelvic floor dysfunction, hypermobility, chronic pelvic pain and altered posture.   If you are wanting to work with a true C-section recovery physical therapist, you have found the right place.  Reach out to us today at (616) 516-4334 to have your questions answered or give us an online submission and we will be in touch with you.  You deserve the best for your C-section recovery!

 When is it Time to Start Physical Therapy after a C-section?

Most women benefit from beginning, on their own, some basic breathing exercises, pelvic floor exercises and abdominal exercises in the first few weeks after a c-section.  For our patients who had a C-section, some of them need to start PT right away.   These women tend to be experiencing more pain than expected, difficulty walking and moving and/or more substantial bladder issues early on.   

We do have some women who come to PT very early on who are not experiencing these excess symptoms, yet have told us that they want and need to get their healing going on the right foot, right away.   We know that a lot of scar healing is occurring in those first two months, so it can be helpful to start care with our PTs sooner, rather than delaying.   

There are many warning signs that women can experience with their postpartum recovery and C-section scars and incision sites that can indicate a need for treatment through a licensed physical therapist. For example, excessive C-section scar pain, even in the first 24 hours after surgery, has been found to have a greater risk of long-term pain and it is important to be proactive about starting PT to work on your scar pain.   Many of our patients have told us “Right away, I knew something wasn’t right with my C-section. I had so much pain, it was so bad.”  If this is you, get into PT sooner, rather than later.   However, it is never too late to start your PT for C-section related scar issues.  Even if it has been years since you had a C-section, if you are noticing symptoms like pain when at rest or moving, puckering of the skin along the length of the scar, feeling restricted in movements in any direction, or feeling pain and discomfort when pants or clothing touch the scar, we help women just like you all the time.   And, yes, your “old” C-section scar can still be improved.   

Many women start PT around 6 weeks postpartum. This is not set in stone, yet it is a guideline.  We understand that you need to rest, restore and bond with your baby.   In those first couple of months we begin to help your body reconnect with your abdominals and breathing. We help your tight low back.   We gently work on your C-section scar and also teach you what you can be doing for yourself to optimize your recovery.  The PT care is progressive, as you move along in your first year postpartum.   We have a return to running guideline that includes assessment of pelvic floor support and risk assessment for prolapse and other concerns, such as hip safety, pelvic floor dysfunction and abdominal wall integrity of the diastasis recti abdominis.   You can call us at (616) 516-4334 to learn more.

Common Issues Physical Therapy Can Help with After a C-section

We’ve already talked about physical therapy for C-section recovery can help with pelvic floor dysfunction, urinary incontinence, weakened abdominal muscles, C-section scar pain, chronic pelvic pain and C-section shelf.  There are also many other pregnancy and postpartum related conditions we help, such as chronic neck pain, tailbone pain, SI joint pain and carpal tunnel syndrome.  Our physical therapy clinic located in Grand Rapids, Michigan specializes in a whole body approach to treating pelvic health, spine, and TMJ solutions. We see many patients daily who experience success in their C-section recovery through physical therapy.   We love to help our patients learn and be educated about their body as they work with us to experience healing and confidence in their postpartum recovery. 

If you or a loved one are noticing pain, weakness, incontinence or lingering symptoms after a pregnancy or C-section, reach out to schedule a visit with us today! You can reach our office at (616) 516-4334 Monday through Friday every week. If you call after hours, our voicemail box is always open, and we will call you back as soon as we can!

Treatment & Time: How Long Does It Take to Recover from a C-section? Give yourself a year or two.

The amount of time that it takes to recover from a C-section and the scar it produces can vary from woman to woman. 

If the question is how long does it take for the surgical tissues from a C-section scar take to heal, the answer is that it takes about 6 to 8 weeks for the initial abdominal incision and internal tissues to heal.  the first two weeks will be when you are most impaired with movement and strength and experience pain.  After the first two weeks, you should be taking it easy with your activities and gradually getting back towards normal daily activities around 6 weeks.   It is often recommended to avoid lifting anything heavier than your baby for those first 6-8 weeks.  Our PTs treat women who have older children, however, that need to be picked up.  So, we teach our patients how to safely lift and move.  Beyond these initial 6 to 8 weeks, scar tissue continues to remodel and your general postpartum recovery takes about one year.  If you are wanting to work with our C-section recovery physical therapist,reach out to us today at (616) 516-4334 to ask us a question or give us an online submission and we will be in touch with you.  You deserve the best for your C-section recovery!

Women who have recently given birth have multiple concerns happening at once. These concerns can be conditions like diastasis recti, painful intimacy, urinary incontinence, low back pain and more.  Our whole body approach is unique.  Most PT clinics approach a person based on their diagnosis (such as low back pain) and then all treatment is limited to their body part associated with their diagnosis (such as the low back). 

The American College of Obstetrics and Gynecology recommends that if you had a cesarean delivery you wait at least 18 months to get pregnant again.   This is because your uterus was cut for your C-section and 18-24 months interval allows your uterine scar the time needed to fully heal, thus lowering risks for preterm birth, uterine rupture and placenta issues in your next pregnancy.  This timeframe of 18-24 months illustrates clearly that your body is healing for a much longer time than you may realize. Be patient with yourself.  And don’t delay starting physical therapy.   It is better to get your recovery from C-section going early on than to live with weakness, potentially hurting yourself, developing awkward movement patterns and straining your body.

At Purple Mountain PT, we expand our understanding of your postpartum recovery to include the fact that your whole body changed during pregnancy and is connected and contributing to symptoms. This is especially important with regard to postpartum recovery, because it acknowledges the tremendous achievement your body accomplished while providing patience and support during your postpartum recovery.  Every part of your body was altered to be able to grow your baby.  Give yourself a pat on the back and know your recovery will take time.  

As specialists in pelvic pain, pregnancy and postpartum recovery, we have a soft spot in our hearts for moms.   Our goal is to help you recognize your pain and what causes it so that we can begin walking the path to your healing! We want you to feel more in-tune with your body and marvel at its ability to heal with help from our specialized physical therapists. 

We know that pregnancy took 9 months and we recommend every woman consider the first year postpartum to be a year of recovery. Several factors are involved in the healing process from a C-section surgery including how the tissues healed and connected to each other after being surgically opened, if there has been any strain to the area through altered posture, repetitive movement patterns or injury after birth, how old the C-section scar is, and more. Scar tissue mobilization, after the incision has healed, is very important in the recovery process and in the improvement of the appearance of the scar.  The incision is delicate in those first few weeks, so it is important to not dive into scar tissue mobilization, cupping, or deep massage too soon. In general, this means waiting around 6-8 weeks postpartum to begin working on improving the scar appearance.  However, in those first 6-8 weeks, your body is laying down new scar and you want to optimize your movement, breathing, posture and care of this so that the scar has the best chance of wonderful healing.  If you want more information about working with us, give us a call at (616) 516-4334 or ask us a question here. 

Your C-section Recovery Journey Begins Today! 

A c-section delivery is major abdominal surgery.  Without proper recovery, it can lead to ongoing issues like pain, a C-section shelf, core weakness and bladder leakage.  Having a baby impacts your body, mind and spirit, and while you give so much to your baby, you deserve to feel your best, too.  You shouldn’t have to navigate this alone or settle for feeling less than your best. 

At Purple Mountain Physical Therapy postpartum and c-section recovery is our specialty.  Our PTs are dedicated to helping you heal fully, regain strength and confidence, and get back to the life you want to live.   We want to be a part of your journey and see you thrive.  Together, we can work as a team to get you to where you want to be. 

Peace,

Dr. Maureen O’Keefe, DPT  Founder of Purple Mountain PT

You May Be Interested In These Other Articles:

Tips to Prevent Pelvic Floor Injury During Childbirth

Tips to Fix Incontinence Naturally

C-Section Recovery Tips

9 Tips That You Need Pelvic Floor Therapy

5 Tips To Ease Pelvic Pain that Won’t Go Away!

Pelvic Floor Pregnancy Considerations

Can Pelvic Floor Therapy Fix Prolapse?

References:

Ana Rebecca Meekins, Nazema Y. Siddiqui, Diagnosis and Management of Postpartum Pelvic Floor Disorders, Obstetrics and Gynecology Clinics of North America, Volume 47, Issue 3, 2020, Pages 477-486.

Angélica Mércia Pascon Barbosa, et al. Prevalence of urinary incontinence and pelvic floor muscle dysfunction in primiparae two years after cesarean section: cross-sectional study. Sao Paulo Med J. 131 (2) • Apr 2013 

Bø K, Sherburn M. Evaluation of female pelvic-floor muscle function and strength. Phys Ther. 2005;85(3):269-82.

Boyles SH, Li H, Mori T, Osterweil P, Guise JM. Effect of mode of delivery on the incidence of urinary incontinence in primiparous women. Obstet Gynecol. 2009;113(1):134-41

Groutz A, Rimon E, Peled S, et al. Cesarean section: does it really prevent the development of postpartum stress urinary incontinence? A prospective study of 363 women one year after their first delivery. Neurourol Urodyn. 2004;23(1):2-6.

Guri Rortveit, M.D., Anne Kjersti Daltveit, Ph.D., Yngvild S. Hannestad, M.D., and Steinar Hunskaar, M.D., Ph.D., for the Norwegian EPINCONT Study.  N Engl J Med 2003; 348 (10):900-907

Murat Bozkurt, Ayşe Ender Yumru, Levent Şahin, Pelvic floor dysfunction, and effects of pregnancy and mode of delivery on pelvic floor,
Taiwanese Journal of Obstetrics and Gynecology, Volume 53, Issue 4, 2014, Pages 452-458.

Natalia Kuciel, et al. A comparison of abdominal muscles fatigue in women after vaginal birth,
women after caesarean section, and a control group. A pilot study.  Physiotherapy Quarterly 2021, 29(2), 62–66

Orovou E, Antoniou E, Zervas I, Sarantaki A Prevalence and correlates of postpartum PTSD following emergency cesarean sections: implications for perinatal mental health care: a systematic review and meta-analysis.  BMC Psychology. Vol 13 (6), 2025.

Shin TM, Bordeaux JS. The role of massage in scar management: a literature review. Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et al.]. 2012 Mar;38(3):414-423

Sousa Shimamura, Lia Keiko, Bettiol, Heloisa, Moura da Silva, Antonio Augusto, et al. Incidence of chronic pelvic pain after childbirth and its causal association with C-section. PAIN 166(8):p 1847-1858, August 2025.

Wasserman, Jennifer B., Abraham, Karen, Massery, Mary, et al. Soft Tissue Mobilization Techniques Are Effective in Treating Chronic Pain Following Cesarean Section: A Multicenter Randomized Clinical Trial.  Journal of Women’s Health Physical Therapy 42 (3); p 111-119, September/December 2018.