Pre / Post Natal

Pregnancy related physical therapy and Post-natal care:

Results for your Pregnancy and Postpartum needs!

Being pregnant and the postpartum months are a unique time period in a woman’s life. We at Purple Mountain Physical Therapy are here to help you, offering our 20+ years of experience working with women through their journey to motherhood and postpartum recovery. We recognize also that healing can occur at any time, even if the baby you gave birth to is transitioning into adulthood themselves! We are here to help you with proven methods that give you results, no matter how long your symptoms have been going on.

We are pelvic health specialists and during your pregnancy we work with you to help you prepare for a safe and healthy birth while treating your musculoskeletal, bladder and bowel conditions you may experience. Following your pregnancy, we can help you recover your pelvic floor health, lose your mommy pooch, regain urinary control, build a strong and healthy back, return to sexual intimacy and prepare you for returning to sport, running or other exercise you love.

Many women struggle to recover from their pregnancy, labor and delivery. Patients, pleased with their results from their physical therapy, have remarked they wish they had known about pelvic health physical therapy during their pregnancy and immediately after the birth of their baby, because they benefited from the guidance and support during their recovery. We’ve treated some women following all of their pregnancies because they recognize the value and importance of their pelvic health and postpartum recovery. Following the treatment of a woman through her pregnancy and postpartum recovery, it is common for us to meet the friends of that woman because she refers them to us. We are very grateful for your trust in the quality of our care and appreciate you spreading the word to others in need.

Our journey together will begin with a thorough evaluation to identify areas that might benefit from treatment and how physical therapy can help you. When you are pregnant, we can help you prepare for a safe and healthy labor and delivery. You will receive information about how to best take care of yourself at home and what exercises and activities would be recommended and avoided. We will discuss your goals and can map out a plan forward for you to achieve them.

We are here to treat all of your pregnancy and postpartum related musculoskeletal and pelvic needs. Some of the conditions that we treat during pregnancy and the postpartum period include:

  • Pelvic girdle pain, pubic symphysis pain, sacroiliac joint dysfunction (SIJ)
  • Low back pain and sciatica
  • Piriformis syndrome
  • Coccydynia
  • Stress urinary incontinence
  • Urinary urgency, frequency and urge incontinence
  • Constipation
  • Abdominal pain
  • Diastasis Rectus Abdominis
  • Scar tissue related pain and healing tissues (hysterectomy incisions and perineal injuries or episiotomy)
  • OASIS recovery
  • Hip pain, hip labral tears
  • Flatulence (gas) incontinence
  • Fecal incontinence
  • Sexual health, Postpartum return to intimacy
  • Fourth trimester musculoskeletal needs

Pelvic Girdle Pain and Pregnancy related pelvic girdle pain, Pubic symphysis pain, Sacroiliac joint dysfunction (SIJ): Pelvic girdle pain can be located anywhere within the ring of bones around your pelvis that begin at the base of the spine, progress down to the vaginal area and laterally to the hips. Therefore, pelvic girdle pain is found anywhere in the front or back of the pelvis, including the symphysis pubis and the sacroiliac joints, and can also affect the hips or thighs. Pelvic girdle pain can occur during pregnancy, after pregnancy and unrelated to a pregnancy. If you have pelvic girdle pain you might feel a variety of uncomfortable symptoms including stiffness, sharp pain, a dull ache, throbbing, clicking, grinding, heaviness and difficulty moving or lifting your legs. If you are pregnant, pelvic girdle pain is not harmful to your baby, but can make it challenging for you to function. At Purple Mountain Physical Therapy, we will evaluate and treat your pelvic girdle pain, following research backed guidelines and will help you recover and get back to your active life.

Low back pain and Sciatica: We all know of women who have experienced low back pain or sciatica during their pregnancy. We are here to help you to feel better. We have helped many women resolve their pregnancy related back pain and get back to being able to sit, stand and move without severe pain. Physical therapy is a first line treatment for low back pain and sciatica and we have advanced education in taking care of back pain in pregnancy. You might be experiencing pain, achiness, shifting, numbness, tingling, muscle spasm or weakness in your low back, hips, thigh, calf or foot. We will evaluate and treat you so you can move freely and get back to your life.

Diastasis Rectus Abdominis (DRA): A diastasis recti is a thinning, weakening and widening of the linea alba connective tissue that lies between the right and left rectus abdominis muscles causing ineffective load transfer capacity through your core muscles. You transfer loads from your legs, through your pelvis and into your abdomen and core when you walk, bend over to pick up your baby, climb stairs and shift your position to feed your baby. If you have a diastasis recti abdominis and your load transfer capacity is dysfunctional, you may experience not only the appearance of a protruding abdomen, even after you have lost your baby weight, but also problems with low back pain, hip pain, pelvic girdle pain, urinary incontinence and constipation. We know how to help you get your body back! We can guide you through a comprehensive program of therapy and exercises to be completed at home that helps facilitate the closure of your diastasis and improves your ability to load transfer effectively.

Piriformis syndrome: The piriformis muscle is a hip muscle that can cause you to experience pain in your gluteal area. It is also a muscle that is part of your greater pelvis, so it can also play a role in pelvic pain, urinary or bladder control issues. Because the sciatic nerve is near the piriformis muscle you might also experience some sciatica symptoms, as well. Sometimes there is macrotrauma to this area contributing to overuse or strain to this muscle, such as when pregnant and “waddling” or walking in a manner that might place excess strain on your hip muscles. When pregnant your growing baby changes the forces through your abdomen and pelvis and may cause you to develop some pain related to your piriformis. Your treatment will be customized to your findings to provide you with the results you want.

SIJ (sacroiliac joint) dysfunction: This condition involves pain in the back of your pelvis, where your sacral bone attaches to your pelvis. A woman can experience this pain during her pregnancy or following it, or also unrelated to pregnancy. We offer expert care to help you recover from your SIJ pain.

Pubic Symphysis Pain: The two sides of your pelvis come together in the front to form a connection at the symphysis pubis. We have worked with many women who have pubic symphysis pain related to their pregnancy and post-partum period. It is quite painful and compromises your ability to move easily, as you experience pain in the pubic bones when you try to walk, climb stairs and squat down. We will evaluate you and treat your pain so you can get back to feeling like yourself and moving without caution at every step.

Coccygodynia (Coccydynia): Coccyx pain can develop following labor and delivery. Women often report severe pain in the tailbone when they are in the middle of trying to stand up or sit down. It also typically hurts to sit. We have experience working with many women who have coccydynia and helping them fully recover. Your pain will improve with the right treatment.

Stress urinary Incontinence: Stress urinary incontinence related to pregnancy and the post-partum period is a sign of pelvic floor dysfunction and improper control of the intra-abdominal pressure. We offer proven treatment to help you to restore your pelvic floor and urinary continence. It is never normal to be leaking urine and starting treatment right away is recommended. We have experience working with many pregnant and post-partum women and will create a customized treatment program to help you get back to walking, running, and exercise without incontinence. Recovery from stress incontinence, especially when post-partum, is more complex than simply doing Kegels because maintaining continence is a coordination of all of your core muscles managing your intra-abdominal pressure. We will evaluate your breathing, abdominal wall, back muscles, hip girdles and pelvic floor and we will teach you how to coordinate muscular control to facilitate the return of continence. This includes helping you to learn how to properly engage your pelvic floor, addressing speed, power, pre-activation, coordination, and release to optimize this muscle group’s ability to coordinate with the rest of your core muscles.

Urinary Urgency: Sometimes when you are pregnant or post-partum your bladder can become overactive, causing you to need to rush to the bathroom. We can evaluate and treat you to help restore your bladder’s ability to be calm when it should be calm! Urinary urgency doesn’t have to be a consequence of your pregnancy, with the right treatment it can be addressed and you’ll be feeling much better.

OASIS recovery (Obstetric anal sphincter injury): OASIS injuries, sometimes referred to as a 3rd or 4th degree tear, occur during vaginal delivery and involve perineal trauma to the anal sphincter complex and, less often, also the anal mucosa. In the acute time following labor and delivery an OASIS injury will cause perineal pain and has risk factors for wound infection and breakdown and fistula formation. Vigilant monitoring of the wound during the immediate weeks post-partum is important. Long-term risk factors related to OASIS injury include pain with intercourse (dyspareunia), difficulty with evacuating bowel movements (defecatory dysfunction), fecal urgency, fecal incontinence, chronic perineal pain and pelvic organ prolapse. Because of the severity of an OASIS injury, a woman should be closely monitored and well supported to optimize her wound recovery and to promote restoration of her anal sphincter control, pelvic floor function, defecatory mechanics and ability to return successfully to sexual intimacy. At Purple Mountain Physical Therapy, you will receive treatment provided by an experienced pelvic health physical therapist who has helped other women recover from their OASIS injuries. We understand the distress, fear, anxiety and difficulty related to an OASIS injury. All of these emotions, and more, occur while also feeling sleep deprived and caring for your infant. We are here to support you, to provide you with a thorough evaluation and to guide you toward an optimal recovery. We will evaluate all areas related to your post-partum body, including your abdominal wall strength, function and diastasis rectus abdominis, your posture, hips, thoracic spine and lumbar spine and your pelvic floor. You can expect compassionate, purposeful care that helps you to restore your pelvic health and recover from your pregnancy. Because of the nature of an OASIS complication we do like to partner with your expert physician team to ensure that you are receiving multidisciplinary care that addresses all of your needs.

Constipation: If your constipation during pregnancy is out of control, come to physical therapy and we can help you find a path forward. Straining is not health and can lead to hemorrhoids and pelvic floor dysfunction. Due to hormonal changes and the growing uterus changing your visceral structures, pregnancy is a time when women commonly experience constipation. When post-partum some women continue to experience constipation and find themselves straining to have a bowel movement, something that can be harmful to your pelvic floor. We can help you with your constipation. Gut health and regular bowel movements are important foundations to your overall health. There is treatment for you and we can help!

Abdominal pain: During pregnancy and the post-partum period you may experience abdominal pain. Your body is undergoing many changes as your developing baby grows and you might feel an ache or pain in your abdomen. When you are pregnant you should first bring this to the attention of your Ob/Gyne or midwife who can assess you and determine if you may benefit from a referral to physical therapy. We have many things we can do to support your growing abdomen and reduce your pain. After you deliver your baby if you continue to have abdominal pain, we have additional measures we can take to help you resolve this problem.

Scar tissue related pain and hysterectomy and perineal incisional healing: Following the birth of your baby, whether vaginal or via a hysterectomy, we can monitor the healing of your tissues and advise you in ways to promote optimal healing and scar development. We have worked with women for whom their scar is uncomfortable, perhaps burns at times or hurts to have underwear touching it. If this is the case for you, we can assess and treat your scar to help alleviate these problems. If you have any abdominal scars, whether from a hysterectomy or other surgery, we will also evaluate those tissues to determine if they are contributing to any pelvic pain you may have. Following vaginal delivery, your pelvic tissues also need to heal, whether you had an episiotomy or not. If you have any concerns about your healing, we can help advise you. If your tissue has healed, but you find it causes you pain, perhaps during intimacy or with clothing touching it, we can assess and treat this scar tissue to help you to feel better.

Hip labral tears and hip pain: Underlying issues in the hips can result in considerable hip and pelvic pain, difficulty walking and exercising and weakness in hip muscles. We can evaluate and treat your hip to optimize your range of motion, mobility, strength and to decrease your pain. Because we are pelvic health specialists, also, we offer the added benefit of truly, comprehensively treating your entire pelvic girdle and hip region. If your hips are achy, clicking, painful, feel stuck, or stiff, we can evaluate you and develop a treatment plan to help you feel better and function at the level you want.

Dyspareunia (Painful sex):
Let’s just put it out there that after giving birth getting back to intimacy might be daunting. To make it worse, imagine if you actually do attempt and you find it hurts! There’s physical therapy for this problem and, yes, it works! We will work with you to gently and effectively correct the things that are contributing to this and provide you with ways to recover your intimacy. Don’t give up, there’s hope! Women have told us that this therapy has changed their lives for the better.

Sexual health and intimacy concerns following pregnancy: Returning to intimacy following giving birth can be challenging. The healing of the perineal region and pelvic floor does take time and some women benefit from skilled pelvic health physical therapy to facilitate your recovery and optimize these tissues to prepare for success with intimacy. We’ve worked with women who sustained traumatic births that has caused them to fear intimacy. If you have difficulty during intimacy, whether it be pain, poor responsiveness, or other challenges, pelvic health physical therapy can provide effective rehabilitation. The skilled care of a pelvic health physical therapist helps you rehabilitate following pregnancy and can give you the confidence to restore intimacy without pain. We have helped many women achieve their goals in this area.