Your body just performed a feat of biological engineering. After nine months of shifting organs and stretching tissues, followed by the intense physical event of childbirth, it is completely natural to feel like you’re living in a body you don’t quite recognize.
You might be experiencing things no one mentioned at the baby shower: leaking when you laugh, a persistent “heavy” feeling in your pelvis, or low back pain that makes lifting your car seat feel like an Olympic event. While these issues are incredibly common, there is a significant difference between “common” and “normal.” You don’t have to simply “live with it.”
At Surrey 152 St (Fleetwood) Physiotherapy & Sports Injury Clinic, we use an evidence-based approach to postpartum recovery. We move beyond “wait and see” advice and help you rebuild strength, coordination, and confidence.
Redefining the Pelvic Floor: It’s Not Just a Hammock
In many circles, the pelvic floor is described simply as a “hammock” that holds your organs. While that’s a helpful visual, it’s a bit of a simplification. In reality, your pelvic floor is a sophisticated multi-layered group of muscles that acts more like a dynamic trampoline.
These muscles must be able to contract to maintain continence, relax to allow for waste elimination and sexual function, and react rhythmically to every breath you take. During pregnancy, this system endures prolonged pressure; during delivery, these muscles can stretch up to 250% of their original length.
Pelvic floor physiotherapy isn’t just about “fixing” a muscle; it’s about restoring the synergy between your diaphragm, your deep abdominals, and your pelvic base. When these systems don’t talk to each other, we see the symptoms that often plague the postpartum period.
Debunking the “Just Do Your Kegels” Myth
One of the most persistent myths in postpartum care is that every woman needs more Kegels. This is not only oversimplified—it can sometimes be counterproductive.
Evidence shows that pelvic floor dysfunction falls into two broad categories: hypotonic (weak/low tone) and hypertonic(tight/high tone). If your muscles are already holding onto tension or “guarding” due to pain or birth trauma, mindlessly squeezing them can increase pelvic pain and even worsen urgency or leakage. A muscle that cannot fully relax cannot effectively contract.
True recovery involves “functional retraining.” We look at how your pelvic floor responds when you squat, how it handles the pressure of a cough, and how it coordinates with your breath. We focus on the quality of the movement rather than just the quantity of repetitions.
Common Postpartum Challenges and the Evidence for Physio
1. Stress Incontinence and Bladder Control
Leaking urine when you sneeze or jump is oftentimes dismissed. However, research consistently shows that Pelvic Floor Muscle Training (PFMT) is the first-line, gold-standard treatment for stress incontinence. Instead of just “squeezing harder,” we work on the “Knack” strategy—learning to engage the pelvic floor a split second before a pressure-increasing event (like a sneeze). This timing is often more important than raw strength.
2. Pelvic Organ Prolapse (POP)
The sensation of heaviness or “bulging” can be distressing. While the structural changes of prolapse are real, your symptoms do not always correlate perfectly with the “grade” of the prolapse. Many women with mild prolapse have significant symptoms, while others with more descent feel nothing. Physiotherapy focuses on pressure management. By changing how you breathe and load your core during daily tasks, we can often reduce or eliminate that heavy sensation without surgery.
3. Diastasis Recti (Abdominal Separation)
There is a common fear that Diastasis Recti (DRAM) means your core is “broken” or that you must avoid planks forever. Current evidence suggests that the gap between the muscles matters less than the tension you can generate in the connective tissue (the linea alba). We move away from restrictive “don’t do this” lists and toward “how can we load this safely?” We help you regain the ability to transfer load across your midline so you can get back to the gym safely.
4. The Back Pain Connection
Low back and pelvic girdle pain are frequently linked to how the pelvis stabilizes after the ligaments have been softened by pregnancy hormones like relaxin. Since four out of five adults experience back pain generally, the postpartum shift in your center of gravity only adds fuel to the fire. We address this by strengthening the “outer unit”—the glutes, latissimus dorsi, and abdominals—which act as a natural corset for the spine.
What Science Says About Timing
A common question we hear in Surrey is, “When should I start?” While the traditional six-week checkup is a great milestone, recovery isn’t a race.
Research indicates that the first three months postpartum are a “fourth trimester” where tissue healing is peak. Starting gentle, breath-based core work early can be helpful, but intensive internal work is usually best reserved for after the six-week mark when the initial healing is complete. However, even if your “baby” is five or ten years old, the neuroplasticity of your muscles means it is never too late to improve function.
Your Path Forward at Surrey 152 St (Fleetwood) Physiotherapy
When you visit our clinic, you aren’t just getting a list of exercises. You’re getting a comprehensive assessment that looks at your posture, your breathing patterns, and your functional goals—whether that’s running a 10k or simply being able to carry your toddler without pain.
We prioritize a patient-centered approach. If an internal exam is recommended, it is always performed with informed consent and can be deferred at any time. We also use tools like biofeedback and education on “bladder habits” (like avoiding “just in case” peeing) to give you full control over your recovery.
Small Steps to Long-Term Health
Postpartum rehab is an investment in your future self. Addressing these issues now prevents them from becoming chronic problems during menopause or later in life. By learning to manage internal pressure and rebuild a functional core, you are protecting your spine, your hips, and your quality of life for decades to come.
Ready to feel like yourself again? At Surrey 152 St (Fleetwood) Physiotherapy & Sports Injury Clinic, we are dedicated to helping you navigate this transition with evidence-based care and a bit of humor. You’ve done the hard work of bringing life into the world; let us help you do the rewarding work of feeling strong within it.
Would you like me to help you draft a specific checklist of “return to running” milestones you can discuss with your physiotherapist?