Pelvic pain that makes walking uncomfortable. Leaking when you cough or sneeze. A gap in your abdominal muscles that won’t close. Lower back pain that started in your second trimester and never left. These complaints affect countless women during and after pregnancy, yet many assume they’re simply part of the experience.
At Surrey 88 Ave Nordel Physiotherapy and Sports Injury Clinic, peripartum physiotherapy addresses these issues at every stage. Whether you’re navigating pregnancy discomfort or rebuilding strength postpartum, targeted treatment helps your body adapt, recover, and function well.
Your body is changing dramatically. The right support makes that transition smoother.
What Is Peripartum Physiotherapy?
Peripartum refers to the time immediately before and after childbirth. Peripartum physiotherapy supports women through pregnancy, delivery preparation, and postpartum recovery.
During pregnancy, your body undergoes significant changes:
- Hormonal shifts that affect ligament laxity
- Postural adaptations to accommodate a growing abdomen
- Increased load on the pelvic floor
- Altered breathing mechanics
These changes can create pain, dysfunction, and movement limitations.
After delivery, recovery involves healing tissues, restoring core and pelvic floor function, managing new movement demands (carrying, feeding, lifting), and eventually returning to exercise or sport.
Physiotherapy addresses both stages by improving strength, managing pain, preventing complications, and supporting gradual progression back to full activity.
Common Issues During Pregnancy
Pregnancy-related musculoskeletal complaints are extremely common. Many can be effectively managed with physiotherapy intervention rather than simply waiting until after delivery.
Pelvic Girdle Pain
Pelvic girdle pain affects the joints at the front and back of the pelvis. Women often describe discomfort in the pubic bone, lower back, hips, or deep in the buttocks. Pain typically worsens with walking, climbing stairs, rolling in bed, or standing on one leg.
This condition develops when increased ligament laxity combines with changes in pelvic alignment and muscle function. Treatment focuses on stabilizing the pelvis through targeted strengthening, improving movement patterns, and sometimes using support belts when appropriate.
Low Back Pain
Low back pain during pregnancy stems from multiple factors: postural changes as your center of gravity shifts forward, increased lumbar curve, weakened core muscles stretched by the growing uterus, and hormonal effects on spinal ligaments.
Physiotherapy helps by strengthening muscles that support the spine, improving posture and body mechanics, teaching safe movement strategies, and providing manual therapy to reduce muscle tension.
Pelvic Floor Changes
Your pelvic floor experiences increasing load throughout pregnancy. The weight of the growing baby, hormonal changes affecting tissue elasticity, and pressure from the uterus all impact pelvic floor function.
Some women develop urinary leakage during pregnancy. Others notice heaviness or pressure in the pelvis. Addressing these symptoms early rather than assuming they’ll resolve after delivery often leads to better postpartum outcomes.
Preparing for Delivery
Pelvic floor physiotherapy before delivery can include perineal massage education, breathing and relaxation techniques for labor, optimal positioning strategies, and understanding how to work with your pelvic floor during pushing.
While physiotherapy cannot guarantee a specific birth outcome, preparation can help you feel more confident and informed about what your body will do during labor.
Postpartum Recovery: More Than Waiting Six Weeks
The traditional “wait six weeks then you’re cleared” approach overlooks the complexity of postpartum recovery. Your body needs structured rehabilitation, not just time.
Pelvic Floor Dysfunction After Delivery
Postpartum incontinence affects many women but should not be accepted as permanent or inevitable. Stress incontinence (leaking with coughing, sneezing, jumping) and urge incontinence (strong, sudden need to urinate) both respond to pelvic floor retraining.
Pelvic organ prolapse, when pelvic organs descend due to weakened support, can develop postpartum. Symptoms include pelvic heaviness, a bulging sensation, or discomfort during intercourse. Early intervention through physiotherapy helps manage symptoms and improve support.
Treatment involves assessing pelvic floor strength and coordination, retraining proper muscle activation, progressive strengthening, breathing and pressure management strategies, and functional movement training.
Diastasis Recti
Diastasis recti is the separation of abdominal muscles that occurs during pregnancy to accommodate the growing uterus. Some separation is normal and expected. However, persistent width or poor tension in the connective tissue between the muscles can affect core function.
Rather than focusing solely on closing the gap, effective treatment emphasizes restoring tension and coordination in the abdominal wall. This involves deep core activation, breathing coordination, gradual progression of abdominal exercises, and avoiding movements that create excessive outward pressure.
Crunches and sit-ups are not the answer. In fact, they can worsen diastasis if performed too early or incorrectly.
Returning to Exercise Safely
Many women want to return to running, lifting weights, or high-intensity exercise postpartum. Jumping back in too quickly can overwhelm tissues that are still healing and adapting.
A graduated return to exercise typically progresses through walking and gentle movement in the early weeks, core and pelvic floor retraining before impact activities, strength training that progressively loads the body, and eventual return to running, jumping, or sport-specific training.
Key indicators of readiness include no leaking during activity, no pelvic heaviness or pressure, ability to engage core and pelvic floor effectively, and adequate strength to control movement.
Some women can return to high-impact exercise within a few months. Others need longer. Individual assessment determines appropriate timing rather than arbitrary timelines.
Why Postpartum Recovery Deserves Attention
Untreated postpartum dysfunction does not always resolve on its own. Problems that develop in the first year postpartum can persist for years or even decades if not addressed.
Early intervention prevents chronic issues from developing. Pelvic floor dysfunction that begins postpartum can worsen over time, particularly with subsequent pregnancies, aging, or menopause. Addressing issues early creates a stronger foundation for long-term pelvic health.
Postpartum recovery also affects quality of life. Leaking during exercise, pain during intercourse, or inability to return to activities you enjoy impacts both physical and mental well-being. Treatment helps you feel like yourself again.
What to Expect at Your First Visit
Initial assessments at Surrey 88 Ave (Nordel) Physiotherapy and Sports Injury Clinic include a thorough discussion of your symptoms, pregnancy and delivery history, current activity levels, and goals.
Physical assessment may examine posture and movement patterns, abdominal muscle function, breathing mechanics, pelvic floor strength and coordination (with consent for internal assessment when appropriate), and any areas of pain or restriction.
Based on findings, your physiotherapist develops a personalized plan that might include pelvic floor exercises, core strengthening, manual therapy, movement retraining, and education about safe progression.
When Should You Seek Peripartum Physiotherapy?
You do not need to wait until problems become severe. Consider assessment if you experience any pelvic or low back pain during pregnancy, urinary leaking at any stage, pelvic pressure or heaviness, difficulty with daily activities, or questions about safe exercise during pregnancy or postpartum.
Even if you feel generally well postpartum, an assessment around 6-8 weeks can identify issues before they become problematic and provide guidance for safe return to activity.