The pelvic floor is susceptible to injury during childbirth. Childbirth can be traumatic and can result in muscle tears and tears in the ligamentous and fascial supports. This can ultimately result in either bladder or bowel symptoms, or pelvic organ prolapse.
Episiotomy scars should resolve within a few weeks to being mobile and non-painful. If pain over the scar persists or if intercourse continues to be painful this means there is a problem with either the scar itself of the underlying area and you should seek help.

Muscles and pelvic floor function should recover approximately 12 weeks post natally and will continue to recover in the six months after the birth of the baby. However, if persistently weak you should not assume that the muscles are inactive due to laxity and damage only as they can also be weak due to muscle tension and negative muscle holding patterns.

It is common that a woman will over hold the pelvic floor muscles in an attempt to protect the pelvic floor.  This will in turn will set up a negative postural holding pattern including abdominal over holding. This can be damaging for the pelvic floor and can ultimately inhibit correct activation.

If this has happened you will need to release the muscles first before going on to strengthening.
– You will then need to change how you do the exercises and change the pathways between the brain and the pelvic floor muscles.
– Be careful not to further keep squeezing the way you are as it may be incorrect.
– Over time your new way of doing the pelvic floor muscle exercises becomes the more automatic way of doing them.

It is important to know that tension patterns are often present before a woman ever goes in to childbirth.
– We can have tension in our pelvic floor muscles all our lives due to posture, bowel habit, history of any back or pelvic pain or it can be hereditary.
– There is some evidence that if we release our pelvic floor muscles before we go into childbirth that it may be protective to our muscles and fascia.
– See our article on  Antenatal Perineal Massage & Pelvic Floor Preparation.

How do I know if I am doing the exercises correctly?
Follow the exercise guide on this website – they will apply to everyone. If you are still struggling after a few weeks then you need the help of a physiotherapist who specialises in this area.