“Why does it hurt down there?” is a question as a physical therapist I often hear from patients following the delivery of their baby. Often during delivery, patients will have tearing of the perineum (the tissues between the anus and the vagina) and the posterior vaginal wall. Patients may also have an episiotomy, which is a surgical incision performed to help the baby pass through the vaginal opening.

One of the causes of the pain is due to the disruption of the perineum, whether it is through tearing or surgical incision. The perineum has an abundance of nerve endings which can make sitting, movement and even having a bowel movement painful after childbirth.

After the tissue has been damaged there is a normal healing process that occurs within the tissues. These tissues can become scarred and can cause pain in the perineum and vaginal region. During the initial healing stages doctors often recommend sitz baths, sitting on soft pillows, or use of a cold pack along the perineum. They may even prescribe anti-inflammatories or pain medications depending on how severe the symptoms and the extent of the tearing.

Tearing of the perineum is often graded depending on the depth and extent of the size of the tear.

  • First Degree
    • Involves only the tearing of the skin in the vaginal region.
  • Second Degree
    • Involves the skin and vaginal muscles.
  • Third Degree
    • Involves the skin, vaginal muscles and extends to the perineum down towards the anal sphincter (the muscle that controls the anus).
  • Fourth Degree
    • Involves the skin, vaginal muscles and extends into the anal sphincter.

Healing of the perineum tissues normally occur over six weeks, but is dependent on the severity of the scar. If the scar continues to be painful and does not seem to be getting better, it may be time to consult with your doctor and address the scar. The doctor may recommend perineal scar tissue mobilization which can be an effective way to help improve the mobility and improve the function of the tissues and muscles underneath them.

Perineal scar massage can be an effective way to help loosen the tissues which have become bound down and immobile. By using a water soluble lubricant on your index finger, you can use the index finger to perform circular/semicircular motions around the perineum tissues between the vagina and rectum. Performing this for 5-10 minutes a day can help to improve the restrictions found in the scar tissue and help to improve the blood flow to the region.

Performing pelvic floor exercises, often referred to as Kegel exercises, can also help to improve the blood flow and provide movement to the restricted area. Improving scar mobility will often times correspond to an improvement in pain.

If symptoms continue to be problematic, it may be beneficial to see a Women’s Health physical therapist for further assessment and treatment of the dysfunction of the muscles and soft tissues.

Share This Post:

Facebook
Twitter
LinkedIn
RehaBlog

More Posts

Connected Pain: How Your Neck May Be Causing Your Headaches

If you have ever dealt with nagging neck pain, you are far from alone. In fact, research shows that roughly half of us will experience a significant episode of neck pain at some point in our lives. Whether it stems from a sudden whiplash injury, age-related changes like arthritis, a pinched nerve, or simply the daily muscle strain of looking down at our phones or computer screens, neck pain is incredibly disruptive. It can present as a dull ache or a sharp, catching pain, and it often robs you of your ability to turn your head comfortably. But there is another common symptom of neck stiffness that surprises many people: headaches.

Occupational Therapy vs. Physical Therapy: What’s the Difference?

Occupational Therapy (OT) and Physical Therapy (PT) are distinct, separate professions, each requiring its own specialized education, licensing, and expertise. Because both fields share the ultimate goal of improving a patient’s independence and quality of life, their roles can sometimes seem to overlap.

Aphasia

Aphasia and the Role of the Speech-Language Pathologist

Aphasia (pronounced uh-FEY-zhuh) is the medical term used to describe difficulty with the production and comprehension of language. This can occur after a stroke or other injury to the brain. In addition to speaking, aphasia can also affect listening, reading, and writing. Individuals with aphasia may experience trouble finding the right words and producing intact sentences, which can impact their ability to express themselves as well as having trouble understanding what others are saying to them. In the most severe cases, a person with aphasia may be non-verbal, meaning they are not able to speak at all.

Reframing Your Outlook on Aging

May is Older Americans Month—a time dedicated to encouraging older adults to take an active role in their well-being through prevention, wellness, and self-management. Yet despite these empowering goals, aging is still often framed negatively in our society. By shifting how we think about getting older, and about ability more broadly, we can create a more positive, inclusive experience for everyone.

Simple Tips to Stay Active

Staying active doesn’t have to mean long workouts or a packed gym schedule. For most people, it’s really about finding simple ways to move more throughout the day. Those small choices—done consistently—can add up to real benefits for your energy, mood, and overall health.

Start your Journey

Learn more about Sheltering Arms Institute

Contact a specialist at Sheltering Arms Institute to learn more about how you can gain more freedom in your everyday life.