During vaginal birth, we may experience tears as your baby is born. There are different grades of tear and directions that the tear can go.
Grade 1: Superficial Perineal Tissues (usually only just a few stitches, if any)
Grade 2: Perineal Muscle has torn (most common)
Grade 3: Less than 50% of the anal sphincter has torn
Grade 4: Over 50% of the anal sphincter has torn
Sometimes we can try to prevent tears, but sometimes it is outside of our control, such as your baby’s head position or if they throw their elbow up as they are crowning.
But, if you have torn, is there any special rehabilitation that we should be doing to help with recovery after vaginal birth? Absolutely!
When we experience tissue damage, the different layers can adhere or stick to one another during the healing process. This stickiness could result in adhesions, that could affect how the different layers of muscle and tissue can glide over one another.
Our body is a kinetic chain, where everything is connected. What happens in our pelvic floor can affect our shoulder, as there is a fascial line or muscles and tissues that connect from the pelvic floor to the shoulder!
The pelvic floor is a major component of our stabilization system; it works with the diaphragm, transverse abdominals, obliques, and multifidus to help stabilize the spine and pelvic girdle as a part of our deep core stabilization system. If one component of our deep core stabilization system is not working as well, it can affect our entire system. Think of it like having a bunch of shiny gears in a machine, but one really rusty one that has a harder time working; it affects the entire system’s ability to function!
When we have a vaginal tear or perineal muscle damage, it affects our pelvic floor. If we have adhesion in our pelvic floor or perineal muscle from a vaginal tear or episiotomy, it could affect the function of the rest of our body.
What can we do to help with recovery after a vaginal birth?
First, we can focus on rest and allowing the tissue to begin its initial healing process. Staying off our feet as much as possible could be helpful, as this helps to alleviate the pressure of gravity against our healing pelvic floor.
If we need to get up and move around due to life demands or going stir crazy, wearing something with perineal support, such as a Bao Bei compression garment (use code MAMASTEFIT for a discount, not an affiliate link just a discount for our readers).
Around 4-6 weeks, we can begin to explore perineal scar mobilization techniques. It can be helpful to work 1:1 with a pelvic floor physical therapist for all scar mobilization (even after a c-section).
Perineal massage involves mobilizing the tissues near the tear site to help release adhesions, both internally and externally. Perineal massage techniques can be more challenging due to the location and trying to get a grip on the tissues. Usually using a pinching method, where you roll or rub the tissues between your thumb and index finger can be helpful. Sometimes an internal pelvic floor wand can be helpful. Therawand is a pelvic floor wand that I have personally used for my own rehab after an episiotomy. Again, working 1:1 with a pelvic floor physical therapist can be incredibly helpful to finding relief from pelvic floor adhesions!
We want the pelvic floor muscle layers to glide smoothly so that we can maintain the optimal function of our pelvic floor. If there are adhesions, different layers may be caught or cause uneven tension in the pelvic floor. Since the pelvic floor is a part of our deep core stabilization system, it can cause a ton of issues if we leave it untreated!