Physiotherapy management in Post natal care focuses on addressing potential structural and functional impairments following childbirth like pelvic floor dysfunction, incontinence, and prolapse. Exercises are important for improving circulation, strengthening muscles like the pelvic floor and abdomen, and preventing issues like backaches. The document outlines goals and exercises for various issues like improving pulmonary function, decreasing incisional pain, preventing complications, enhancing incision healing, correcting posture, and developing abdominal strength. It provides examples of specific exercises and references literature on treatments like TENS and exercises for diastasis recti.

1. Physiotherapy management in Post natal
care
Mayuri Zanwar

2. Potential Structural and Functional Impairments
 Risk of pulmonary ,GIT , or vascular complications.
 Post surgical pain and discomfort.
 Development of adhesions at incision site.
 Faulty posture after childbirth.
 Pelvic floor dysfunction
 Incontinence.
 Prolapse.
 Diastasis recti.

3. Importance of Post-Natal Exercises
 Improve circulation
 Strengthen pelvic floor muscle
 Prevent backache
 Strengthen the tummy muscles

4.  Goal: To improve pulmonary function and decrease the risk of
pneumonia
 Breathing exercises.
 Coughing and huffing technique.
 Goal: To decrease incisional pain with movement or during breast
feeding.
 TENS.
 Support incision site.

5.  Goal: To prevent post surgical vascular or GIT complications
 Active leg exercise.
 Early ambulation& abdominal massage to peristalsis can be thought.
 Goal: To enhance incisional circulation and healing prevent adhesion
formation.
 Scar mobilization.
 Friction massage.

6.  Goal: To correct posture& To prevent injury and reduce LBP
 Postural education during child care and feeding
 Ergonomic advice.
 Goal :To prevent pelvic floor dysfunction
 Pelvic floor exercises.
 Goal : To develop abdominal muscle strength.
 Corrective exercise for diastasis recti.

7. Post Natal Exercises
 Deep breathing exercise
 Lie on bed with knees bent, with a
pillow behind
 Breathe in deeply through nose.
Sigh out.
 Repeat 5 times
Breathing exercises
help to
improve your
circulation

8. Foot and ankle exercise
 Keep knees relaxed for both
exercises.
 Bend and stretch ankles
vigorously up and down for 30
seconds.
 Circle both feet 10 times in each
direction.
 Repeat these exercises
frequently

9. Pelvic floor exercise
1. Contract the pelvic floor muscles every time the intra-abdominal pressure
increases.
2. Support the sutures.
3. Start with static abdominal exercises to dynamic.
4. Rhythmic gluteal contractions.
5. Pelvic tilt

14. Goal: To decrease incisional pain with movement or
during breast feeding.
 de Sousa L et al. transcutaneous electrical nerve stimulation for the relief
of post-partum uterine contraction pain during breast-feeding : a
randomized clinical trial. J Obstet Gynaecol Res 2014.
 Electrode placement between T10-L1 and S2-S4, frequency 100Hz pulse
duration 75 us and amplitude adjusted to produce a strong tolerable sensation
for 40 min.

15. Goal : To develop abdominal muscle strength.
 Agata michalska et al. Diastasis recti abdominis- a review of treatment
methods . Ginekologia Polska 2018, vol 89,no 2
 Strengthening of transversus abdominis muscles or rectus abdominis muscles.-
Pilates
 Postural training ,education and training on appropriate mobility techniques and
lifting techniques.
 Abdominal bracing and taping or a corset.

18. References
 Physiotherapy in obstetrics and gynaecology By- Margaret Polden, & Jill Mantle
2nd edition.
 Therapeutic exercise By- CAROLYN KISNER,LYNN ALLEN COLBY 5th edition.