Many women have undergone a hysterectomy (surgical removal of the uterus) at some point in their lives. Most of us either know someone who has had a hysterectomy or had one ourselves. 

Here are some reasons why pelvic floor therapy should be a standard treatment after hysterectomy.

Pelvic floor therapy is a type of physical or occupational therapy that includes the treatment of the pelvic floor muscles and surrounding areas. The pelvic organs, including the uterus, rest right on top of the pelvic floor musculature and have a close relationship with the pelvic floor muscles. 

I’m always dismayed at how few surgeons refer women to pelvic floor therapy after their hysterectomies. When someone has surgery on any other part of their body, such as their shoulder, knee, or spine, they get an automatic referral to physical therapy. Why aren’t women getting a pelvic floor therapy referral after their hysterectomies?

Here are some reasons why I believe women should see a pelvic floor therapist after hysterectomy: 

1. Scar tissue management: Depending on the type of surgery, the uterus will be removed from either an abdominal incision or vaginally. Either technique leaves scar tissue in the pelvic cavity. This scar tissue can lead to restrictions in mobility throughout the pelvic fascia. This could cause adhesions which could show up as abdominal pain or cramping or pain with intercourse. It could also lead to pelvic floor weakness. At Sacred Roots, your pelvic therapist will check for scar tissue adhesions and do scar tissue massage and visceral manipulation to ensure good mobility throughout the pelvic region.

1. Prevent prolapse: When the uterus is missing from the pelvic bowl, it leaves a gap. This gap can put you at risk of prolapse of the other pelvic organs (the bladder or the rectum) into the vaginal canal. In pelvic floor physical therapy, we make sure our patients are not bearing down excessively with bowel movements, urination, exercise, or other activities that add too much pressure down toward the pelvic organs and increase their risk of prolapse. Pressure management is one of the most important things we cover in women’s health physical therapy. Check out more information on “prolapse.”

1. Pelvic floor muscle health: The pelvic floor muscles can often be a little traumatized after a hysterectomy. We want to make sure your pelvic floor muscles are strong with good muscle tone after your hysterectomy. Pelvic floor therapy after a hysterectomy will prevent pelvic floor muscle dysfunction such as pain with intercourse or urinary incontinence from popping up down the line. 

1. Return to exercise: The core muscles are also greatly affected after a hysterectomy, especially if there were any abdominal incisions (even laparoscopic). Your pelvic floor therapist will teach you how to properly engage your core as well as progress you through core rehab exercises. Then they will get you on a return to exercise strengthening program that will allow you to feel confident while doing the exercise you love.

1. Post-operative support: I have worked with many women who are shocked to find how painful they find the surgical recovery and the difficulties they have even after the post-operative healing has ended. I have seen women have pain that didn’t go away after the incisions have healed before they came to pelvic floor therapy. Your pelvic floor therapist should be listening and supporting you throughout your healing after a hysterectomy.

Pelvic floor therapy should be a part of every woman’s care team after her hysterectomy to ensure good healing and prevention of pelvic floor dysfunction either right after her surgery or even later on in life.

At Sacred Roots Pelvic Health, we typically recommend seeing our patients 6 weeks after their hysterectomy to begin their pelvic floor physical therapy. However, we recommend it to anyone even if it’s been years since their hysterectomy. If you have questions or would like to get on the schedule, give us a call at 505-506-6943!