How effective is postnatal physiotherapy for perineal tear?

A perineal tear can affect skin, muscle, and the tissues around the vagina and anus. Physiotherapy does not replace an examination of the repair, but it can help you reconnect with the pelvic floor, relax muscles that are guarding, and gradually rebuild strength. Later care may include scar desensitisation or mobility work when the wound is healed, advice about comfortable positions, and a paced return to walking, exercise, and sex. Recovery is influenced by the tear, pain, infection, bowel symptoms, and how the repair is healing.

Ask your maternity or pelvic-health team when assessment is appropriate, particularly after a deeper tear or repair involving the anal sphincter. Keep the area clean according to your discharge advice and avoid pressing or massaging an unhealed wound. Tell the physiotherapist about pain, pulling, numbness, urgency, leakage, constipation, or fear of opening your bowels. They can teach gentle contractions and relaxation, breathing with bowel movements, and a gradual activity plan. Do not push through sharp pain or marked pressure.

Contact your maternity team promptly for increasing perineal pain, wound separation, fever, offensive discharge, new swelling, or difficulty passing urine or stool. Seek urgent help for heavy bleeding, severe pain, loss of bowel control, or feeling faint. These symptoms need medical review before rehabilitation is progressed, because infection or a repair problem may require treatment.

How extensive was my tear and which tissues were repaired? When can pelvic floor exercises begin? Is my scar healed enough for touch or mobility work? What bowel, bladder, or sexual symptoms should prompt review?