How long does postnatal physiotherapy take to work for perineal tear?

A perineal tear affects the tissue between the vagina and anus, and deeper tears can involve the anal sphincter. Rehabilitation may include advice on wound protection, bowel habits, breathing, pelvic-floor relaxation, strengthening, scar sensitivity, and returning to intimacy or exercise. The right starting point depends on examination and how the wound is healing.

Progress can show as less pulling or soreness, easier bowel movements, improved control of urine or wind, and greater confidence with sitting and walking. Healing symptoms should be assessed rather than pushed through.

Arrange a postnatal assessment, particularly after a deeper tear. Keep the area clean as advised, prevent constipation with fluids and suitable fibre, and follow instructions about pelvic-floor exercises. Begin gently and avoid straining, breath-holding, or activities that increase pain or pressure. A physiotherapist can teach relaxation as well as contraction, which is useful when muscles feel tight or intercourse is uncomfortable.

See [Postnatal Physiotherapy](/treatments/pelvic-floor-and-rehabilitation/postnatal-physiotherapy/) for treatment context.

Seek prompt review for worsening pain, increasing swelling, foul-smelling discharge, fever, wound separation, or difficulty passing urine or stool. Contact your maternity team about new loss of bowel control, inability to control wind, or a sudden change in continence. Severe bleeding, fainting, or severe pain requires urgent care. Do not wait for physiotherapy if these symptoms occur.

Ask when the tear is ready for pelvic-floor work, which exercises are safe, and how to manage scar tenderness or painful sex. Ask whether bowel symptoms or continence changes require review by a specialist clinician.