What to Expect from Postnatal Physiotherapy for a Perineal Tear

Your physiotherapist may ask about pain, wound healing, bowel movements, bladder control, vaginal or rectal pressure, sexual discomfort and how daily activities feel. They may look at posture, breathing, movement and the coordination of the pelvic-floor muscles, but an internal examination is not always needed at the first visit and should be discussed with you first.

Treatment may include comfortable breathing, relaxation, gentle pelvic-floor activation, scar-care guidance once the area has healed, and advice on lifting, feeding positions, walking and returning to intimacy. Exercises should be adjusted if they increase pain, heaviness or pressure.

Bring details of the tear or repair if you have them, and mention medicines, constipation, leakage or fear of movement. Wear clothing that allows easy movement. Follow wound-care instructions from your maternity team, keep bowel movements soft as advised, and build activity gradually. Do not force pelvic-floor squeezes while the wound is painful or before your clinician says they are suitable.

Seek prompt medical advice for worsening pain, fever, feeling unwell, increasing redness or swelling, pus or a bad smell from the wound, heavy bleeding, the wound opening, new loss of bowel control, or difficulty passing urine or stool. Physiotherapy supports recovery but does not replace assessment of a possible infection or repair problem.

Ask when an examination and pelvic-floor exercises are appropriate, which symptoms should trigger review, how to manage constipation, and when to increase walking, lifting, driving or sexual activity.