Postpartum Physiotherapy: When Should You Start?

The first days

Gentle breathing, pelvic floor contractions and short walks can usually begin soon after an uncomplicated vaginal birth, as soon as they feel comfortable. The pelvic floor may feel weak or numb at first, which is normal. Gentle, frequent contractions help restore awareness and circulation.

After a caesarean birth, early walking and breathing exercises are encouraged too, though the abdominal wound limits what feels comfortable. Our guide to physiotherapy after a C-section covers that timeline in more detail.

The first six weeks

Most of the body's early healing happens here. Walking can gradually increase. Gentle core activation and pelvic floor exercises continue. Heavy lifting, high-impact exercise and intense abdominal work should wait.

The postnatal assessment

Around six weeks is a common time for a full postnatal physiotherapy assessment, though it can happen earlier if you have symptoms. It usually checks:

• pelvic floor strength and function
• abdominal separation (diastasis recti)
• back and pelvic pain
• bladder and bowel control
• readiness to return to exercise

Signs to seek help sooner

Don't wait for six weeks if you have:

• leaking urine or faeces
• a feeling of heaviness or dragging in the vagina
• pain during intercourse once you've resumed it
• significant back or pelvic pain
• a noticeable gap or bulge along the middle of your tummy

These are common but not normal, and they respond well to treatment.

Returning to exercise

Low-impact activity can build gradually from around six weeks, depending on your recovery. Running and high-impact exercise are often best delayed until around three months postnatally, once the pelvic floor and core have been rebuilt. A physiotherapist can assess readiness rather than relying on a fixed timeline.

Why six weeks isn't a magic date

The six-week postnatal check is often seen as the point when everything returns to normal. In reality, recovery varies a lot. Some women feel strong at six weeks. Others still have significant pelvic floor weakness, abdominal separation or pain.

Tissues continue healing for months after birth, especially after a difficult delivery or tearing. The pelvic floor and abdominal wall may need longer to regain strength.

That's why readiness to return to exercise is better judged by function than by date. Being able to walk comfortably, do daily activities without leaking or heaviness, and perform basic strength exercises with good control are better signs than simply reaching six weeks.

Why it matters

Postnatal physiotherapy isn't only for problems. It helps rebuild strength after pregnancy and birth and prevents issues later. Our piece on why postnatal physiotherapy matters explains more, and our postnatal core exercises guide covers the early exercises.