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The perineum is an area of muscle located between the anus and vagina. It is relatively common for women to experience some form ofperineal tear may during childbirth or following labour. Pregnancy related perineal tears can be treatedconservatively (non-surgical) or surgically. Physiotherapy is very important to give you the best chance of recovery after either treatment. The specialist physiotherapists at Physio.co.uk will provide you with a full assessment and physiotherapy programme to minimise the risk of further complications.

There are different classifications of pregnancy related perineal tears depending on the severity of the injury:

First degree: a tear of the perineal skin

Second degree: a tear of the peroneal skin and muscles

Third degree: involves the peroneal skin, muscles and the anal sphincter. This category can be sub-categorised into:

a. less than half of the external sphincteris torn (muscle of the back passage)
b. a complete tear of the external sphincter
c. a tear in the internal sphincter

Fourth degree: a third degree tear and the anal epithelium (layer of tissue covering the anus) is also torn


What causes a pregnancy related perineal tear?

  • If forceps are used to increase the space for delivery
  • If an episiotomy (surgical incision) is needed to facilitate the delivery
  • A large baby (over 9lb)
  • Previous perineal tears
  • Delivering a first child

What are the benefits of physiotherapy for pregnancy related perineal tears?



Regardless of the type of perineal tear, physiotherapy is a very effective way of reducing the pain and other symptoms that you may be experiencing. Physio.co.uk will work with you to create a comprehensive physiotherapy programme to help you achieve your goals. The benefits of physiotherapy include:

Conservative (non surgical) treatment for pregnancy relatedperineal tears



For first and second degreeperoneal tears, the healing will naturally occur meaning that surgery is not necessary. However, it is important that you take an active role in your recovery. Physiotherapy is an effective way of strengthening your pelvic floor muscles and minimising the risk of re-injury. The physiotherapists at Physio.co.uk can devise an individualised programme to help you with your recovery which may include:

Surgical treatment for pregnancy related perineal tears



For third and fourth degree perinealtears, your wound will be repaired using dissolvable stitches which do not have to be removed. The stitches should dissolve after six weeks and most women do not experience any problems after this. The operation will be performed under general anaesthetic or using an epidural (spinal) anaesthetic meaning that you will not feel anything during the surgery. It is important that you continue with your physiotherapy programme created by Physio.co.uk to reduce the risk of any long term complications.


Physiotherapy before perineal repair surgery



It is important to begin a simple physiotherapy programme designed by Physio.co.uk to optimise the success of your operation. Physiotherapy at this stage may include:

Symptoms following perinealrepair surgery



There are certain temporary symptoms that you may experience following the operation. Your physiotherapist at Physio.co.uk can help you manage these to reduce any pain or discomfort. Potential symptoms include:
  • Swelling
  • A small amount of bleeding from the wound
  • Pain going to the toilet
  • Bruising
  • Temporary pain

Physiotherapy following perineal repair surgery



Your comprehensive physiotherapy programme designed by Physio.co.uk will begin shortly after your operation. There are a variety of treatment options available to you and these will depend on the rate of your recovery.


Week 1



During the first week, your physiotherapy programme will concentrate on controlling your pain and reducing any symptoms you may be experiencing as a result of the surgery. Physiotherapy may include:

Weeks 2-5



You symptoms should now be reducing and you will feel able to return to some parts of your daily routine. Your physiotherapy programme with Physio.co.uk will now focus on:

Week 6 onwards



The original stitches used to repair your tear should now all have been dissolved. You should be experiencing little pain and feel more able to do your usual activities of daily living. Physiotherapy at this stage will include: It is important for you to follow your physiotherapy programme for up to six months following your operation to reduce the risk of further perineal tears in the future. Your physiotherapist at Physio.co.uk will continually adapt your programme depending on your goals and symptoms and keep you motivated!


Summary



A pregnancy related perineal tear can occur during or following childbirth and involves a tear in the soft tissue known as the perineum. It can be treated conservatively or surgically and physiotherapy is important part of recovery following either approach. The specialist physiotherapists at Physio.co.uk can create a comprehensive physiotherapy programmeto maximise your recovery and help prevent any long term complications. To book a physiotherapy appointment, call Physio.co.uk on 0330 088 7800 today! You can also book online!


Call us on: 0330 088 7800
Phone: 0330 088 7800
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Mobile: 0330 088 7800
Email us on: office@physio.co.uk
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