Perineal Scarring

Renew PT Research Review:

Title of Study Reviewed:
Therapy for Management of Childbirth Perineal Tears and Post-Partum Pain
By: Isa Herrera, Luz Perez, Rachel Schneiderman, Practical Pain Management, January 2011

Introduction – Pain “Down There” After Baby?

Women frequently leave their 6-week post-partum appointment with the “green light” to return to sexual activity. However many soon discover that intercourse is now painful, or for some, not even possible. Common? Absolutely.

Many women experience some perineal tearing or receive an episiotomy during vaginal birth. Similar to injuries sustained elsewhere on the body, your body will produce scar tissue to help close the tear and make the tissue strong again. Scar tissue is helpful and very necessary, however this tissue is not as flexible as the tissue that it is replacing. As a result, the perineum may not be able to stretch as much as it used to upon exam or sexual activity and cause pain.

Renew PT – Discussion

Childbirth is a transformative event in a woman’s life. The onset of motherhood presents a unique set of physical, emotional, and psychological challenges. The post-partum phase can become even more challenging when the new mother experiences perinal or genital tract trauma as a result of childbirth. Gynecological pain imposes physical limitations on the new mothers, making child-care, sitting, walking, and other activities of daily living (ADLs) extremely difficult and painful.

I’m too tired for sex anyway….

Perineal scar tissue also affects your ability to perform a strong kegel after birth. If you are experiencing any kind of urinary leaking or pelvic pressure since birth, perineal scar tissue may be a contributing factor. To stop leaking, you must address the scar.


Genital tract trauma following childbirth results in pain, loss of function, and decreased quality of life for many post-partum women. Scar tissue that develops secondary to perinial taring or episiotomy is often the source of significant pain, muscle weakness, and muscle spasms in the pelvic floor muscles. Physical therapists possess numerous techniques that can reduce painful scar tissue and pelvic muscle spasm. In addition to traditional manual techniques, physical therapists can also use pain-relieving modalities such as a cold laser.

What Can I Do?

If your OBGYN or midwife determines that your perineum is healing well and free of infection, then scar tissue may be your source of pain. Gentle self-stretching of the perineum can be performed, similar to the perineal stretching that is advised at the end of pregnancy.

The physical therapists of Renew Physical Therapy are experts at evaluating and treating perineal scar tissue. With state-of-the-art cold laser therapy and specific scar tissue techniques, we can quickly relieve your pain and help you return to your pre-baby self. Your physical therapist will also teach you techniques that you or your partner can perform at home to speed up your recovery time and put you in control of your health!


Renew Physical Therapy New York, NY – Call 877-Renew-PT for Your Free 10 Minute Phone Consultation

Ending Female Pain, A Woman’s Manual – by Isa Herrera

Therapy for Management of Childbirth Perineal Tears and Post-Partum Pain – Copy of Above Reviewed Article by Isa Herrera, Luz Perez, Rachel Schneiderman, Practical Pain Management

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