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Sarah*, a 34-year-old mother of three, welcomed her twins via C-section one year ago. While embracing the joys of motherhood, she has found herself struggling with persistent physical challenges. Her core felt weak, she noticed a visible abdominal bulge that hadn’t been there prior to her recent pregnancy, and she could feel a gap running down her midline. Alongside this, she occasionally experienced bladder leakage, which made her even more conscious of her postpartum recovery.
Frustrated but determined, Sarah sought out the expertise of our Women’s Health Physiotherapist, Candice Kwok (remotely), while travelling abroad.
Sarah’s symptoms:
- Can feel a ‘gap’ down the midline of her stomach
- Lower abdominal bulging that never used to be there before her twin pregnancy
- Core feels weak and ‘soft’
- Unhappy with the physical appearance of her abdomen
- Occasional incontinence issues (bladder releasing too early when using the bathroom)
Sarah has recently started resuming running and exercise, but felt pain after running.. Her ultimate goal is to get back to moving pain-free, and looking and feeling like she did before her twin pregnancy.
First Online Physiotherapy Appointment: Assessment and Foundations
Sarah’s first appointment was a virtual consultation with Candice, conducted from the comfort of her own home. All that was needed was a stable internet connection, and a space for Sarah to be able to sit, stand and lay on the floor.
Candice began by understanding Sarah’s history, symptoms, and goals. Sarah’s primary concerns included her abdominal separation (diastasis recti), core weakness, and occasional incontinence. She wanted to rebuild her strength, regain confidence in her body, and ultimately return to running and exercise.
Through a series of guided assessments, Candice observed Sarah’s posture and asymmetry, functional strength testing, and checked the depth and width of her diastasis recti abdominal separation through educating the client, using anatomical models and with her own body.
Next, Sarah’s rehab plan was discussed. One of the cornerstones of effective physiotherapy is ensuring that the plan is realistic and achievable. As a mother of three, Sarah couldn’t commit to an hour-long routine every day, so Candice tailored the plan to fit into her daily life, incorporating movements she could do while caring for her kids.
Candice carefully guided Sarah through foundational core activation and strength-building exercises, addressing her core weakness and the left-sided glute weakness that was uncovered at her assessment, much to Sarah’s surprise. She provided step-by-step instructions, ensuring Sarah performed the movements correctly for maximum effectiveness. Sarah left the session with clear guidelines, practical strategies for incorporating her rehab into daily activities, and a structured plan to work towards her goals.
Her next session was scheduled in two weeks’ time, and Candice provided a written summary of the recommendations so Sarah could refer back to them at any time.
Second Online Physio Appointment: Review and Strengthening
In Sarah’s second appointment, Candice reassessed her core activation and functional strength levels, and both were thrilled to see noticeable improvements. Sarah was able to stay largely consistent with her rehab, with some days being tougher due to the demands of a household with three kids - all natural!
Now that Sarah was in a good routine with her foundational exercises, it was time to add some more resistance. This included modifying some movements to include clam shells, single-leg bridges, single-leg calf raises, sit-to-stands, and curl-ups. These were carefully selected to support both daily function and Sarah’s long-term goal of returning to running. Candice and Sarah went over the deep breathing practices and the core recruitment strategy they had gone over in the first session.
Sarah was happy with the progress and excited to be taking notable steps forward. She was able to start planning some bigger fitness goals, something she couldn’t consider or see herself doing a few weeks back. Sarah’s next appointment was scheduled for three weeks from now.
Third Online Physio Appointment: Hypopressives
At her third session, Sarah was already feeling stronger, more confident, and more in control of her body. Candice reviewed her progress and made further adjustments to her rehab plan where exercises had started to feel too easy. This session also marked the introduction of hypopressive exercises.
Hypopressives are a series of breathwork and movement techniques that can help strengthen and support the pelvic floor. They can also help with pelvic floor issues such as pelvic organ prolapse and incontinence, build more tone and strength in abdominal muscles, and improve postural awareness. You can learn more about hypopressives and their benefits here.
Candice is one of the few women’s health physiotherapists in the region who has completed her hypopressive training certification with the International Hypopressives Council in Canada.
Candice carefully guided Sarah through the hypopressives exercises, helping her understand what low abdominal pressure looks and feels like, which helped Sarah be able to self-check her technique throughout the movements.
Sarah was feeling incredibly motivated by having the support, encouragement and accountability with her physiotherapy sessions, and she felt herself taking significant steps towards her goals. From here, Sarah scheduled a review session for 3-4 weeks’ time, going at her own pace and what would best suit her needs. Client’s can schedule periodic reviews at time intervals that work best for you to keep you supported and moving towards your goals where we’ll review your plan and progress and update accordingly.
The Impact of Online Physiotherapy
Sarah’s case is a powerful example of how online physiotherapy can deliver real, measurable results - all without in-person, hands-on treatment. Through expert guidance, personalised rehab strategies, and a flexible approach, Sarah was able to restore her core strength, improve her posture, and regain confidence in her body.
For mothers navigating the postpartum journey, especially those who struggle to find time for in-clinic visits, online physiotherapy offers a game-changing solution. With the right support, recovery is possible from anywhere. You can learn more about our online physiotherapy sessions and how they work on our blog.
If Sarah’s story resonates with you, and you’re looking for guidance on postpartum recovery, core strengthening, or pelvic floor rehabilitation, we’re here to help.
Call us at +852 2801 4801 to book your appointment, or book online here.