The Future of Postpartum PT and Advocacy
Where the research is heading, how to advocate within the medical system, and the call to action for every PT working with postpartum athletes
What This Series Has Covered — and Why It Matters
Over seven articles, this series has made a single sustained argument: postpartum return to impact sport requires clinical expertise, individualized assessment, and a criterion-based framework — and physical therapists are the best-positioned clinicians to provide it. We've covered pelvic floor physiology, diastasis recti, four-phase progression, bone density during lactation, cesarean scar rehabilitation, and the biopsychosocial dimensions of athletic identity. This final article looks forward: where is the research heading, and what does advocacy in this space look like in practice?
What the 2025 Guidelines Represent
The publication of the 2025 Canadian Guideline for Physical Activity Throughout the First Year Postpartum (Davenport et al., BJSM 2025) represents meaningful progress. For the first time, a national-level guideline recommends individualized, symptom-based progression toward 120 minutes of moderate-to-vigorous physical activity per week across four or more days — with explicit attention to pelvic floor symptoms as a gate for progression. This is a significant step beyond time-based clearance.
The 2024 international Delphi consensus on return-to-running readiness (Christopher et al.) and the 2025 Delphi on postpartum physical activity contraindications (Davenport et al.) further indicate a field moving toward clinical rigor. The conversations that were happening only in specialist circles five years ago are now producing peer-reviewed guidelines.
“The postpartum athlete is most effectively served by a clinician who speaks both languages — sports medicine and pelvic health. The field is building that clinician. Be one of them.”
Emerging Directions in the Field
Several areas of research and clinical innovation are worth watching. Telehealth pelvic floor rehabilitation has grown significantly since 2020 and shows promise for expanding access to specialist PT in underserved populations — though evidence specifically for impact sport return is still developing. Wearable technology that monitors pelvic floor pressure, ground reaction forces, and training load may eventually enable real-time symptom-load correlation in ways that manual assessment cannot. AI-assisted movement analysis for postpartum gait and landing mechanics is in early stages but directionally promising.
The integration of sports medicine and pelvic health PT — historically siloed — is also accelerating. The postpartum athlete is most effectively served by a clinician who can speak both languages: who understands load management and periodization as well as pelvic floor motor control and fascial mobility.
GAPS THE RESEARCH STILL NEEDS TO FILL
No validated, sport-specific postpartum return-to-sport outcome measure exists
Most RCTs exclude elite and competitive athletes; evidence base is weighted toward recreational populations
C-section-specific rehabilitation protocols are underrepresented in the RTS literature
Telehealth and digital pelvic floor rehabilitation — promising but evidence-thin for impact sport populations
Biopsychosocial screening tools validated for postpartum athletes are not yet standardized
Longitudinal data on injury rates and long-term outcomes in postpartum athletes remains scarce
How to Advocate Within the Medical System
Individual advocacy starts at the referral level. Building relationships with OBs, midwives, and family physicians in your community — through case reports, lunch-and-learns, and collegial communication about outcomes — is how the standard of care shifts from six-week clearance to criterion-based PT referral. Framing is important: PT is not replacing obstetric care, it is extending it. OBs are excellent at identifying that a patient is safe to exercise; PTs are trained to determine what safe exercise looks like.
At the practice level, building a postpartum athlete intake protocol, developing a clear return-to-sport assessment battery, and tracking outcomes systematically creates the data that drives evidence-based practice — and that supports future research. Every postpartum athlete you assess is a data point in an evidence base that is still being built.
The Call to Action
This series was built on a simple premise: the standard of care for postpartum athletes is inadequate, the evidence base to improve it exists and is growing, and physical therapists are the clinicians best positioned to make that change. The research supports it. The patients need it. The profession is ready for it.
Whether you are a seasoned pelvic health specialist or a general PT who wants to better serve the postpartum athletes in your practice, the steps forward are clear: stay current with the evidence, build the referral pathways, use criterion-based frameworks, and advocate loudly for the standard of care this population deserves. The postpartum athlete has been underserved long enough.
Thank you for following this series. Share it with a colleague who works with postpartum athletes — the more clinicians who know this evidence, the better the standard of care becomes.
END OF SERIES
Thank You for Reading
Share this series with a colleague who works with postpartum athletes. The more clinicians who know this evidence, the better the standard of care becomes.
Davenport MH, et al. 2025 Canadian guideline for physical activity throughout the first year postpartum. Br J Sports Med. 2025.
Christopher SM, et al. Return-to-running readiness after childbirth: Delphi consensus. Br J Sports Med. 2024.
Thornton JS, et al. Navigating the new normal: postpartum return-to-sport guidelines scoping review. Br J Sports Med. 2023.
Hewitt CM, et al. Postpartum return to sport in Canadian elite athletes. Front Sports Act Living. 2025.
Beamish NF, et al. Postpartum exercise and pelvic floor disorders. Br J Sports Med. 2024.
IOC Consensus Statement on REDs. Br J Sports Med. 2023.