Over the 40 (or so) weeks of pregnancy a woman’s body goes through many changes: growing, making room, and nourishing her baby; not to mention continuing with daily life and activities. This challenges and changes the alignment, movement and stability of her system, oftentimes creating aches and pains. This is where physiotherapy can help: keeping women as active as possible throughout pregnancy so that they can be mobile during labour and delivery, optimizing outcomes and assisting in recovering well post-partum.
What are some pregnancy-related symptoms?
Here are some common symptoms women can experience during pregnancy, and some can even persist post-partum. It should be noted that while these symptoms are common, they are not normal and can be treated.
- neck or back pain
- pelvic girdle pain including pubic bone pain (aka symphysis pubis dysfunction), sacroiliac (SI) joint pain, or coccyx (tailbone) pain
- rib pain or numbness
- carpal tunnel syndrome
- diastasic recti abdominis
- urinary frequency, urgency &/or incontinence
- pain with intercourse
- edema including hands, feet, legs and vulva
- fecal incontinence
- pelvic organ prolapse
How can physiotherapy help?
Physiotherapy works with the integrated systems of the body as it relates to movement, health and wellness. Women’s health and pelvic floor physiotherapists have specific training in how pregnancy, birth and the postpartum period can affect the body and activities of women. They will ask about health history, including previous pregnancies and births, as well as your movement profile to get a better sense of how these may influence current complaints or goals for pregnancy, birth and postpartum.
Some treatment techniques used may include:
- gentle manual therapy including joint mobilizations, myofascial release and the like
- functional movement modifications and recommendations
- stretching and strengthening exercises
- breathing exercises
- pelvic floor awareness, relaxation and strengthening exercises
- bracing, splinting or compression garment prescription
- mobilization & desensitization of scar tissue (from C-section, tearing, episiotomy)
- education about healthy physical activity during pregnancy, potentially with a link to PARC’s Active Pregnancy handbook or similar
- education about ways of positioning the body and moving comfortably throughout pregnancy
- education about returning to activity following delivery
- strategies for making activities such as breastfeeding and baby carrying easier and more comfortable
- education about the mechanics of various birth positions
- blocked milk duct treatment, mastitis prevention
Good to know
- Keep moving: Research supports staying active during pregnancy to keep Mom and baby healthy and fit for labour, birth and recovery. The key is to do what works for you based on pre-pregnancy activity levels, not starting anything new that is very strenuous or high impact. You may need to modify higher impact activities (e.g. running, heavy weightlifting, etc.) as your pregnancy progresses.
- Kegels are not for everyone: The pelvic floor is always working and sometimes can become too tight or overactive. Especially in preparation for birth, we need the pelvic floor to length and relax to allow baby to deliver, also helping to limit tearing or the need for an episiotomy. Bringing awareness, as well as relaxation and functional strengthening to the pelvic floor can be very helpful.
- DRA movement: Research has shown that between 66-100% of women by the 3rd trimester have some form of abdominal stretching and/or separation (i.e. “DRA”: diastatic recti abdominis). Limiting the movements that cause midline bulging (e.g. crunching actions like sitting from laying down, as well as laying straight back from seated, leg lifts, etc.) will be important. Note that the midline bulge can happen with different movements for different people.
- Connect with your breath: Your deep core, including pelvic floor, should work reflexively with your breath. Expanding your inhale (ribcage, belly and chest), and gently blowing with your exhale will enhance the reflexive deep core system. Make sure not to hold your breath especially with lifting or heavier tasks – instead exhale with effort.
- Get assessed before investing: Many women have the belief that a pelvic compression belt will fix all their pelvic girdle aches and pains during pregnancy. However they can be quite expensive and may not be what you need. Find a women’s health or pelvic floor physiotherapist to properly determine if bracing will be helpful for you.
- Prevention is key: Even if you are feeling great during pregnancy, learning how to enhance your body’s alignment, mobility, and stability can create more room for baby, balance muscle tension, and provide functional strength to optimize movement during labour and birth, as well as assist in your recovery post-partum.
If you are unsure about activities, modifications or any other complaints or symptoms you are having, please consult your physician and/or local women’s health or pelvic floor physiotherapist sooner rather than later to ensure a happy and healthy pregnancy, birth and recovery post-partum.