Physical Therapy During Pregnancy2. Pre-Natal Physical Therapy (During Pregnancy)

What factors contribute to a woman experiencing low back pain (LBP), pelvic girdle pain (PGP), weakness, and stress urinary incontinence?

  • Weight gain: A pregnant women typically gains 25+ lbs.
  • Posture: Excessive arching in the low back (lumbar lordosis) and forward positioning of the pelvis (anterior pelvic tilt) occurs due to overstretching of the abdominal muscles, tightening of the low back paraspinals muscles, and forward changes to the center of gravity as the baby grows
  • Hormonal changes: Increases in the hormone relaxin, causing ligament laxity, increased joint motion, and decreased stability
  • Force changes: Excessive tensile and compressive forces exerted onto ligamentous support structures, leading to micro injury
  • Muscular changes: Muscle overuse and muscle fatigue due to overstretch and deconditioning of the pelvic floor muscles and abdominal muscles
  • Diastasis Rectus: Separation and stretching of the abdominal muscles
  • Circulatory and Vascular changes: Increased pressure on nerves and blood vessels causing decreased circulation and increased inflammation

Is it safe to exercise and do physical therapy while pregnant?

  • Exercise and PT are both safe and effective during pregnancy! Before coming to PT and participating in exercise, OBGYN clearance is always required. If you participated in exercise (running, spinning, swimming etc.) prior to becoming pregnant, you are typically able to continue exercising at similar or slightly modified intensity levels throughout pregnancy. If you are totally new to exercise or haven’t exercised for a prolonged period of time, you may perform light-intensity exercise.
  • It is important to note that exercise does not increase risk of muscle injuries, change arterial blood pressure, or increase the risk of preterm labor or low fetal weight.

What if a mom-to-be is not experiencing any pain?

  • The P3 program is not only a treatment program, it’s a preventative health and wellness program! We will provide a mom-to-be with a program to help prevent common issues and impairments that may arise during pregnancy (see above).

What can I expect from physical therapy while pregnant?

  • As a woman’s body changes with pregnancy, many postural, biomechanical, skeletal, ligamentous, and muscular changes occur (as mentioned above). Armed with the knowledge of exactly what changes to expect during pregnancy, your physical therapist can tailor the P3 program towards your specific needs and goals. Deficits discovered during the initial examination will be used to build your individualized P3 program, tailored to your specific stage of pregnancy.

What are some typical issues and conditions women experience during the different trimesters of pregnancy?

  • 1st Trimester – Nausea, low back pain, neck pain, sacroiliac pain
  • 2nd Trimester – Weight gain, SI joint pain, sciatica, low back pain, pelvic misalignment, loss of core abdominal and pelvic floor support, muscle tightness, etc.
  • 3rd Trimester – Continued weight gain, slackening of joints, loss of core abdominal and pelvic floor support, SI joint pain, sciatica, low back pain, pelvic girdle pain, swelling, incontinence, hip and lower extremity weakness, fatigue, decreased endurance, etc.

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