Congratulations, you are expecting a baby! Pregnancy is a wonderful privilege and exciting time for expectant mothers. We here at Ballsbridge Physiotherapy Clinic want to support you in having a healthy and happy pregnancy. One of the best ways to prepare for pregnancy, both physically and mentally, is to become or remain physically active prior to, during and after pregnancy. Preparing your body for your pregnancy is worthwhile to promote a healthy pregnancy for both you and your baby.
We feel looking after yourself during pregnancy is important to promote a healthy pregnancy and minimise the risk of pregnancy related aches and pains. However, when pregnancy related aches and pains arise, it is important to contact your physiotherapist for assessment and treatment. Every person is different so finding out why you have a problem is essential to ensure appropriate treatment and care.
Many changes happen to your body over the course of the 9 months to allow for the growing foetus. Your body changes and adapts to carry the baby, but this may also put more strain on certain parts of the body due to the increasing weight. Back pain, both lower and mid back, pelvic pain, swelling in hands or feet may be some of the problems you experience during pregnancy. Check out the tabs below to learn more.
It is our mission to support you in pursuing a healthy lifestyle and regaining confidence in your body. We address any issues that may present post-partum such as back pain, continence problems, pelvic floor /core weakness and tummy muscle separation (DRAM).
Being pregnant does not protect you from common musculoskeletal injuries such as; ankle sprains, neck pain etc. These should be treated promptly to minimise any knock on effects. The normal physiological changes in pregnancy govern treatment of any musculoskeletal injury and the chartered physiotherapists at Ballsbridge Physiotherapy clinic with their extensive medical background are best placed to manage these problems.
Common Problems During Pregnancy/Antenatal Care
Low Back and Pelvis
General aches and pains are often thought to be part and parcel of pregnancy. In reality, there is much that can be done to minimise the effects of hormonal changes and a growing bump. 80% of women experience low back or pelvic pain during their pregnancy and 20% experienced moderate to severe pain (Mens et al (2012)).
Why do we experience symptoms?
- Decreased support available from stretched abdominal muscles
- Altered posture to accommodate the ever growing bump
- Ligamentous laxity to accommodate the growth and delivery of the baby
- Fatigue, the extra demands of a growing baby
Tips for keeping a healthy back during pregnancy
- In bed when lying on your side, place a pillow between your legs
- Make a habit of taking frequent short walks during your day
- Stand with a good posture, stand tall with your bottom tucked in
- Sit in supportive chairs; you may require a small cushion in the small of your back for comfort
- At your desk, avoid crossing your legs
- High heels increase the load on your lumbar spine and should be avoided. However, flats such as pumps do not provide sufficient support either. Supportive, comfortable footwear is the key.
- Exercise during pregnancy is recommended but seek advice from your chartered physiotherapist or ante-natal clinic before commencing a new form of exercise. Inactivity decreases your fitness making life more difficult in the later stages.
- Rest when you are tired, this may not always be at night time
Firstly, being pregnant does not protect you from common musculoskeletal injuries such as; ankle sprains, neck pain etc. These should be treated promptly to minimise any knock on effects. The normal physiological changes in pregnancy must govern treatment of any musculoskeletal injuries and any chartered physiotherapist at Ballsbridge Physiotherapy clinic with their extensive medical background are best placed to manage these problems. Specific management of low back or pelvic girdle pain is recommended. The increased load that your pelvis is exposed to during pregnancy can result in an imbalance. The good news is that these changes can be managed quickly and effectively through specific exercise (Stuge et al (2004)), manual therapy and advice. In our experiences, this problem is managed effectively and safely with early intervention.
Your uterus is not only part of your body that has to stretch to accommodate your growing baby. During the 2nd trimester your rib cage has to expand as the baby sits high in the uterus. This can result in rib or mid back pain. If you work at a desk this section of your spine is often quite stiff and the resulting rapid expansion can cause significant discomfort.
Thoracic pain is a common problem in pregnancy and it can be quite disabling. The most common symptoms are pain on turning your trunk/deep breathing or coughing. This pregnancy symptom can be safely and effectively treated by our chartered physiotherapists here at Ballsbridge Physiotherapy Clinic. Manual therapy and exercise will resolve the problem quickly and easily. Thoracic pain is less common in the later stages as the baby descends in the pelvis.
- Relaxed deep breathing helps to stretch the tiny muscles between your ribs. Just 5 breaths at a time
- Watch your posture at your desk. Avoid over reaching and regularly changing position.
- Heat applied between shoulder blades or to the muscles of the neck/shoulder area can give a lot of relief. Watch the temperature of the hot water bottle and your posture when you are using it. Do not apply heat over your bump.
Common Problems Post Pregnancy/Post Pregnancy Care
Pelvic Floor Muscles
The pelvic floor muscles act as a broad sling between your legs. These muscles stretch from the pubic bone at the front of your body to the base of your spine at the back. They have a supportive role helping to hold your bladder, uterus (womb) and bowel in place. These muscles also give you control over when you empty your bladder or move your bowels.
During pregnancy, these muscles will change due to increasing laxity and the weight and position of your baby. As a result, you may find you leak a little urine (stress incontinence) when you cough or sneeze. This problem can carry on after your baby is born.
If done properly, pelvic floor exercises can help to protect you from leaking urine when you’re pregnant and after your baby is born. While weaknesses in your pelvic floor muscles is common during pregnancy, it does generally recover completely within 12 weeks of having your baby. If you are concerned about your pelvic floor, contact our continence specialist, Aileen MaGuire. Being able to contract and release your pelvic floor muscles is of equal importance. The physiotherapist will assess your exercise technique and prescribe an appropriate exercise programme. If you are experiencing symptoms after having your baby early intervention is key to prevent any long term issues.
Exercise and Pregnancy
It is good idea to keep active during your pregnancy. There are many physical and psychological health benefits to remaining active throughout the duration of the pregnancy. Exercise will help you adapt to your changing shape and weight gain as your pregnancy progresses.
Remaining active during your pregnancy will also keep you in the best physical shape in preparation for your labour. Other benefits of exercise during your pregnancy include weight management, maintaining muscle tone, strength and endurance. Research has also shown that exercise may prevent and treat lower back pain, gestational diabetes and reduce ankle swelling. Evidence also indicates that exercise reduces the risk of complications in late pregnancy and labour.
Here are some tips to keep in mind while exercising when pregnant:
- If you were not overly active before your pregnancy it is advisable that you do not suddenly take up a strenuous exercise programme. Start by doing 15 minutes of continuous exercise, gradually increasing this to 30 minutes of exercise 5 times a week e.g. brisk walking. Remember that exercise does not have to be strenuous to be beneficial.
- Pregnancy is deemed established at 12 weeks, so avoid taking up a new exercise until you pass this point.
- As a general rule, you should be able to hold a conversation while exercising when pregnant. If you become very breathless as you are talking, you are probably exercising too strenuously. Listen to your body: If you feel tired: it is not the time to push yourself: it’s time for rest.
- As with exercising in general, a thorough warm-up and cool-down is advised.
- Avoiding over heating or exercising in very warm temperatures. This also includes exercising in hot water. Keep hydrated.
- When exercising be mindful not to lie flat on your back for prolonged periods of time, particularly after 16 weeks. This position may be problematic as the baby’s weight can compress the main blood vessel that brings blood back to your heart and cause you to feel faint.
- In general, low impact activities such as walking, Pilates, yoga and water-based programmes are beneficial but ensure your instructor is aware that you are pregnant.
- If your exercise is limited by persistent pain or discomfort seek advice from us; specific exercise programmes are of benefit.
Should you require further information or guidance on safely exercising while pregnant please contact us to book an appointment with one of our chartered Physiotherapists.
Tummy Muscles: Diastasis Recti
Diastasis recti can be defined as a separation of your outer most abdominal muscles. These muscles are called rectus abdominis and their job is to help support your back and organs. During pregnancy, this separation occurs in order to accommodate the growing uterus. Other causes of diastasis recti include weight gain in the abdominal area or doing abdominal exercise incorrectly.
When the muscles separate, the connective tissue that joins them stretches sideways. The more it stretches sideways. The more it stretches sideways the thinner and weaker it becomes. A small widening of the midline is totally normal during pregnancy, in fact, about 30 – 40% of all pregnancies will result in diastasis.
Depending on the degree of separation, you may require a support for the muscles. Correct exercise prescribed by your chartered physiotherapist is important in maximising recovery and building a strong abdominal wall. Poor recovery is a risk factor in developing back pain at a later stage.
Our physiotherapist, Olive McCafferty has a special interest in helping you retrain these muscles to full function. Her training in Pilates with a Master’s in Sports Medicine adds to her knowledge base in this field.
To find out more about the services that Ballsbridge Physiotherapy can provide please contact us.