At Ballsbridge Physiotherapy Clinic, we believe that any pain and discomfort experienced during pregnancy should be treated effectively with the appropriate physiotherapy treatments.
Pregnancy is a wonderful and exciting time for expectant mothers. However, the changes that your body goes through during this period can play havoc on both your muscles and bones. We specialise in the treatment of many issues experienced during pregnancy such as lower back pain, diastases recti and especially, pelvic floor problems.
- Low back and Pelvis
- Mid Back
- Pelvic Floor Muscles
- Exercise and Pregnancy
- Tummy Muscles: Diastasis Recti
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.
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
Many myths surround the topic of exercise and pregnancy: from Victorian times where in the wealthy classes being pregnancy called for an extended “lying-in” period to today’s social media bombardment of blogs and vlogs of super fit pregnant mums.
Now that you are pregnant, there are some simple tips to follow so that you can exercise safely:
- Pregnancy is deemed established at 12 weeks so avoid taking up a new or vigorous exercise until you pass this point.
- 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.
- Listen to your body: If you feel tired that is not the time to push yourself, it’s time for rest.
- Keep hydrated and wear sensible footwear.
- If your exercise is limited by persistent pain or discomfort seek advice from us; specific exercise programmes are of benefit.
When should I return to pregnancy post-birth? If you have had a normal birth you should be able to start back when your body feels ready. Guidelines recommend that you should not commence high impact exercise until at least six weeks post-partum. However, a more realistic guideline is 12-16 weeks due to the impact your pregnancy has had on your pelvic floor muscles.
Pilates is a great way to regain your body shape and strength. We have small Pilates classes (5-6 participants) led by a chartered physiotherapist, which is an ideal way to return to exercise. These classes are perfect post pregnancy to target your core muscle groups, regain strength, stability and balance.
Perhaps you have returned to high level sport and are starting to experience some symptoms; such as low back ache, dragging sensation in your pelvic region or pain over your symphysis pubis. Restoring stability and correct recruitment of the pelvic floor muscles is crucial to enable a safe return to sports such as running, tennis and hockey.
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.