By Julie Dresch PT, MS, OCS, CMPT, Director | TAI Ballard Physical Therapy

Pregnancy can be a time of joy, excitement, and anticipation, but most definitely it is a time of change.

Understanding the musculoskeletal changes that can occur during this time will allow you to embrace the changes as they come and understand when it is time to visit your local physical therapist to address some of the aches and pains before they become a real problem. The benefits of physical therapy for the pregnant client can include:

  • Physical preparations for childbirth
  • Pain relief measures during labor and post-partum
  • Physical rehabilitation post-partum
  • Proper endurance, muscle tone, and posture during the childbearing year

Prior to getting pregnant, it is important to exercise regularly, get fit, and maintain a healthy weight. A physical therapist can assist in finding appropriate exercises to target specific problems and treat nagging injuries before the added stress and weight of pregnancy. Two-thirds of pregnant women will experience back pain, which can worsen if you have a previous history. Addressing flexibility and strength deficits prior to pregnancy can make the experience much more comfortable.

Significant Physical Changes

After becoming pregnant, the body will undergo significant physical changes affecting the musculoskeletal system. These can include postural and hormonal changes and weight gain.

Posture changes include an increase in the lordosis, or curvature of your lumbar spine, and a forward shift of your head and neck. This shift of posture, combined with the weight of your belly, can lead to overuse of the muscles that extend your spine and hips and can strain the muscles that flex your ankles.

Hormonal changes that are integral to allow for widening of the pelvis during delivery can cause ligamentous laxity. This can make some positions uncomfortable, such as sitting or standing for an extended amount of time or rolling over in bed.

Weight gain puts increased stress on the spine and lower extremities and causes fluid retention that can compromise the space where nerves typically move freely. Both of these latter deficits, hormonal shifts and weight gain, contribute to a stress at the midline of the abdominal muscles called a diastasis recti. This separation, if not corrected, can lead to increased strain on the lower spine.

Physical therapists can provide patient education, exercise instruction, and hands-on manual therapy to address each of these concerns. Education focuses on proper posture and positioning to ease the stress or strain on ligaments and joints. PTs are the experts at proper fit and use of maternal supports that allow women to remain comfortable in both activity and rest. Finally, a physical therapist can provide one-on-one, hands-on treatment to address joint and muscular dysfunction during all stages of pregnancy.

Before and After Delivery

In preparation for delivery day, physical therapists can assist with appropriate labor and delivery positions that are specific to your dysfunctions. They can also assist through the use of biofeedback machines in finding relaxing positions for your pelvic floor that may provide an increased sense of comfort and control during delivery. Prior to delivery, physical therapists can provide instruction on correct pelvic floor contractions to minimize pain and maximize outcomes during this stage of recovery.

Following delivery, the focus shifts to healing the pelvic floor. Learning how to correctly identify and contract the pelvic floor prior to or soon after delivery can have positive effects in the early stages of healing. Even if you have had some tearing or an episiotomy, early contraction of the pelvic floor promotes quicker healing. It can also relieve congestion of the area and help alleviate tailbone pain. Most importantly, early return to exercise of the pelvic floor can reduce the risk of both urinary and fecal incontinence for years to come.

Pregnancy and childbirth is a magical time! Don’t let your aches and pains get in the way. See a local physical therapist and find out what he or she can do to help you. Our PTs at Therapeutic Associates provide one-on-one evaluations and treatments designed specifically to fit your needs.