There is usually plenty of focus on caring for the growing baby during pregnancy, but far too often the physical needs of the mother are all but forgotten in the excitement.

Changing hormone levels cause supporting ligaments to soften and become more stretchy during pregnancy and levels can take as long as six months after birth to normalise again. Your stomach and your pelvic floor muscles stretch with the growth, and later the birth of your baby. With the joints not being well supported, it is easy to strain or injure your back or pelvis.

Here are some of the common complaints experienced by women during pregnancy that Physiotherapy can assist with:

Low back Pain:

The most common condition experienced during pregnancy is low back pain, which increases after the third trimester as the centre of gravity shifts due to stomach size and as the load on the pelvis and back increases. This can be treated with manual and passive Physiotherapy, postural education, strapping and some strengthening & stability exercises.

Pain in the sacroiliac joint:

These joints are present in the lowest region of the lower back. This pain is usually concentrated in the buttock region. During pregnancy, due to excessive hormone release, the body’s connective tissues tend to relax so that the muscles can stretch to aid in delivery. This may cause the sacroiliac muscles and ligaments to become more mobile, causing increased joint movements and pain as a result. This can be treated with manual and passive Physiotherapy techniques such as mobilization, manual techniques, strapping, strengthening exercises and stretching can help reduce these symptoms.

Urinary incontinence (Bladder issues):

The muscles of the pelvic floor relax to make it supple and ready for delivery. These muscles can weaken and strain during pregnancy and childbirth, which may lead to urinary incontinence and pelvic floor dysfunction. Physiotherapists help you strengthen the Pelvic floor muscles with exercises. A control and strengthening exercise program during pregnancy can help reduce this muscle weakness and prevent post childbirth issues as well.

Sciatica (pain that radiates from lower back through hips and buttocks to the leg):

The weight of the baby in the final trimester can place pressure or strain on the sciatic nerve and lead to backache, pain down the leg and weakness. Physiotherapy uses stretching exercises and manual therapy to relieve these symptoms.

Carpal Tunnel Syndrome:

The build-up of excessive fluid towards the end of pregnancy results in swelling in the carpal tunnel in the wrist. The added strain on the wrists while caring for and holding a new born can lead to symptoms such as pain, numbness, tingling and loss of co-ordination in your hands and fingers. Physiotherapy techniques such as mobilization, strengthening exercises and stretching can help reduce these symptoms.

Neck and Shoulder Pain:

With all your body changes and increased weight around the abdomen, you can tend to be more hunched and in a rounded shoulder posture which increases the load through your neck and shoulders. This can also be intensified postnatally with breastfeeding and holding your baby. Physiotherapists can help by treating this with postural education, manual techniques, stretching, strapping and some strengthening & stability exercises.

This resting pose is great for gently stretching those aching hips, pelvis, and thighs. You’ll also stretch the spine, especially the lower back.

1. Begin on all fours on the mat, with your knees directly under your hips.

2. Keep your big toes touching. This will give your belly room to slide between your knees and avoid putting strain on your hips. You can also widen your toes if having them touching puts any pressure on your knees or does not provide enough room for your belly.

3. Inhale and feel your spine grow longer.

4. As you exhale, take your bum to your heels and lower your head towards the mat while tucking your chin to your chest.

5. Rest here, with your forehead on the ground. You can also fold a blanket or use a pillow and let your head rest on it if the ground is too far away. Keep your arms outstretched.

6. Hold this for at least 5 deep, even breaths.

7. Repeat 3-5 times.

This stretch will help gently strengthen your lower back, decrease hip and lower back pain, and help with round ligament pain. It can also increase spine mobility. Increasing the circulation of your spinal fluid helps lubricate it all day long. This can help ward off new pain and ease what’s there.

1. Begin on all fours. Keep the tops of your feet flat on the mat, shoulders directly over your wrists, and hips directly over your knees.

2. As you inhale, drop your belly, letting your back arch, but keep your shoulders rolled back and down while looking forward and slightly upward. This is the Camel position.

3. As you exhale, press into your hands and round your upper back, while looking in toward your belly. This is the Cat position.

4. Continue moving on your arch (camel) on your inhales and round (cat) on your exhales.

5. Repeat 5 times.

Bridge provides a gentle stretch for your hip flexors. It can also help strengthen your lower back, abdominals, and glutes. It will help relieve hip and lower back aches.

1. Lie flat on your back with your knees bent and your feet flat on the floor. They should be approximately hip-width distance apart but can be more spaced out if it’s comfortable. Keep your arms straight alongside your body and if possible, have your legs bent enough that your fingers can graze the backs of your heels.

2. As you inhale, curl your pelvis until your lower back is gently pressing against the floor, then gently lift your hips and back off the ground, pressing evenly into your feet, keeping a neutral spine.

3. Hold for 3-5 seconds.

4. As you exhale, gently roll your spine back onto the ground, one vertebra at a time.

5. As you relax preparing for the next lift, be sure your spine is neutral. Your lower back should be slightly off the ground, respecting the natural curve of your lumbar spine.

6. Repeat 5- 10 times.

This stretch is helpful for those with low back or sciatic pain. The piriformis muscle is a small muscle deep in the glutes that can spasm during pregnancy. This can often cause back and leg pain because of its close relationship with the sciatic nerve. Gentle stretching of this muscle can help decrease tightness and pain.

1. Sit on a chair with your feet flat on the ground.

2. Cross one foot over the other knee in the shape of the number “4.”

3. As you exhale, slowly lean forward keeping a flat back until you feel a stretch in your lower back and buttocks. Think about elongating your spine rather than curling your shoulders in toward your lap.

4. Hold position for 30 seconds.

5. Repeat on other side.

The Role of Physiotherapy in Pregnancy

28.07.22

Which Pregnancy Related Issues Can Physiotherapy Address?

Some Simple And Effective Stretches & Exercises for Pregnancy:

1. Child’s Pose:

2. Cat/CamelStretch:

3. Bridging:

4. Seated Buttock Stretch:

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