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Physiotherapy during pregnancy

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The physical toll of pregnancy is significant. During pregnancy there will be changes in hormones,
weight and biomechanics in the body, all of which are expected and normal. These changes can
increase the chance of musculoskeletal pain, such as back pain or pelvic girdle pain, and pelvic floor
issues, such as leaking urine. There are many possible post-natal considerations and in this blog we focus on what you can do during pregnancy, to improve your comfort and recovery.

Pelvic girdle, back and hip pain
During pregnancy, around 20% of women experience discomfort in their pelvis and hips, this is
known as ‘pelvic girdle pain’. Around 50% of women experience back pain. For most women, the
pain comes and goes. Sometimes the pain can be debilitating.
Pelvic musculoskeletal physiotherapy can help with specific biomechanical assessment, and with a
range of treatment options, including:
 hands on treatment, such as joint mobilisation, myofascial release or massage
 prescribed exercises for mobility and strengthening
 advice on positioning and activity modification
 advice on additional aids, such as maternity belts

Pelvic floor issues
Many women, maybe up to 40%, notice a decrease in pelvic floor function during pregnancy – for
example, leaking a bit of urine when laughing or coughing. This can be due to increase pressure on
your bladder and pelvic floor, changes in hormones, or pre-existing muscle weakness/tension.
Pelvic physiotherapy can assess your pelvic floor and give you specific advice and exercises to
improve your function short term, and to help prevent issues longer term such as postnatal
incontinence and pelvic organ prolapse.
Internal assessments are safe during pregnancy, as long as you haven’t been told otherwise by your
consultant or midwife. If you would like help with your pelvic floor, but would prefer not to have an
internal assessment, physio can still be really helpful.

Exercise during pregnancy
All the evidence available supports exercise during pregnancy. Exercise can:
 reduce the risk of high blood pressure
 reduce the risk of gestational diabetes
 help you to maintain a healthy weight and return to your pre-pregnancy weight more easily
 reduce your baby’s risk of developing childhood obesity, diabetes & heart disease later in life

 have mental health benefits – improves mood, reduces anxiety and stress and improves
sleep pattern
 reduce risk of postnatal depression
 increase strength and stamina
 prepare you for labour and delivery
 reduce aches and pains during pregnancy, such as pelvic or back pain
The National Guidelines suggest 150 minutes of exercise a week during pregnancy. If you have been
exercising regularly pre-pregnancy, you may well be able to continue. If you were inactive prior to
pregnancy, start gradually. Physiotherapy can help with advice for general fitness and exercise, as
well as specific core, strengthening and mobility exercises.

Other postnatal considerations:

Abdominal separation
Diastasis rectus abdominus is very common during pregnancy. Most women will experience a
degree of muscle separation later on in pregnancy, and most will have a natural recovery within the
first few months. There is lots of physio help available to assist the recovery of the outer abdominals,
as well you’re the deep core. Assessment and advice during pregnancy can get you on the right
track with core exercises, breathing and mobility work for during pregnancy, as well as things to do
in the early days post partum.

Pelvic organ prolapse
Pelvic organ prolapse is the ‘descent’ pelvic organs (rectum, bladder or uterus) into the vagina, and
is surprisingly common. Up to 50% of women will have findings on assessment but may well be
asymptomatic. Symptoms include a feeling of heaviness in the vagina or a dragging sensation, to
maybe being able to see or feel a bulge.
Physiotherapy can assess for prolapse. Mild to moderate prolapses can be very well
managed/treated with conservative measures, i.e. physiotherapy. Physiotherapy for prolapse
involves pelvic floor assessment and conditioning, progressive strengthening and activity
modification. The aim of physiotherapy for prolapse would be to be symptom free and able to do
whatever physical activity you want.

The physical effects of pregnancy can be wide ranging but are usually quite common and very
treatable. If you are pregnant suffering from any of the above, please get in touch. If you are
pregnant and not experiencing any of the above but would like to come in for an assessment or for
postnatal recovery advice, that can be really useful. Book your FREE 15 minute mini consultation today.