Physical Therapy During Pregnancy and Post-partum Period

Postpartum pelvic floor physical therapy

Pregnancy and post-partum are times in a woman’s life that bring about many feelings; excitement, anticipation, joy, nervousness, and sometimes discomfort. A number of changes happen to your body during and after pregnancy. It can take several weeks or months to get back to the condition you were in before you became
pregnant, and there are some things that will just never be the same!

Physical Changes in the Childbearing Year and Their Possible Consequences

  • Blood volume increases – swelling
  • Hormone level changes – ligament laxity leading to low back or pelvic girdle pain, changes in digestive motility, headaches
  • Changes in rib cage dimensions – pressure on nerves and tissues above and between ribs, difficulty deep breathing, abdominals stretched, generalized trunk discomfort, mid/upper back pain
  • Weight gain – extra stress on feet, legs and back, forward weight of baby changes spinal curves, weak and overstretched abdominals
  • Breast changes – larger breasts may alter posture
  • Vaginal delivery – injury to pelvic floor (pain, incontinence, urgency, prolapse, coccyx pain)
  • Cesarean delivery – scarring and pain, weak abdominals

PHYSICAL THERAPY DURING PREGNANCY AND THE POST-PARTUM PERIOD A REFERRAL TO A PHYSICAL THERAPIST WOULD BE APPROPRIATE FOR WOMEN WITH:

  • Low back pain
  • Pelvic pain
  • Tendonitis
  • Shoulder/arm pain and tingling
  • Upper back and neck pain
  • Headaches
  • Incontinence (involuntary leakage of urine)
  • Urgency of urination
  • Pain associated with scars (episiotomy or
    Cesarean section)
  • Leg/foot pain, weakness, and/or swelling
  • Carpal tunnel syndrome
  • Thoracic outlet syndrome
  • Hip pain
  • Pain with intercourse
  • Musculoskeletal issues related to bed rest
  • Diastasis recti (separation of the
    abdominal muscles)
  • Prolapse (lack of support in the pelvic area
    that allows the organs, like the uterus, to
    fall from their normal position)
  • Coccydynia (tailbone pain)

Physical therapists can also assist women who are not experiencing pain or discomfort inpregnancy and post-partum. These services may include:

How Can Physical Therapy Help?

  • Joint and soft tissue mobilization techniques to reduce muscle guarding, scarring, joint dysfunction, and optimize musculoskeletal alignment
  • Exercise to re-educate and strengthen muscles that are not properly supporting the body’s alignment and performing the demands placed on the body.
  • Education regarding home techniques for symptom management, proper positioning and
    postures, proper and more efficient performance of activities of daily living to reduce stresses on the body and conserve energy, and relaxation techniques.
  • Bracing/ Supports to add external support to the body to allow tissues to heal and strengthen and to reduce stresses on the body.
  • Biofeedback to re-educate muscles to reduce pain and guarding and to reduce or eliminate incontinence.
  • Modalities (mostly used post-partum) with the goals of reducing pain, inflammation, muscle guarding and increasing soft tissue and/or joint immobility.