Every female that goes through pregnancy reads about what she will or will not experience. Often underestimated are the changes that happened to her musculoskeletal system (the muscles, bones and the joints), that often result in unexpected and unwanted pain.
Of the changes that happened in the body is the eventual increase in body weight over the period of pregnancy. This extra weight, anywhere between 10 -12kgs, gained during pregnancy increases the amount of force going through your lumbar spine and the lower extremities (our weight bearing joints). A major change the body goes through is preparing the body to accommodate a newborn child.
The hormone Relaxin plays a vital role in achieving an increase in abdominal space causing the relaxation of the ligaments, especially around the pelvis. Relaxin also causes inhibition of muscle contractions, especially the abdominal muscles (including the important transverse abdominus) and pelvic floor muscles to allow them to be become stretched. Another factor is the uterine enlargement and displacement that causes a forward shift of the pelvis. The extra strain that those structures go through creates more stress on other muscles that subsequently become fatigued and tight. Of the muscles that get affected are the calves, hamstrings, quadriceps, and lower back muscles.
While the above are common changes that occur during pregnancies, these can lead to specific musculoskeletal conditions including:
- Thoracic and rib pain
- Neck pain and headaches
- Lower back pain (LBP) and pelvic pain
- Calf cramps and restless legs
- Carpal tunnel syndrome
- De Quervain’s tenosynovitis
Different stages of pregnancy will require different physiotherapy management. Early treatment has a main focus assessing the body for potential risk factors that could lead to pain further into the pregnancy. Of importance is assessing the deep abdominal and pelvic muscle function to check for any weakness. Also during an assessment any potential postural issues are checked, while exercise and healthy living skills are promoting. Further into the pregnancy, skills can be provided to assist in labour and with postnatal recovery of body.
Throughout the pregnancy the following treatments can be used to minimise any discomfort associated with pregnancy.
- Postural re-education to ensure a neutral spine position is maintained, especially with standing and sitting postures
- Specific exercise for lumbopelvic stability that includes deep abdominal and pelvic muscle strengthening
- Pain relief like heat and ice
- The prescription of support belts, aids and footwear that will help to maintain stability through susceptible joints
- Exercise, especially important to maintain a level of fitness, flexibility and strength
- Though often the most important treatment is REST, essentially resting from activities that cause extra discomfort and pain.
After pregnancy the same treatment principles apply, especially encouraging women to continue with pelvic floor and core abdominal muscles. During birth, these muscles become weakened and stretched and without strengthen will increase the woman’s risk of lower back and pelvis pain. An added benefit is improving their bladder and bowel function. Also promoting a return to a healthy lifestyle and a gradual return to exercise is important.
At Coastal Physiotherapy we have extensive experience with treating musculoskeletal injuries that occur during your pregnancy and effective treatments that will help ease any unnecessary pain. Among what we offer is a range of supportive equipment to help during pregnancy and an excellent knowledge of deep abdominal and pelvic muscles to help improve lumbopelvic stability.
For more assistance or information on how we can help you through your pregnancy, talk to your friendly Gold Coast Physio today on (07) 5574 4303!