Author Kiera Bradley BSc(Hons) MCSP
COMMON PROBLEMS DURING & AFTER PREGNANCY
A staggering 81% of women give birth to at least one child in their lifetime (Gov.uk, 2018). Growing and carrying a baby and caring for a growing child takes its toll on our body (and sanity!). These different stresses can build up and result in a number of different aches, pains and problems throughout your body. We treat a variety of different patients, a large proportion of which are female, of which many have had children in the past or are currently pregnant. Carrying and delivering a baby is a traumatic experience for our bodies and as a result it is normal to have certain aches, pain and changes to our musculoskeletal systems.
In this blog we will discuss:
- Neck & Low Back Pain
- Stress Incontinence
- Rectus Diastisis
- Symphysis Pubis Dysfunction (SPD)
NECK & LOW BACK PAIN
Due to the increased weight of a ‘baby bump’ on the spine it is common for women to experience both thoracic (around the rib cage) and lumbar (lower back) spine pain during and after pregnancy. This pain is as a result of increased stiffness in the joints of the spine and subsequent inflammation caused by sustained strain on the soft tissues leading to aches and even sharp pains on movement, as well as potential referred nerve pain or sciatica . Posture plays a key part in the management of neck and lower back pain after pregnancy due to long hours sitting feeding babies, lifting car seats and bending down to lift growing, increasingly heavy & wriggly babies!
What can be done?
Spinal pain and stiffness is the bread and butter of a musckuloskeletal physiotherapist. We make use of a variety of safe treatment methods that have been tried and tested over our 25 years in business to help our patients:
- Manual therapy – via mobilisation of the spinal joints to encourage the normal gliding movements of the spine, relieving stiffness and increasing the lubrication of the spinal joints. These techniques can be performed in lying or sitting dependant on the stage of your pregnancy.
- Acupuncture – aids in reducing muscle tension and inflammation by the insertion on fine needles into key acupuncture points that are proven to be safe to use during pregnancy
- Posture – we will give you lots of advice on how to improve your posture which will reduce your pain during pregnancy is and prevent long term problems with spinal pain
- Pilates – Pilates is a fun and simple way to not only help in preventing future neck and back pain by combining stretching with core strengthening but to also aid in pelvic floor strengthening which is important post-pregnancy.
Stress urinary incontinence (leakage of urine on exertion) commonly affects women during pregnancy and in the postnatal period. It can lead to leakage of urine during coughing, sneezing, laughing (we’ve all been there!) as a result of increased pressure on the pelvic floor muscles during pregnancy as well as the obvious trauma induced via childbirth.
What is the Pelvic Floor?
The pelvic floor muscles function as a support for our organs. The sphincters (anal and urethral sphincters) allow us to have voluntary & involuntary control of our bowels and bladder. When contracted, the pelvic floor muscles lift upwards, tightening the sphincters. Relaxation of the pelvic floor muscles allows for passage of faeces and urine.
The pelvic floor muscles are also an integral part of your core muscles that stabilise your pelvis and lower back to allow normal movement throughout the rest of your body.
The sustained stretch of these muscles during pregnancy and possible trauma to the joints of the pelvis that occurs during pregnancy & childbirth affects the ability of the pelvic floor to function to its full potential, often resulting in problems such as pelvic girdle pain or stress incontinence.
How can we help?
Your physiotherapist will guide you through a routine of strengthening exercises to restore the pelvic floor to their pre-pregnancy power.
Once you have restored the ability of your pelvic floor to function again our pilates classes will strengthen your core & pelvic floor to ensure your body remains fit to carry out your physical duties as a Mum and allow you to return to normal activities and sport.
During pregnancy the abdominal muscles stretch and separate to accommodate a growing baby. 100% of women have a degree of separation of the abdominal muscles in the midline, above and below the belly button, at 35 weeks pregnant and 39% at 6 months postnatal (Mota et al, 2014).
With a Rectus Diastasis it is common to notice a “doming” or a gap of the stomach muscles when you do abdominal activity, such as sitting up from lying, coughing or straining to move your bowels.
How can we help?
Pilates – Strengthening both the core muscles and the pelvic floor is key to aiding the recovery and repair o the rectus diastasis. This can be achieved via a regime of pilates exercises. Pilates works to strengthen the core muscles, which includes Rectus Abdominis, Transverse Abdominis and the Pelvic Floor muscles, all of which are key to reducing a Rectus Diastasis.
SYMPHYSIS PUBIUC DYSFUNCTION (SPD)
During pregnancy women experience an increased laxity (stretch) of the ligaments, particularly around the pelvis, resulting in potential for joint instability and subsequent pain, often described as Pelvic Girdle Pain or Symphysis Pubis Dysfunction. SPD occurs where symphysis pubis joint (the joint at the front of the pelvis) becomes sufficiently relaxed to allow instability in the pelvic girdle. The pubic symphysis is found on the front of the pelvis and works to keep the two bones of the pelvis together and steady during activity. SPD is described as a sharp pain or constant ache around the pubis region, often increasing into the 2nd and 3rd trimesters as the baby’s weight onto the pelvic floor muscles increases.
How can we help?
- Acupuncture – has been shown to have a significant and postive impact on the pain caused by SPD and its associated symptoms. Acupuncture can reduce muscle spasm, alleviate pain via it’s postive impact of the body’s natural opioid (pain relieving) system and increases circulation thus creating a natural & safe (drug-free) anti-inflammatory response.
- Pilates – as previously discussed in this article pilates aims to strengthen the pelvic floor & core muscles which in turn increase the stability of the pelvis, reducing the strain on the pubic symphysis. Pilates can be easily modified to allow for a growing bump!
- Support belts – can provide a degree of relief by reinforcing the role of the pelvic ligaments and encouraging the two sides of the pelvis to remain congruent and more stable.
To book an appointment with one of our specialised therapists or learn more about our Live Streamed Zoom or Studio Based Pilates Classes contact us NOW.