Pre and post natal issues

What is it?

Pregnancy causes lots of hormonal and musculo-skeletal changes, all of these are completely natural, and necessary to support and nurture a growing baby, but it can cause lots of stress and strain on a woman’s body.

There are many conditions that are common during pregnancy, and specialized physiotherapy support can help alleviate some of their symptoms and reduce the impact they have on the woman’s quality of life.

Low Back pain

Back pain is very common during pregnancy and doesn’t necessarily mean there is a serious problem with the spine, just that the back has become sensitive to the changing stresses on it. Current figure suggest that up to 70% of women experience low back pain during pregnancy. Pregnancy causes lots of changes to the posture of the back, and hormonal changes have an effect on the elasticity of the supporting structures of the spine. These factors coupled, along with perhaps disturbances in sleep and changes in exercise routines can causes a woman’s back to become sensitive and painful.

We can advise women on appropriate exercises to do during pregnancy, which can help maintain tone in supporting muscles of the spine and flexibility of surrounding areas.

We can also advise women on sleeping and sitting positions, and of any appropriate supports that may be helpful. Acupuncture can be beneficial at certain stages during pregnancy to enable some pain relief and help promote good sleep.

Neck and shoulder pain

Neck and shoulder pain is very common in pregnancy. Whilst pregnancy can be a wondrous and magical time, it can also bring with it natural worries and concerns and stresses. Stress can have an impact of neck and shoulder muscle tone, as can sleep disturbances which are also very common during pregnancy.

A woman’s body undergoes lots of changes during pregnancy apart from the obvious addition of a growing bump. Breasts can become bigger and heavier, the ribcage becomes wider, these factors cause changes to thoracic and shoulder postures which can end up causing lots of muscle tension and pain.

We can advise women on appropriate exercises to do to optimize spinal posture, and prepare women for the physical demands of having a baby to lift and carry.

We can also provide women with massage or acupuncture to give some relief to aching tight muscles.

Trochanteric bursitis

Trochanteric bursitis can cause pain on the outside of the hip, which can radiate down the leg. Lying on that side at night can be really painful, and if a woman is unlucky enough to experience pain on both sides, sleep can become very disturbed.

During pregnancy the ligaments around the pelvis relax, allowing the pelvis to expand. The position of the pelvis can be altered too, as the weight of the growing baby increases causing it to tip forwards more.

This causes changes in the way muscles act around the hip, and back, and certain structures can become very tight. 

On the bony part on the outside of the hip there is a bursa, which is a little sac filled with fluid, there to provide some cushioning. This bursa can become inflamed, and the tendons that insert into the bony part can become very sensitive to being compressed.

Physio can help by providing advice around good positioning that prevents the problem from happening in the first place, or from worsening. Also advice regarding exercises to maintain good muscular function around the hip, especially strong glutes, and relaxed hip flexors.

If it becomes very painful, acupuncture can help, or other soft tissue techniques can help alleviate the pain.

Pelvic girdle pain

Pelvic girdle pain is different from low back pain in that the structures that generate the pain are the pelvic structures. The pelvis is a bony ring, made up of the two innominate bones and the sacrum nestled between them. They are held together at the sacro-iliac joints and the pubic symphysis joint by strong ligaments

It is a commonly held yet outdated belief, that pelvic girdle pain is caused by a loosening of the ligaments that hold the pelvis together, and an instability that then occurs through the joints of the pelvis. 

This is simply not true.

Multiple studies have shown that there is no link between relaxin levels and pelvic girdle pain. (Relaxin is the hormone produced during pregnancy that helps the ligaments soften) Studies also show there is no correlation between how much the pubic symphysis moves and how much pain a woman is likely to experience. Studies also show that women experiencing pelvic girdle pain are more likely to have increased activation of the core muscles, which probably explains why core strengthening exercises are no more effective in helping women with this problem than general exercise.

So what does all this mean???

It means that your pelvis is not going to fall apart. It cannot come out of place. Yes it hurts, and it can hurt a lot. But moving normally is not going to harm it further.

What can we do about this?

Education. Teaching you about what is really happening can help you relax and trust your body more.

Exercise. Teaching you ways of moving differently. Moving better.

Goal setting. We can help empower you to set appropriate and realistic goals, and work with you to achieve them.

10-15% of women who have pelvic girdle pain during pregnancy can go on to have persistent pain post partum. And these are the women that we can help.

For more information please read this excellent article:

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