Then, how to treat these conditions in pregnancy?
Most of the pain comes from poor connective tissue condition (myofascial dysfunction) due to increased mechanical stress and muscle weakness in addition to the loose joint from the pregnancy.
Prenatal & Postpartum
Physical Therapy
Pregnant woman’s body experiences a wide variety of physiological and physical changes to help manage her pregnancy.
The changes a woman experiences during this time include:
1. Postural changes to accommodate the growing fetus/uterus
2. Stretching of the abdominal wall leading to muscle weakness
3. Stretching and weakening of the pelvic muscles
4. Increased weight and lordosis in lower back put lots of stress in spine, pelvis and hip joints
5. Increased ligament laxity (3rd trimester) can increase risk of injury
The common pain and dysfunction due to the body changes during the pregnancy
1. Low back, pelvis, sacrum, tail bone, pubic symphysis, sacroiliac joint pain
2. Rib cage, sternum, thoracic spine pain, breathing difficulties,
3. Neck and shoulder pain, upper trapezius tightness, myofascial trigger point pain
4. Diastasis Rectus Abdominis
5. Nerve Dysfunction: Carpal Tunnel Syndrome, Sciatica, Pudendal Neuralgia
6. Poor circulation and leg spasm
Common Myth: I am feeling pain because of pregnancy. There is nothing I can do to fix these issues.
Answer: No. Most of the mechanical pain pregnant women experience can be relieved by manual physical therapy.
1. Manual Therapy – skilled physical therapy doctor can find out the location of dysfunctional tissue and joint by palpation skill and movement test. He will apply proper techniques (myofascial release, trigger point therapy, stretching, joint mobilization, treatment tools) to restore the dysfunctional tissue and joint. This is the most important part of the treatment program.
2. Exercise Program – once the dysfunctional tissues are restored, patients will begin to perform customized exercise program designed by physical therapy doctor to improve flexibility and strength. The exercise program usually emphasizes on pelvis, hip and spine movement, flexibility, and strength. Gentle core exercises with some resistance (theraband) will be included in the program.
3. Patient Education and Home Exercise Program – ergonomic modification, posture correction, home exercise program, self-releasing techniques will be educated and will be performed at home by the patients to maximize the treatment effect.