Physical Therapy: What Can It Do for Your Pregnancy?

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By News Team on June 7, 2022

Pregnancy is a beautiful and exciting time for a woman, but it can also be uncomfortable and painful. After birth, many of us are left with pain and a body we don’t quite recognize. Ranessa Gibson, P.T., D.P.T., a physical therapist with Carilion Clinic Urogynecology and our Pelvic Floor Disorders Clinic, explains more about what a woman’s body goes through during the course of pregnancy and how to get back to your old self after delivery.

Living: What kind of physical changes does a woman's body go through during pregnancy?

Gibson: The female body undergoes tremendous hormonal and physical changes during pregnancy. Some of these changes include increased blood volume, changes to our center of gravity, increased breast size, ligament laxity (loose ligaments) and increased curvature in our spine, which can make us much more susceptible to injury. Common issues that I hear are neck or low back pain, swelling, nerve entrapment, ligament strain, shortness of breath and leg cramps, just to name a few.

Living: What about during the actual birth? How can that affect a women’s body?

Gibson: During a vaginal delivery, a woman will experience extreme stretching and straining, and some may experience tearing or an episiotomy at the perineum. Vaginal deliveries that result in perineal stitches can be painful and tight even once healed. For those women, we offer a perineal laceration clinic for third and fourth degree lacerations to decrease pain and promote healing. Women who deliver their baby via cesarean are at risk for scar tissue adhesions and pelvic pain. Both types of patients would greatly benefit from manual therapy for scar tissue mobilization.  

Occasionally, women will have urinary or bowel leakage or difficulty going to the bathroom following delivery. A trained physical therapist can help resolve these issues, as well.

It is also very common for women to have low back pain or sacroiliac joint dysfunction, all of which can be resolved with physical therapy. Many patients can also experience diastasis recti, or the separation of their abdominals, and require specific core stabilization exercises. 

I always talk about proper posture and body mechanics with my patients. This is especially important for nursing positions and with daily childcare activities.  Another issue that many women face after birth is painful intercourse following either a vaginal or cesarean delivery. They don’t realize that it can be quite common and manual therapy with a skilled physical therapist is helpful in resolving this issue. 

Women who deliver their baby via cesarean or have perineal stitches following a vaginal delivery will also greatly benefit from manual therapy for scar tissue mobilization.

Living: What are some simple things a woman can do to help get her body back together after birth?

Gibson: I tell women to start that process before the actual birth. During pregnancy it is very important for the mother to stay as active as she can for as long as she can.  It is recommended that she continue the same level of training that she was doing prior to pregnancy. 

Aside from cardio exercise, I find patients benefit the most from stretching, diaphragmatic (deep) breathing and core stabilization.  We focus on stretching tight or short muscle groups such as hip flexors, hamstrings, calves, piriformis and lumbar extensors. 

We also work to strengthen the core muscles with safe progressive exercises.  Many women may benefit from some sort of maternity support belt. A physical therapist can help you find the right one for your issues and activity. And remember to use good body mechanics and posture with daily activities. 

Some helpful exercises include isometric abdominals, pelvic floor muscle strengthening, posterior pelvic tilts, bridging and curl ups.

Living: How does going to a physical therapist help?

Gibson: Many people are not aware that physical therapists treat women during and after pregnancy. We are musculoskeletal specialists, so we can help a woman with the multitude of issues that she may face during her pregnancy and after birth.

Physical therapists assess a patient’s strength, muscle length, posture, pain and function. Then they develop a plan of care with the goal to restore muscle strength, muscle length, eliminate or decrease pain and return the patient to prior level of function.

Living: What should women focus on right after birth?

Gibson: Following delivery, it is very important to just listen to your body. Follow your doctor’s orders and communicate anything unusual to your provider. Please report any signs of depression to your doctor right away. The physical, emotional and psychological needs of the mother will be more pronounced than during pregnancy. 

The most important thing is to listen to your body after baby! It might not be as simple as "bouncing back" after delivery. 

If you are pregnant or planning to become pregnant, ask your primary care provider or OB/GYN if physical therapy can help you.

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