Finding out you are expecting brings on a whirlwind of emotions- excitement, nervousness, anxiety, joy. It's normal to experience a range of feelings, and every woman is different. Whether it is your first pregnancy or your sixth, every pregnancy is different! What may have felt great with your first child may not feel so great with number two. Likewise, asking your friends what they felt to compare against during your first pregnancy can be overwhelming, because they may have experienced something totally different!
One thing is constant throughout pregnancies-and that is the benefit of prenatal physical therapy.
Exercise Benefits During Pregnancy
What have you heard about exercise during pregnancy? Don't do it? Keep doing what you did before? Don't get your heart rate too high? Avoid certain movements? There is a lot of information out there that is outdated. The most recent recommendations from ACOG are for women to receive 150 minutes of moderate intensity physical activity a week, over a minimum of 3 days per week, combining strength and resistance training. Even if you were not active prior to pregnancy, in most cases it has been shown to be safe to begin an exercise routine after becoming pregnant. Benefits of exercise during pregnancy include:
Decreased risk of cesarean delivery
Decreased gestational weight gain
Decreased incidence of diabetes mellitus
Decreased risk of gestational hypertensive disorders
Decreased risk of preterm birth
Decreased risk of lower birth weight
Decreased risk of postpartum depression
How can a physical therapist help with keeping you exercising during pregnancy? Many women are unsure of how to modify exercise routines. Guidance from a physical therapist can keep you in the gym, yoga studio, or on the track throughout your pregnancy with appropriate modifications safe for you and baby! PTs are trained in conditions that may historically be considered contraindicated or exercise in pregnancy, as well as in the red flags and warning signs for discontinuing exercise. Additionally, if you begin to develop musculoskeletal pain, a physical therapist can help address and eliminate the pain to help you stay moving!
Neuromusculoskeletal Pain in Pregnancy
It is not uncommon to experience aches and pains during pregnancy; that being said, common does not necessarily mean normal! Just because you are pregnant, you shouldn't be told you have to deal with low back, pelvic girdle, sciatic nerve, neck, shoulder, or knee pain for the next 9 months!
During pregnancy, our hormones begin adjusting to prepare our bodies to help baby grow, as well as aid in delivery. This hormone, relaxin, can cause mobility and laxity in your joints, meaning you have way more motion available than you had before! Our muscles are strong in the ranges we typically work them in. When we introduce a ton of new mobility, we may not have muscle control over our bodies in that range. Additionally, as our bodies adapt to baby, we experience musculoskeletal changes in response- our center of gravity shifts forward, causing an increase in the curve in the low back and forward tilt of the pelvis, as well as requiring other muscles that previously weren't working as hard like our calves, to be more active. All of this can lead to some pains you may not have had before.
Remember-you are not doomed to 9 months of pain! Seeking out care from a physical therapist can help decrease and manage neuromusculoskeletal pain as your body continues to adapt for your little one!
Labor and Birth Prep
Seeking care from a trained physical therapist isn't just about exercising or managing pain. Many pelvic floor or perinatal physical therapists specialize in education regarding labor and delivery! Starting at 34 weeks of pregnancy, there are ways to begin preparing for labor to ultimately reduce your risk of tearing and improve postpartum health, including perineal massage and pelvic floor relaxation. Physical therapists can also discuss birth strategies, such as pushing techniques, labor and delivery positions, and pain management techniques to empower you in your birth experience.
"Prehab" For Postpartum
Did you know you can begin starting breathing exercises and pelvic floor contraction the same day you deliver? The 6 week mark to be "cleared" for exercise doesn't necessarily mean any and all movement and exercise can't begin prior to that. Learning the proper way to coordinate breathing, and perform pelvic floor contractions, can be a key component of early postpartum recovery. A study done in 1991 showed when given verbal instruction only, 40% of women had an ineffective effort when attempting to perform a pelvic floor muscle contraction. While I will be the first to admit that study is a bit old (aka as old as I am!), it does stand to show that verbal instruction only may not be enough to truly teach women how to perform pelvic floor contraction.
Physical therapists can aid women in their pregnancy in many ways! Looking for a pelvic floor, prenatal/postpartum, or obstetric physical therapist in your area can not only keep you out of pain, but also provide a key member of your healthcare team to keep you active and prepare for labor and postpartum!
Did your OB/GYN or midwife recommend prenatal physical therapy for you? If so, what was your experience?