Musculoskeletal complaints are common both during and following pregnancy. You don’t need to just put up with the pain or discomfort! Nikki Richards, senior clinical physiotherapist at Little Venice Pilates describes common symptoms and treatments that a physiotherapist can help with.
Lower Back Pain and Sciatica
Your body is undergoing changes from as early as two weeks into your pregnancy when the hormone Relaxin starts increasing the elasticity of your ligaments preparing you for labour. The combination of laxer ligaments as well as the weight of the growing uterus increasing the load and stretch on the pelvic floor and abdominal muscles can lead to lower back pain
A physiotherapist will assess your back and give you advice on how to maintain good posture in advancing pregnancy. You may be prescribed specific exercises, which are safe to do in pregnancy and given massage, gentle mobilisation techniques or offered acupuncture for pain relief.
Sometimes more pain is felt in the leg than in the actual spine. This is known as sciatica but is often connected with dysfunction in the lower back or pelvis. Your physiotherapist can help to diagnose the cause of your sciatica and provide appropriate treatment to help relieve the symptoms.
Pelvic Girdle Pain
Around 1 in 5 women suffer from Pelvic girdle pain. This is usually felt as pain over the pubic bones, which can be severely limiting to mobility. As well as the ligament and muscle changes occurring, there is sometimes an underlying asymmetry in the pelvis, which may be contributing to the increased load on the joints. Your physiotherapist will examine your pelvic movement for unevenness and can use gentle muscle energy techniques and mobilisations to improve the alignment and alleviate some symptoms. They will advise you on how to manage your symptoms and may give you a support belt to wear so you can walk more comfortably.
Other Problems e.g. Carpel tunnel syndrome, Plantarfascitis, Anterior Knee Pain
The increased ligament elasticity can cause problems for other joints such as your wrists, elbows, knees and feet. Your physiotherapist can assess and diagnose the symptoms and may help with appropriate exercises and in some cases providing supports.
Relaxin levels can take 3-6 months to return to normal after giving birth so it can still be a contributing factor to aches and pains. A long labour or an assisted delivery can have implication for the recovery of strength in the Pelvic floor muscles, whereas a C-section will compromise the lower abdominals more. On top of this you now have the extra demands of looking after a baby! Common complaints, which can be helped by physiotherapy post natally include:
Upper Back Pain
Poor posture when breast or bottle-feeding a new-born frequently can leave you with pain in you upper back. Your physiotherapist can advise you on good positions and give you strengthening exercises for the postural muscles as well as providing mobilisation and massage techniques to alleviate acute symptoms.
Lower Back Pain
This may have already been present during pregnancy or could be brought on by lifting and carrying a baby with weakened abdominal and pelvic floor muscles. A physiotherapist will assess for dysfunction in these muscles, and then prescribe appropriate exercises to regain the important core control of the spine.
Pelvic Floor Dysfunction
Some women experience on-going pelvic floor problems following pregnancy such as stress or urge incontinence. In many cases this will improve with prescribed exercises to engage your pelvic floor and lower abdominals. If you are unable to regain normal function in this way you may be advised to see as specialist Women’s Health physiotherapist for internal examination of the pelvic floor muscles to lead to more effective treatment.