Physical Therapy During Pregnancy
Relieving Pregnancy Pains
How common is back pain and why does this happen?
Fifty to seventy percent of all pregnant women have back pain. The majority of this pain can be attributed to the following:
- an increase in hormones
- a change of the body’s center of gravity
- gaining additional weight
- a decline in posture
- added stress
Over the last 40 years, the average age of women having their first child has risen from 21.4 to 25 years of age. Factoring in the reality that many women are juggling both the demands of pursuing higher education and the competitive nature of today’s workforce, more and more women are having their first child after the age of thirty-five. As a result, many women becoming pregnant are less physically active in their daily lives. This decreased activity, along with the increasing national prevalence of a sedentary lifestyle, leaves and alarming number of women less prepared for the athletic event of carrying and delivering a baby.
How can physical therapy help relieve my pain during pregnancy?
Women searching for ways to cope with this reality may be surprised to know that four of the above factors can be directly addressed with a proper physical therapy program.
Physical therapy is a medically based profession specializing in pain relief. PT’s work with individuals to develop a treatment plan to decrease pain by identifying and addressing its causes.
Treatment plans take a comprehensive approach by working on pain’s typical triggers:
- posture
- joint alignment
- muscle strength
- flexibility
- nerve involvement.
Additional weight, decreased posture, stress and control of the center of gravity are not independent from one another. A change in your center of gravity affects your posture, which causes the muscles to work harder. The increased exertion exacerbates overall fatigue, which leads to decreased motivation to move. The absence of an athletic release often results in increased stress. Though it is difficult, the domino effect can be slowed greatly with the help of physical therapy.
Low back pain is an all too common reality of many expecting mothers. As the uterus and baby grow, the mother's center of gravity moves forward. This shift increases the amount of force the muscles must generate for everyday support causing women to slump forward. Over time, this poor alignment creates muscle tightness in the pectoral muscles, rolling the shoulders forward and creating increased stress on the muscles of the neck, shoulders and mid-back. If these muscular factors are not addressed, these forces will ultimately be translated down to the low back, an area which is already under a great deal of stress because it is supporting the increased center of gravity.
Hormonal fluctuations and stress impact mood and emotions. Exercise, no matter how basic, releases endorphins, chemicals naturally produced by the body that are known to decrease stress and elevate mood. Additionally, exercise increases physical endurance and muscle strength, especially in the hips, back and abdomen. Improving in these areas can prepare the body for the physically demanding event of delivering a baby, positioning oneself for a better labor experience. Finally, therapeutic exercise during pregnancy can assist the recovery after the delivery. It tones muscle, which will improve metabolism, decrease the severity of fatigue, and assist in reclaiming your pre-pregnant weight.
I thought physical therapy was weight lifting and for recovery after surgery, how can it help me?
There is a general impression that physical therapists are similar to personal trainers or only work with people after surgery or catastrophic injury. While that is a component of what physical therapist’s do, that does not entirely encompass the scope of the profession. As stated previously, physical therapy is a medically based profession specializing in pain relief by identifying and treating the causes of pain in each individual.
A good program will take both an active, exercise based approach, as well as a passive one. The ultimate goal is to educate the client so that they can be independent in their program and continue to treat themselves at their own convenience.
Are there exercises I can do at home to make my pregnancy and delivery easier?
There is no guarantee, but logically, if you have better muscular endurance, strength and flexibility, labor tends to be easier than they would if you did not. The importance of a home program cannot be overemphasized. It is understandable that receiving treatment for an hour three times a week, devoting only 2% or less of your weekly time to your pain will rarely lead to long term solution. Especially when you consider that you will be spending the other 98% of your time counteracting that work. You need to perform a home program, and you need to be educated in proper techniques to insure you are doing it correctly to reap the benefits. Though passive treatments may feel good temporarily, they ultimately fail the client by offering a temporary palliative (comfort-focused) treatment versus a true pain solution.
It seems that not all programs are the same, how do I know how to choose a good program?
Search for a program that has been developed by a certified and trustworthy medical professional. A preventative physical therapy program is one such option that makes good sense. Physical strengths and weaknesses are identified. Clients are supervised as they practice exercises focused on building muscle strength, increasing flexibility and endurance, improving posture and addressing nerve involvement. Clients are taught strategies for dealing with some of the changes pregnant bodies experience and therefore women are prepared to practice self care at home consistently each day.
Being proactive and addressing any weakness, before it becomes a problem, is a successful application to many areas of life. The pregnant body is no different. Pregnancy is the ultimate strain on one’s body, and is a condition that physical therapy can intervene to lessen this strain. A proactive strength, flexibility and stabilization program can be very beneficial to preventing or decreasing the intensity of painful symptoms, thus making your pregnancy experience a more positive one.