McGovern Physical Therapy Associates - The Personal Care Professionals

FIT FOR MOTHERHOOD

Whether you are pregnant for the first time, or expecting the latest addition to your family, this special time in your life requires the best care for you and your baby. However, for more than half of all pregnant women, low-back pain is inevitable. Many woman also experience headaches, sciatica, varicose veins, carpal tunnel syndrome and muscle cramps. At McGovern Physical Therapy Associates, we specialize in helping woman who are experiencing physical discomfort during pregnancy. Our specialists carefully evaluate your pain and work with you throughout your pregnancy to minimize discomfort.

What causes it?

During pregnancy, the ligaments between your pelvic bones begin to soften and your joints loosen in preparation for the baby's passage through your pelvis. These changes result in mobility of the joints in your pelvis, which have not moved very much since you were 3 years old. The movement causes considerable discomfort on either side of your lower back, often with walking, especially up and down stairs.

In the second trimester, your uterus becomes heavier, changing your center of gravity. Gradually, and perhaps without notice, you begin to adjust your posture and the ways in which you move. The compensations you make for the change can result in back pain, strain or other injury.

Another contributor to back pain may be the separation of the muscles along the front of your abdomen and the muscles which line your pelvis, referred to as the “pelvic floor.” These front abdominal muscles are two parallel sheets of muscles that run from your rib cage to your pubic bone. As your uterus expands, these muscles sometimes separate along the center seam, and back pain can then become worse.

The pelvic floor muscles help stabilize the sacroiliac joint in the pelvis. These muscles are severely stretched during pregnancy and the birthing process. The pelvic floor muscles remain in this overstretched position causing pelvic instability which can then lead to pain. One easy way to notice pelvic floor muscle weakness is when an expectant mother, with prior children, “shows” much earlier than with her first baby. This is due to the pelvic floor not being able to stabilize the lower abdominal contents and the fetus, thus causing an earlier than average bulge.

What can I do?

McGovern Physical Therapy Associates will help you with structured exercise plans, manual therapy and patient education.

A simple exercise program begun early in pregnancy can make a world of difference. Exercises that increase low back and abdominal muscle strength, pelvic floor stability and increase flexibility of the hamstrings and emphasize pelvic-tilt are just some of the ways to help reduce the risk of low back pain later in pregnancy. Such exercises help promote better spine posture while minimizing the increasingly unnatural forces being placed across the lower back structures. No exercise program should be started, however, without first consulting your physician and, if he or she so determines, without the guidance of a physical therapist familiar with pregnancy-related back pain.

Women who have had Caesarean sections or hysterectomies can also benefit from physical therapy, which helps with healing scar tissue and regaining the use of abdominal muscles.

After giving birth, upper back and neck pain are also common. Lifting and carrying a growing baby can cause a hunched over posture and greater muscle or ligament pain. Physical therapy can help reduce your pain at this time as well as controlling it throughout your pregnancy.

Our trained clinicians will educate you on proper posture, sitting, standing and lifting techniques. We will teach you about making sleep more comfortable, and about ergonomic enhancements and braces that will help you along your way.

McGovern Physical Therapy Associates has the solutions for low back pain and other pregnancy-related conditions. Strengthening exercises done throughout your pregnancy will help you during labor and delivery and while caring for your growing infant. Let the personal care professionals help you so you and your baby can enjoy this special time, pain free.

References

1. Berg G, Hammar M, Möller-Nielsen J, et al: Low back pain during pregnancy. Obstetric Gynecology 1988; 71(1):71-75
2. Fast A, Shapiro D, Ducommun EJ, et al: Low-back pain in pregnancy. Spine 1987;12(4):368-371
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4. Svensson HO, Andersson GB, Hagstad A, et al: The relationship of low-back pain to pregnancy and gynecologic factors. Spine 1990;15(5):371-375
5. Östgaard HC, Andersson GB, Karlsson K: Prevalence of back pain in pregnancy. Spine 1991;16(5):549-552
6. Hainline B: Low-back pain in pregnancy. Adv Neurol 1994;64:65-76
7. Östgaard HC, Zetherström G, Roos-Hansson E, et al: Reduction of back and posterior pelvic pain in pregnancy. Spine 1994;19(8):894-900
8. Endresen EH: Pelvic pain and low back pain in pregnant women: an epidemiological study. Scand J Rheumatol 1995;24(3):135-141
9. Hummel P: Changes in Posture During Pregnancy. Philadelphia, WB Saunders, 1987
10. Calguneri M, Bird HA, Wright V: Changes in joint laxity during pregnancy. Ann Rheum Dis 1982;41(2):126-128
11. Fast A, Weiss L, Parikh S, et al: Night backache in pregnancy: hypothetical pathophysiological mechanisms. Am J Phys Med Rehabil 1989;68(5):227-229
12. Wyke B: The neurology of low back pain, in Jaydon MIV (ed): The Lumbar Spine and Back Pain, ed 3. New York City, Churchill Livingstone, 1987, pp 56-99.

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