PT & Rehab: Physical Therapy and Pregnancy

FEBRUARY 2018 The Therapy Bulletin The Newsletter About Your Health And Caring For Your Body A Painful Truth About Pregnancy

Over the last 40 years, the average age of women having their first child has risen from 21.4 to 25 years of age. Due to the fact that many women are juggling both the demands of pursuing higher education and the competitive nature of today’s workforce, 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 leaves an alarming number of women under-prepared for the strenuous journey of carrying and delivering a baby” shares Madhu Rishi PT, DPT, owner of Physical Therapy & Rehab Specialists. During pregnancy, the most common areas where women experience pain are the pelvic girdle, lumbar region, and hips, says Sandi Gallagher, PT, of Oregon Health & Science University in Portland. She chairs the Certificate of Achievement in Pregnancy/Postpartum (CAPP-OB) Committee for APTA’s Section on Women’s Health. “In pregnancy, women are more predisposed to these conditions because of the ligamentous laxity that results from hormonal changes, and because a woman’s center of gravity and body mass are changing,” Gallagher explains. “So, any muscle weakness or joint instability that she had coming into the pregnancy increases her difficulty meeting the increased demands of her body’s changes.” Some people believe that back and pelvic pain during pregnancy will get better once the baby is born. However, that is not the case for all women. The literature is pretty clear that if women are having pelvic girdle pain early on in their pregnancy that isn’t treated, often it can become quite severe in the last trimester. Thirty percent of women who have untreated pelvic girdle pain during pregnancy later become chronic pelvic pain patients. Other common problems experienced during pregnancy include Diastasis Recti, which is the separation of the rectus abdominis muscle from the mid-line; above, at, or below the umbilicus. A separation of 2 cm and more is considered significant. The diastasis may appear during the second trimester and result in low back pain. After childbirth, women should have a follow up with a physical therapist in order to put back on a proper exercise and stretching

program. Some women notice changes after childbirth, that might have not been present during pregnancy. Again, these discomforts can be treated and include scarring, C-Section, episiotomy, or perineal tear, Pelvic floor weakness, Prolapse and Urinary or fecal incontinence. Most physical “ailments” experienced during pregnancy can be treated with physical therapy explains Amanda Srader PT, DPT a women’s’ health physical therapist at PTRS. “A physical therapist can help by starting an exercise program that is focused on balance and support. The best advice is to call a women’s health physical therapist to get individualized attention and guidance. We can help identify your problems and get you on the right track to overcoming your pain. As PTs, we are musculoskeletal experts. Part of our job is to teach our patients how to reengage their body and to move again in a way that makes sense with what is happening during pregnancy. At Physical Therapy & Rehab Specialists we encourage that kind of creativity of movement. We help you get stronger.”

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