“Common” but NOT “Normal”: Tackling Prenatal Pelvic Health Issues
Why Prenatal Integrative Pelvic Health Physical Therapy is Crucial if you are in Pain or Having Pelvic Floor Dysfunction
Prenatal integrative pelvic health physical therapy is crucial for those who are dealing with pain or pelvic floor dysfunction during pregnancy. A previous post discussed how Pelvic floor Physical therapy is important for any pregnant body, but it is even more important if there is pain or pelvic floor dysfunction during pregnancy to prevent loss of function.
The changes that occur naturally during pregnancy can sometimes lead to significant back, pelvic, head/neck, hip, knee, foot, and even wrist and shoulder pain. They can also often lead to incontinence, urinary frequency/urgency, pain with intercourse, constipation and more. When pain and dysfunction go untreated during pregnancy they are likely to lead to decreased activity levels, loss of work and income, and may even affect the likelihood of complications during delivery.
Integrative pelvic floor physical therapy can help you get out of pain and reduce or eliminate these symptoms so you can enjoy (or at least not loathe) being pregnant. Along with traditional physical therapy interventions, integrative physical therapy empowers you to support your body through nutrition, improved sleep, stress management, physical activity prescription, functional medicine, and removing environmental toxins that can disrupt hormone balance and pelvic health.
When “Normal” Changes Become Problematic
Certain changes are inevitable during pregnancy due to the simple fact that your center of gravity shifts forward and your joints become a little less stable with the addition of Relaxin and other pregnancy-related hormone changes. (read more about this in last month’s blog) These changes do not always lead to dysfunction and/or pain, but often can.
I had an incident myself during my pregnancy where I simply stepped off of a (slightly taller than normal) stair and landed heavily on my right foot, which led to pain and instability through my whole right leg and low back. Luckily, I was able to recognize the cause of the issue and get the physical therapy I needed quickly and was back to myself in a relatively short time frame.
Unfortunately, many people have a similar incident and are told by their provider that it is “normal” to have pain during pregnancy so they are not referred to physical therapy at all. The good news is you do not have to live with the pain and weakness through your pregnancy and beyond. Ask for physical therapy, or find one here: https://pelvicguru.com/directory/
Why Me? Why Now?
One reason that pain and dysfunction are common during pregnancy is that less stability means it can be a much smaller catalyst that leads to some kind of mal-alignment through the spine or pelvis which can cause pressure on nerve-roots and leads to spasms and pain. It can also be gradual postural changes and muscular imbalances from things as simple as carrying your 2-year old on the same hip all the time or letting your back “sway” under the weight of the baby that lead to dysfunction.
Lengthened ligaments, weakened core muscles, and spasms can result in pain in the hip, pelvis, back, neck, shoulders, and more as well as changes in continence, constipation, and pain with intercourse among other things. During this time, you may also feel the impact of minor differences in how you are built, such as a small leg-length difference or slight scoliosis, both of which may not have caused any concerns pre-baby when your body had better ligamentous support.
The chance that you will have pain or dysfunction during pregnancy does increase with multiple pregnancies, especially if they are close together. This DOES NOT mean that pain and dysfunction are inevitable, however, and is just due to the fact that your body has likely never fully returned to the balance that existed in your pre-baby body. Pelvic health physical therapy can help you successfully manage pain and dysfunction during pregnancy.
How Pelvic Floor Physical Therapy Helps
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Prenatal integrative pelvic health physical therapy allows for recognition of what is causing your pain/dysfunction and creation of a plan to combat against that cause. Some interventions that we use include:
- Soft tissue release and dry needling (to decrease pain and help improve posture/muscular balance)
- Postural training (to help you decrease pressure on unhappy tissues)
- Myofascial release & Strength-based mindful movement (to manage stress, improve sleep, and decrease pain)
- Taping (to help improve recruitment of important muscles and support good posture)
- Bracing (to give extra support to joints that are very unstable such as in pubic symphysis or sacroiliac joint dysfunction)
- Neuromuscular Retraining (to help you find and use the muscles you have which may not be functioning at their best ability)
- Empowering you with best practices for sleep, nutrition, stress, etc. may be affecting your condition and what you can do to help
- Education on integrating yoga, birthing positions, natural pain reduction methods, and more to help you have an easier childbirth.
Why Earlier is Better
When you access prenatal integrative pelvic health physical therapy early in your pregnancy it is easier to correct imbalances and get you on a happier path through pregnancy. There is research supporting early physical therapy for acute low back pain in providing for faster recovery and better outcomes.
Starting pelvic physical therapy early in pregnancy usually provides the best outcomes. It teaches you how to differentiate types of aches and pains so you can self-manage, which means less need for therapy!
The flip side of that is when a patient does not find their way to a pelvic PT until the third trimester, it is still possible to help significantly, but it takes more time and effort to get back on track and the results may not be as successful.
For example – I have seen women only after they had to take a leave of absence from work due to high levels of pain, only for them to become pain-free (or nearly so) when they have already had to use leave time that they could have otherwise spent bonding with their baby.
The bottom line is the earlier you access pelvic physical therapy care, the more proactive we can be to treat and prevent pain and dysfunction. We can also help you with things you may not have even realized could be improved such as comfort with sleep, decreased breathlessness, and easing nausea and extreme cravings.
