Pain and Pregnancy: How Physical Therapy Helps


Pregnancy is a marathon like journey for your body and as your pregnancy progresses, you'll likely experience some types of musculoskeletal pain. Additionally, that pain is likely to evolve and change throughout pregnancy and your body is still very vulnerable during the time when you may be nursing and when caring for your new bundle of joy.  Moreover, pregnancy related pain can evolve and worsen in the months and years post-partum especially if you don’t tackle some of the issues you acquired during pregnancy. Some common complaints women have during pregnancy are lower back pain, pubalgia (pain in the pubic bone right behind your zipper), sacro-iliac joint pain, sciatica (pain into the buttock and/or leg), rib pain, and pelvic pain. 

Although these issues arise as your body changes during pregnancy, there's no reason to wait it out - nine months is a long time to hurt and cause lasting damage! There are many ways in which physical therapy can help.

To start with, we all know how significantly the the body changes during pregnancy. As the baby grows, your all important abdominal and oblique muscles weaken, stretch and sometimes tear.  As the baby grows further outward/forward, your center of mass shifts forward and your pelvis widens. As a compensation for this start to bear more weight through our toes, lean back, and let our legs rotate outward. These compensations cause us to overwork our buttock/piriformis muscles, and lower back muscles as well as negatively altering our diaphragm and pelvic floor muscles.  Hyperextension (sway-back) of our lumbar spines due to leaning backward will also compact the facet joints in our lower back and can cause nerve entrapment and pain. These postural and diaphragm changes and the weight of the baby itself will cause our pelvic floor to weaken, work harder, possibly spasm and irritate and entrap nerves. In addition to these drastic changes, the spinal, hip and pelvis ligaments in our bodies naturally become more lax as pregnancy progresses so that the baby can move easily through the pelvis. This is necessary during delivery, but can cause hip and pelvis instability and lumbar malalignments and result in a myriad of pains throughout the pelvis, hips and back that add up to make you miserable during and after pregnancy. 

Postural Restoration Institute (PRI) based physical therapy helps prevent these damaging body changes from excessively occurring and can significantly ease the pain. What’s more exciting and practical, is that PRI interventions address all of these issues as a whole and can be initiated any time during pregnancy and certainly is effective post-partum as well. PRI manual and exercise based approaches focus on promoting thoraco-lumbar flexion via abdominal/oblique facilitation and diaphragm and pelvic floor positioning optimization and strengthening to move the center of gravity backward to its normal position. This decompresses the lumbar facet joints, intervertebral discs, and relieves a lot of pregnancy related lower back and/or leg pain. As our lumbar spines, respiratory diaphragm and urogenital diaphragm return to a more normal position, our legs will also return to a more normal angle and no longer be rotated outward. These changes help hip rotator muscles relax and ease pain in the buttock region including sciatica, and promote improved stability and strength throughout the hips and pelvis. 

How does PRI Pelvic Restoration treatment and exercises accomplish this? 

We utilize many pregnancy capable positions in which to exercise to achieve maximum results. We emphasize safe and effective activities that involve lying on your side or on your hands and your knees as those allow us to isolate areas of the body and specific muscles that we want to effect. These safe positions unweight your pelvis and allows areas such as your pelvic floor muscles to become less stretched and to Relax! We can also work on upright standing activities and promote improved upright function to allow for pain free walking, hiking and other exercises that are necessary to keep you active and in shape throughout pregnancy and beyond.  

Want to address your pregnancy-related pain?

Call Pinnacle Physical Therapy and ask about our PRI based Pelvic Restoration program for moms to be and all moms affected by the challenges and changes their bodies undergo during pregnancy.