Pregnancy and Physical Therapy

pregnancy and physical therapy

Pregnancy and Physical Therapy

Did you know a physical therapist can effectively treat many diagnoses both during and after pregnancy? Few people are aware of this option, although the benefits are well worth it. A women’s health physical therapist can treat a large range of diagnoses, including but not limited to: back pain, pelvic pain, incontinence, carpal tunnel, headaches, painful intercourse and diastasis recti (separation of abdominal musculature). Often these symptoms are disregarded because of how commonly they occur with pregnancy. However, you do not have to suffer through these symptoms; we can help you overcome them for improved quality of life during pregnancy.

Why Would I Need Physical Therapy During Pregnancy?

During pregnancy, women experience many changes. As the baby grows, a mother’s ribs must expand, organs slide out of the way and the abdomen stretches. As the baby grows heavier, the pelvic floor also has more pressure being pushed down onto it. This extra pressure can cause pelvic floor symptoms, such as pelvic pain or incontinence. A women’s health physical therapist can work with you during pregnancy to reduce and/or prevent these symptoms altogether. 

Pregnant women may also experience back pain, carpal tunnel and headaches during pregnancy. Poor posture, stress, the additional baby weight and the change in your center of gravity can all contribute to these symptoms. However, these are all musculoskeletal issues that physical therapists are able to address with positioning considerations, manual therapy techniques and gentle therapeutic exercises for optimal posture and strength. Any of these conditions can be effectively treated at any point in your pregnancy. Your physical therapist will evaluate you and provide an individualized plan of care aligned with your trimester of pregnancy. 

Physical therapists can also provide tips and techniques for labor and delivery, while taking into consideration any musculoskeletal pain or impairments. Previous injuries or painful regions, especially in your back or hips, may become irritated or worsened from labor or delivery. To prevent this, you can set up a third trimester appointment with one of our women’s health physical therapists. During the third trimester visit, we will discuss your medical history, perform a thorough musculoskeletal evaluation and discuss potential laboring positions. We will also talk about the functions of the pelvic floor and how to prevent tearing during delivery. Then, following your third trimester visit, you can schedule a postpartum evaluation to ensure you are on track for a good recovery.

 

What About Postpartum Physical Therapy?

In the past few years, studies have shown that women do not feel they are adequately prepared for the postpartum experience, termed “the fourth trimester.” Typically, women are seen for many doctor visits before the baby is born but only one visit postpartum. In 2018, the American College of Obstetricians and Gynecologists published guidelines for postpartum care, which included a referral to physical therapy for urinary or fecal incontinence. It also explained that postpartum care should be an ongoing process, rather than just one visit.

There are many diagnoses a women’s health physical therapist can treat following delivery. A few common examples are: low back pain, pelvic pain, urinary or fecal incontinence, pain with sexual intercourse and diastasis recti (separation of abdominal musculature). Therapeutic exercise and manual therapy techniques are used during treatment of these depending on your individual presentation and symptoms.

A women’s health physical therapist can even be useful for a postpartum checkup to provide you with the necessary knowledge to prevent future issues. This can be especially important if you want to return to working out or running. It is even more highly recommended if you experienced a tear or surgical cut during your delivery to make sure your body heals correctly without any complications. A women’s health physical therapist can help you gradually return to your normal daily activities and manage any pelvic floor symptoms that occur along the way.

Exercise is also an important aspect of the recovery process postpartum. We can create a program focusing on strengthening and stability to improve motor control and overall well-being. A women’s health physical therapist is trained to do this, while also considering any postpartum complications to ensure your safety. If there is a post-surgical scar, this is extremely important so the scar is not re-opened from too much rigorous activity. A therapist can suggest adjustments and specific exercises based on your functional capabilities and limitations.

 

When to Call Us?

If you are experiencing any of the symptoms discussed above, women’s health or pelvic floor therapy may be a great option for you. This includes:

  • Pain during or following pregnancy, especially pelvic pain, hip pain or low back pain
  • Urinary or fecal incontinence (leakage) in general or during exercise
  • Diastasis recti
  • Pain with sexual intercourse
  • Carpal tunnel
  • Headaches
  • Back pain

During your first visit, we will take a subjective medical history and chat with you about your goals. We will also perform a musculoskeletal exam of your trunk & lower extremities and, when indicated, an internal pelvic floor examination. Follow-up visits will include therapeutic exercise and manual therapy dependent upon the findings of your evaluation.

To schedule an appointment with one of our women’s health physical therapists, you can either give us a call directly or you can ask to be referred by your physician. Please don’t hesitate to also reach out if you have any questions or if you would like to learn more about pelvic floor physical therapy & what we can offer. We would love to help!

Pelvic floor muscles

What to Expect at Your First Pelvic Floor PT Visit

Pelvic floor muscles

By: Rachel Larson, PT, DPT, CLT

What is Pelvic Floor Physical Therapy?

A pelvic floor physical therapist is just like any other physical therapist you may have worked with in the past! We are musculoskeletal, neurological, and movement specialists. However, we also have additional training specifically for pelvic floor muscles. Pelvic floor physical therapists address diagnoses such as pelvic pain, urinary incontinence, pelvic organ prolapses, diastasis recti (separation of abdominal muscles), low back pain due to pregnancy, and much, much more. We can even see you if you don’t have any issues and just want to proactively strengthen your pelvic floor!

Why Pelvic Floor PT?

While it’s more common than people think, it is not normal to pee your pants after having a baby or to have pain with intercourse! Pelvic floor physical therapy is a great, non-surgical solution to these problems. If you are experiencing urinary incontinence, then your therapist can help retrain your bladder and strengthen your pelvic floor. Or for pelvic pain, rather than strengthening the pelvic floor, we can also help train your pelvic floor to relax. Please know that there is help out there for you for any of these problems you may be experiencing!

What will my first appointment be like?

Based on your main concern regarding your pelvic floor, you can expect your pelvic floor physical therapist to:

  • Start by having a conversation about what your area of concern is, when it began, and how we can help you
  • Assess your posture, gait pattern, lower back and hip ranges of motion, as well as your strength
  • With your consent and only if they believe it is appropriate for your specific case, your therapist can perform an internal assessment of your pelvic floor musculature. The purpose of the internal assessment is to test the strength and range of motion of your pelvic floor muscles to get a better idea of your specific diagnosis. The setup of an internal assessment is similar to the setup of your yearly OBGYN visit. You, and a chaperone if you wish, will be brought into a private room. The room is sanitized including sheets on the table and has sheets to keep you covered during the exam. Your therapist also won’t need to use stirrups or speculums! They will put on a clean pair of gloves and use a water-based lubricant to perform a manual exam. Any additional tools will only be used in follow-up treatments and not in the initial internal evaluation.
  • Prescribe a personalized exercise program that is tailored to your main concern to help return you to your daily life
What do I do next?

To schedule an evaluation with a pelvic floor physical therapist, you can either give us a call directly or you can see your doctor to be referred. If you have any questions or want to learn more about pelvic floor physical therapy and what we can offer, please give us a call!