Physical Therapy Services for Pregnancy and Postpartum

Common Misconceptions

Myths about the normalcy of pain during pregnancy are pervasive. In order to understand what we treat‚ it’s important to know:

  • Back pain during pregnancy is not normal.
  • Waddling during pregnancy is not normal.
  • Urinary incontinence during pregnancy is not normal.

While these are all common‚ they are signs of musculoskeletal dysfunction. The good news is that physical therapists are experts in musculoskeletal dysfunction.

 

What We Can Treat

  • Diastasis recti
  • Back pain
  • Hip pain/pelvic pain
  • Sacroiliac dysfunction (commonly confused with low back pain)
  • Pubic symphysis dysfunction (pain or instability at front of groin area)
  • Numbness and tingling in arms or legs
  • General aches and pains in muscular areas
  • Headaches/neck pain
  • Difficulty walking or having a severe waddling gait
  • Balance issues/feeling like you are falling
  • Urinary or fecal incontinence (difficulty controlling bowel or bladder in any way)
  • Pain with sex or other pelvic pains
  • Prolapse (when abdominal organs are pushing into the vaginal wall)

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Assessment

Depending on your specific concerns‚ this assessment will include some or all of the following:

  • Posture analysis
  • Gait (walking) and balance tests
  • Range of motion of spine‚ arms‚ and legs
  • Strength testing of multiple muscle groups
  • Palpitation of affected areas
  • Internal and/or external palpitation of pelvic floor muscles (assessing how well you can contract and relax the muscles you use for bowel and bladder control)
  • Mobility assessments (watching how you perform daily tasks to assess possible contributors to the problem)

Treatment

Treatment is determined by and specific to deficits found during your evaluation. In general, treatment is likely to include some or all of the following:

  • Postural correction
  • Therapeutic exercises and stretches
  • Gentle joint mobilizations (applying gentle pressure to help a joint move properly)
  • Myofascial release or soft tissue mobilization (different massage techniques)
  • Gait training (instruction on how to walk properly)
  • Education on body mechanics (how to perform your daily activities without aggravating your problem)
  • Joint protection techniques (how to move so as to avoid furthering any joint pains)

For your convenience‚ your physical therapy evaluation and treatments will be held in the privacy and comfort of your home and at a time that works best for you. Your therapist will bring all of the necessary supplies; you will simply be asked to provide space in your home for the assessment. All of the details will be emailed to you prior to your initial evaluation. Dress comfortably and let your therapist take care of the rest!

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Wellness Program for Pregnancy and Postpartum

We offer the following for women who have recently found out they are expecting and wish to be proactive in avoiding all of the above-mentioned diagnoses, or for those who wish, for any reason, to have a specialized professional guiding them through pregnancy.

This program is tailored specifically to the unique needs of each client. It includes an exercise and stretching routine, and so much more!

  • Education on and training in an appropriate exercise program specific for your needs
  • Instruction on when to decrease exercise intensity or stop exercising altogether
  • Proper postural training for all daily activities to promote the growing belly
  • Managing the increasing demands of your bladder with a specialized bathroom program
  • Massage and relaxation techniques for stress reduction
  • Training on the best baby holds for nursing‚ calming and changing

 

Please contact us with any questions you may have to see if the wellness program is right for you.

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Let’s talk about the most common diagnoses that we see in pregnant and postpartum women not just in South Florida but all over the world. The most common diagnosis is lower back pain. What are the most common causes of lower back pain? There are quite a few reasons why pregnant women could get back pain. Back pain usually worsens during the second trimester and into the third.

One of the reasons why women get back pain is increasing their weight. Most women during healthy pregnancy gain anywhere from 25 to 35 pounds. That increases stress on your spine and thus may cause pain. As your belly is growing it also shifts the center of mass in your body and you might find yourself in the pasture where your pelvis is arched. This posture puts a lot of compression forces through your low back and might cause the back pain. Also there is a hormone relaxing that secretes in your body around as early as 10 weeks into the pregnancy.

This hormone will make the ligaments in your body looser. Those Will include the ligaments that are connecting your pelvic bones in your spine to the triangular bone right in the middle of your pelvis called sacrum. Usually pregnant women get pain in their sacroiliac joints. Another common reason for low back pain in pregnant women is diastasis recti. Diastasis recti is a condition where two halves of the abdominal muscle called rectus abdominis separate and the connective tissue that connects those two halves called Linnea alba stretches out. That will contribute to lower back pain. Because the linea alba and the rectus abdominis stretch out, the change is the intra-abdominal pressure and that’s causing back pain. Furthermore, in my experience lower back pain comes commonly from poor posture and poor body mechanics that person uses throughout the day.

Number two on the list would be symphysis pubis dysfunction. Symphysis pubis is a joint that is formed by two pubic bones and a disc between them and it is located right above the vulva. Ligaments surrounding the joints will loosen up before the delivery, however if it happens before that it causes the pain in the pubic area. It usually is a sharp or shooting pain that is most bothersome with activities involving hip flexion such as putting on your pants, climbing into the car, transitioning sit to stand, or sometimes it hurts with walking. It also often bothers pregnant women during night time when they move in bed, as well as with stare negotiation and one putting weight on one leg at a time. When a woman is pregnant as early as 10 weeks she starts to secrete a hormone called relaxing.

The name of this hormone speaks for itself: it helps the body to relax the ligaments and prepare for opening up the pelvis in preparation for birth. However when the ligaments become too loose it may cause excessive motion in the joint which in turn causes the irritation and thus pain. Without proper intervention as you progress throughout the pregnancy the pain might get worse just because the weight of the baby is increasing and there is more pressure on the joint. Now let’s talk about what you can do to help yourself with those pains that you might get throughout the pregnancy. First of all I watch your posture. Women need to make sure that they are utilizing back support when they’re sitting. It doesn’t matter whether you see it on the couch, dining chair, or office chair, you always need to support your back in a way that will keep the spine in neutral alignment. Your feet should be weight-bearing on the floor. If you are still working and utilizing a standing desk, you need to make sure that you’re sending in proper posture as well. Weight should be evenly distributed between both feet, your core should be jumping engaged, your back should be in neutral alignment and your computer/laptop should be set at the proper height.

If you have younger kids or picking up or moving something heavy you need to make sure that you’re using your legs and not your back. In day-to-day life and especially during pregnancy when your weight is increasing It is important to keep all the major muscle groups strong. Especially those in your hips and legs. One of the most important muscle groups to keep strong are your glute muscles: gluteus maximus, gluteus medius, and gluteus minimus, as well as your hip abductors. Those muscles will support your joints in the pelvis and ensure that your body is able to handle the increasing weight. It is also very important to keep your deep core musculature active. Your deep core muscles that are important to know are transversus abdominis. Exercising during pregnancy is really important, it will help to prevent and treat any pregnancy symptoms that you might have. Lower back pain, any urinary incontinence, because it will help to take the pressure off pelvic floor muscles and distributed along all the major muscle groups. Flexibility and stability are equally important during pregnancy.

Here at painless pregnancy we are making sure that your joints remain mobile and within an optimal range, we also make sure that all of your bones are moving in the way they are supposed to move in preparation for delivery. We make sure that your rib cage remains mobile and it can accommodate for the growing valley, we also make sure that all the fascial tissues are in Maine mobile again to accommodate for the growing baby. Pregnant women who stay with us throughout the pregnancy and follow all of the directions that are given to them usually end up having a painless pregnancy, maintain their muscles strong, have easy delivery, and recover much faster postpartum. Painless pregnancy is a company that has many qualified physical therapists that can help solve and prevent lower back pain and pubic symphysis dysfunction as well as diastasis recti.