Pregnancy/Pre-Partum

Low back and Pelvic Girdle Pain (PGP) and Symphysis Pubis Dysfunction (SPD)

Low back and Pelvic Girdle Pain is common during pregnancy. Although it is painful and impacts your quality of life it does not pose a risk to your health or your babies health. The cause it most likely multifactorial. Increasing levels of hormones with can play a role in increasing movement at the pelvis can create pain in some cases. As your baby grows your center of gravity shifts forward and this puts extra strain on your pubic symphysis and low back which can lead to pain. Those who have had a history of low back pain are more likely to experience pain during pregnancy. Symptoms include pain in the pubic bone or pain in the low back or sacrum with sit to stand, rolling over in bed, getting out of the car, climbing stairs, etc. Sometimes pain can radiate down the leg. Pelvic floor Physical Therapy can help. Treatments may include providing a belt for external stability, strengthening intrinsic stabilizer muscles including the pelvic floor muscles, and activity modifications. 

Sciatica

The body experiences a lot of physical changes during pregnancy. As your baby grows, your body has to adjust. Sometimes that leads to unfamiliar aches and pains. A common symptom for pregnant women is sciatic nerve pain. Also called sciatica, or lumbar radiculopathy, it’s described as a “radiating pain” that travels from the sciatic nerve, located in the lower spine, down the back of your thigh. The sciatic nerve is the largest in your body and the main nerve in the legs. The cause is most likely multifactorial. Increasing levels of hormones can play a role in increasing movement at the pelvis and can irritate the sciatic nerve in some cases. As your baby grows your center of gravity shifts forward and this puts extra strain on your pubic symphysis and low back which can lead to pain. Those who have had a history of low back pain are more likely to experience pain during pregnancy. Treatments may include providing a belt for external stability, strengthening intrinsic stabilizer muscles including the pelvic floor muscles, stretches, nerve glides and activity modifications. 

Round Ligament Pain

The round ligaments are connective tissues that connect the labia majora to the uterus. They help to support the uterus during movement. As your uterus grows the ligament stretches and sometimes fast movements can pull on the connective tissue and create a sharp pain. Pelvic floor Physical Therapy can help. Treatment will vary but may include activity modifications, compression garments or kinesiotaping techniques to offload pressure, stretches and pelvic floor muscle training. 

Preparation for Vaginal or Cesarean birth

Preparing for delivery is a daunting task- whether it is for a vaginal delivery or cesarean. In terms of a vaginal delivery, it is important to increase muscle awareness and improve the ability to relax and lengthen the pelvic floor for birthing. In PT we will work on improve pelvic floor muscle awareness and relaxation, practice laboring positions that more easily allow the pelvic floor to lengthen and the bony anatomy to open, learn what pushing positions and strategies are best for one’s body, increase tactile stimulation and stretch tolerance to the pelvic floor tissues via perineal massage. In cases of a breech baby we can assist in optimizing the pelvic position to allow baby to flip into a head down position. In cases of a planned cesarean, knowing what to expect and preparing the body is important. Like any surgery, having prehab beforehand will improve outcomes and recovery post op.  We will educate you on the anatomy and physiology of pelvis, pelvic floor muscles, and surrounding soft tissue related to C-section delivery, optimize the function of your pelvic floor muscles, understand recovery timelines and learn what to do post op.