It’s no secret that pregnancy isn’t a walk in the park. Your body experiences dramatic physiological changes.
These are natural changes, but they may have a significant impact on the neck, back, pelvic floor muscles and ligaments as they become softer, allowing your baby to grow and your body to change.
In fact, 50-70% of pregnant women experience chronic back pain during their pregnancies (defined as a persistent pain lasting longer than 2-3 months) and many simply push through this discomfort.
Pregnancy can bring many aches and pains, due to added stress, weight gain, hormone increases, and changes to the body’s posture and center of gravity.
Commonly Treated Conditions
Low back, sciatic, pelvic girdle, and pubic bone pain
Arm pain or tingling related to nerve compression from postural changes
Urine leakage due to stressed pelvic floor muscles
Varicose veins involving the vulva
Pelvic Floor Preparation
Prenatal physiotherapy can also be helpful in preparing the perineum for delivery. The perineum is the soft skin between the anus and the vagina.
Because of its proximity to where the baby exits the vaginal canal, as well as the pressure put on it while pushing, this delicate area is prone to tearing, especially for women having their first vaginal birth.
Performing perineal stretching and massage has many potential benefits.
Easing Pain During Crowning
If the perineum stretches more easily, baby’s head may come out more easily or quickly.
It may also mentally prepare you for the feeling of pressure and stretching and may help you become more comfortable with it. If you know what to expect, you may be less tense and more able to stretch.
Helping the Baby's Head Come Out Easier and/or Quicker
This massage can ease the “ring of fire” so often experienced while baby’s head is crowning.
The idea is that gently stretching the perineum regularly will allow it to stretch more easily when baby is crowning, causing less pain.
In four trials of nearly 2,500 women, researchers found that perineal massage before birth reduced the incidences of perineal trauma requiring suturing in first-time moms.
The study also found that women who practiced perineal massage were less likely to have episiotomies.
Experienced moms who practiced perineal massaging also reported less pain at three months postpartum.
What to Expect at Your Visit
Your assessment starts with your story. A review of your description of your symptoms and concerns, medical and surgical history, your lifestyle, functional abilities (and limitations), social or emotional issues and your personal goals you would like to achieve with therapy.
Specific questions depending on your issues may include:
Pelvic/hip/low back/neck pain
Pain with intercourse
Leakage of urine or stool
These are very personal and sensitive questions for most; rest assured that your comfort and consent are of the utmost importance.
The Physical Examination
The physical examination includes a whole-body assessment.
Components will include:
Range of motion of the neck, back and hips
Observations of the abdominal wall and perineum
An intravaginal and/or rectal examination of the perineum
The methods used are always based on your comfort and consent. I will discuss all options with you during your assessment.
The internal examination and treatment is not performed during the first trimester of pregnancy. However, external evaluation and treatment may still be utilized to address any issues in the early stages.
An individualized treatment plan is developed based on assessment findings.Treatment may include education regarding posture, a global strengthening program, relaxation and stretching exercises, pelvic floor exercises, myofascial release, and manual therapy or mobilization techniques to address any tight or restricted joints or muscles.
Perineal massage and stretching may be introduced in the third trimester.