Physiotherapy During and Post Pregnancy: An Insight

What Are the Common Problems That Physiotherapy Can Help With?

Physiotherapy after childbirth helps in relieving common concerns, including:

1. Improving bladder and bowel functions, as well as addressing issues with incontinence.

2. Addressing pelvic floor issues.

3. Guiding proper techniques suitable for childcare and other daily activities.

4. Alleviating lower back pain.

5. Correcting posture and offering advice on ergonomics.

6. Post-natal physiotherapy can help alleviate pain, urinary incontinence, and pelvic floor muscle issues and improve strength, flexibility, and long-term health.

Why Do Problems Arise During Pregnancy for Some Women?

Not all pregnant women will have these symptoms, so if someone is pregnant or planning to be, there is no need to be concerned. Certain factors make it more likely for some women to experience these problems. Women with a history of back pain or pelvic issues and those with a heavy workload may struggle with pain in their pelvis or lower back during and after pregnancy.

Urinary incontinence may be more common in women who are overweight or have had a baby. The risk of pelvic organ prolapse increases with age, number of deliveries, family history, weak pelvic muscles, obesity, heavy lifting, and constipation.

What Is the Role of Physiotherapy in Pre and Post-pregnancy?

• The physiotherapist who performs physical therapy involves proper assessment, treatment, and education of pregnant women in safe and effective exercises that have shown a reduction in the effects of pre and post-pregnancy, such as pelvic pain, back pain, urinary incontinence, and others.

• The main goal of the physiotherapy program in pregnancy and postpartum is to offer women improved prenatal and postnatal fitness that may result in easier and healthier pregnancy, delivery, and postpartum care.

• Seeing a physical therapist who gives the right treatment and guidance to prevent all the issues that come during pregnancy and postpartum may be the key to making the woman's pregnancy journey peaceful.

What Is the Role of Physiotherapists in the Prenatal Period?

• The physiotherapist will advise pregnant women to stay healthy and fit, and they prescribe safe exercises.

• The physiotherapist is involved in teaching about the strategies and posture that help decrease the risk of lower back strain and pain in the pelvic joints in the prenatal period.

• They are involved in relieving and preventing pelvic girdle pain and lower back pain.

• The physiotherapist is involved in teaching pelvic floor exercises.

• They also suggest an exercise that helps prepare the body for labor and teaches perineal massage techniques.

• They are also involved in advising on pain management during labor.

What Is the Role of Physiotherapists in the Postnatal Period?

• Physiotherapists advise on recovering strategies from either vaginal delivery or C- section birth.

• They suggest physiotherapy exercises by assessing breathing, posture, pelvic muscle function, and the gap in the abdominal muscles.

• They are involved in creating rehabilitation plans for abdominal muscles and pelvic muscles.

• They are also involved in advising on safely performing postpartum exercises.

• They also suggest exercise for pelvic floor dysfunction that can cause urinary incontinence after childbirth.

• The physiotherapist may be involved in teaching about improving bowel, bladder, sexual health, and pelvic health.

What Are the Exercises That Women Can Do During Pregnancy?

The physical therapist usually recommends stretching and strengthening exercises during pregnancy. The exercises include

Piriformis Stretch:

• The person should sit on a chair with the pelvis in a neutral position.

• Then, the person should keep one foot over the opposite knee and bend forward from the hips by keeping the pelvis neutral until they feel a stretch.

• Then, the person should hold the position for 20 to 30 seconds and repeat on the opposite side.

Butterfly Pose:

• The person should sit on the floor and bring the soles of their feet together by allowing the knees to point out.

• Then, the person should grasp the feet and draw both heels close to the body.

• Then, the person should lean forward slightly and hold the position for a few seconds.

• This exercise can be repeated 20 to 30 times.

Squats:

• The person should stand on the floor with their feet slightly more than leg hip-width apart.

• Then, the person should clasp their hands and bring the hands forward.

• Then, the person should squat while exhaling, press down, and straighten the legs while moving up.

• This exercise can be repeated 10 to 15 times.

Garland Pose:

• The person should stand with the feet facing slightly wider than the hip-width apart.

• Then, the person should slowly and gently lower their body by bending their knees and extending their hands out for balance.

• Then, the person should balance their body's weight on the balls of their heels and hold the position for a few seconds.

• Then, the person should slowly rise to the starting position and repeat the exercise several times.

What Are the Exercises That Women Can Do After Pregnancy?

The physical therapist mainly suggests exercises that strengthen the pelvic floor muscles. The exercises include

Pelvic Tilt:

• The person should lie on their back on the floor with both knees bent.

• Then the person should flatten their back against the floor by tightening their abdominal muscles and bending their pelvic muscles up slightly.

• Then the person should hold the position for up to 10 seconds and repeat the exercise 10 to 20 times.

Happy Baby Yoga Pose:

• The person should lie on the floor with their back and bring their knees towards their chest.

• Then the person should open their knees wider than the hips.

• By keeping their arms inside the knees, the person should use their hands to hold the outside of their feet.

• Then, the person should bend their knees and gently pull their feet downward, which causes some tension in the pelvic floor muscles.

• Then, the person should hold the position for 90 seconds.

Diaphragmatic Breathing:

• The person should lie flat on the floor and put one hand on the chest and another hand on the stomach.

• Then, the person should take a deep breath in the nose, which will expand the stomach, and breathe in for two to three seconds.

• Then, the person should exhale slowly and repeat the exercise for two to three minutes several times.

Kegels:

• The person should tighten their pelvic floor muscles by stopping the flow of urination and holding for 10 seconds.

• This exercise can be repeated throughout the day whenever possible.

• This helps in reducing urinary incontinence.

Postpartum Planks:

• The person should lie on their stomach, forearms on the floor, and elbows placed beneath their shoulders.

• The feet should be flexed with the toes on the floor.

• Then the person should engage their glutes and core muscles and raise their body up on their toes so that only toes and forearms should touch the floor.

• By contracting the deep abdominal muscles, the person should breathe normally and hold the position for 30 seconds.

• This exercise can be repeated one to two times.

What Will Happen During the Initial Visit?

During the first session with a physiotherapist, they will assess one's condition by asking about the symptoms and medical history. Individuals' privacy is guaranteed throughout the assessment. Then, they will conduct a physical examination tailored to one's condition, which may involve checking posture, muscle tone, flexibility, and strength.

What Are the Physiotherapy Treatment Options for Pregnancy-Related Problems?

After assessing the patient, the physiotherapist will create a personalized treatment plan to suit their needs. This plan varies depending on the individual's condition.

• For pelvic floor and bladder, or bowel conditions, treatment may involve exercises for pelvic floor muscles, hands-on therapy, advice on bladder and bowel health, and lifestyle changes.

• For musculoskeletal conditions, treatment may include hands-on therapy, exercises to strengthen muscles, stretches to loosen tight muscles, Kinisio-taping therapy, and advice on activities and lifestyle adjustments.

Conclusion:

Routine exercises during and post-pregnancy can help strengthen the abdominal, pelvic floor, and thigh muscles, boost mood, and reduce the stress caused by hormonal changes. Exercise may also help prevent lower back injuries and ease pelvic and lower back pain. So, reaching out to a physical therapist during pregnancy and postpartum may be beneficial.