Pregnancy and Pain: How Physical Therapy Can Help

Pregnancy is a journey and as time passes, you'll likely experience some sort of musculoskeletal pain. Additionally, that pain is likely to evolve and change as your pregnancy progresses. Some common complaints women have during pregnancy are low back pain, pubalgia (pain in the pubic bone right behind your zipper), sciatica (pain into the buttock and/or leg), rib pain, and pelvic pain. Although these issues arise as your body changes from the pregnancy, there's no reason to wait it out - nine months is a long time to hurt! There are many ways in which physical therapy can help.

Let's start with discussing how the body changes during pregnancy. As the baby grows, so does your stomach. As it grows further outward, your center of mass shifts forward and your pelvis widens. To compensate for this we tend to bear more weight through our toes, lean back, and let our legs rotate outward. These compensations cause us to overutilize our piriformis muscle and other hip rotators, lower back extensors, and calves. Leaning backward will also close the facet joints in our lumbar spines (lower backs) and can cause nerve entrapment and pain. These postural changes and the weight of the baby itself will cause our pelvic floor to work harder which can cause muscle spasm and more nerve entrapment. On top of all of this, ligaments in our bodies naturally become more lax as pregnancy progresses so that the baby can move easily through the pelvis. This is good news during delivery, but can cause skeletal malalignments and additional pain. 

Postural Restoration Institute-based physical therapy can help ease this pain as our interventions address all of these issues at one time. PRI focuses on flexing the lumbar spine and moving the center of gravity as far backward to its normal position as possible. This opens the lumbar facet joints and can relieve a great deal or lower back and/or leg pain. As our lumbar spines return to a more normal position, our legs will also return to a more normal rotational angle. This takes a great deal of strain off of the hip rotators that may be causing pain in the buttock region, but those muscles may also be compressing the sciatic nerve causing leg pain. Lastly, when our center of gravity moves backward, we can bear more weight through our heels as intended which will alleviate calf or foot pain. 

How does this happen? We utilize many positions in which to exercise to achieve maximum results. We tend to gravitate toward activities that involve lying on your side or on your hands and your knees as those allow us to isolate areas of the body and specifics muscles that we want to effect. This also unweights your pelvis and allows areas like your pelvic floor to relax for a bit. To make things more functional, we will reposition and strengthen in standing as well as long as our patient can tolerate it. Additionally, we do have modalities and various manual therapies to help us along in our goal of reducing your pain that can be utilized as needed. 

Think pregnancy-related issues stop once the baby is born? Unfortunately no, there are a multitude of problems that can arise aftward as well. Stay tuned as we discuss this topic in next week's blog post. 

Want to address your pregnancy-related pain? Call Integrate 360 Physical Therapy and 314-733-5000 or email or