The following common conditions can benefit from physiotherapy.
Symphysis Pubis Dysfunction (SPD)
In pregnancy a hormone called relaxin causes increased flexibility into your ligaments and other soft tissue, allowing space for your baby to grow within your pelvis. The ligaments that support your pubic bone become more lax, allowing your pelvis to move more than normal, causing pain and instability.
It causes pain and tenderness over the pubic bone which may extend into the groin and down the inner thighs.
In addition to treatment by a physiotherapist, there are specific SPD belts that can be purchased through me which can be worn to reduce pain and prevent further damage. Please contact me for purchase enquiries.
Rectus Abdominis Diastasis (RAD)
During pregnancy, a hormone is produced called relaxin, which enables the abdominal muscles to stretch. This allows the uterus to grow out into the abdominal space. However, despite the effects of this hormone, the abdominal muscles still undergo an incredible amount of stress.The outermost abdominal muscle, called the rectus abdominus, forms two halves, a right and left recti muscle. These two halves are held together at the midline by a connective sheath called the linea alba.
During pregnancy, relaxin softens the linea alba and the two bands of recti muscles which previously lay parallel may stretch away from the midline to allow more space for the growing uterus. This separation is called rectus abdominis diastasis (RAD).Significant separation of the recti muscles is defined as a gap greater than two fingers widths, found 2cm below the umbilicus, three days post delivery.
There are no obvious symptoms of a RAD. However, it can alter posture and contribute towards lower back and pelvic instability which in turn can lead to pain.
This is pain over the middle part of the spine. It is normally caused by the shift in posture due to the enlargement of the uterus.
This pain is a direct result of the baby and uterus getting bigger and poking and prodding into you. In pregnant women the demand for oxygen is increased. You will exhale more carbon dioxide which triggers the respiratory system to increase the respiratory rate slightly, and this is the reason you may find yourself more breathless during strenuous activity. Your diaphragm will have to work harder as well.
You may find the baby beginning to press up and under your ribs and chest. This is the uterus ascending as the abdomen stretches upward and outward, so the baby can grow. The growing baby can obstruct the descent of the diaphragm, which is needed for deep breathing. Hence the pressure pushes the rib cage out sideways and forwards, known as rib flaring and causing a lot of pain. It can also lead to shoulder pain due to the nerves of the diaphragm referring pain there.
Sacroiliac Joint (SIJ) Dysfunction
In pregnancy, the hormone relaxin causes increased flexibility by softening the ligaments that support your pelvis. This means the joints are more mobile than normal causing pain. They sometimes become wrongly aligned. This increased flexibility remains for up to 6 months after stopping breastfeeding.
It causes pain and tenderness over the sacroiliac joint area, most commonly felt in the buttock and or the back of the thigh (occasionally in the groin or back of entire leg).
This is pain over your lower back. It is caused by the change in your posture from your growing uterus, over a relatively short space of time, not giving your muscles enough time to strengthen to support your spine. Some of the muscles that are shortened need to be lengthened, and vice versa, in order to support your new posture.
Pelvic Floor Conditions
There are many different pelvic floor conditions, ranging from pain to incontinence, and within these there are many sub-categories. Often with pregnancy, stress incontinence can develop, due to the growing weight of your uterus over your bladder. However, I do treat many other pelvic floor conditions too.
This condition is so named as it is caused by your sciatic nerve. The course the nerve takes runs from your lower back travelling down the back of your legs and branching out into your feet. This is also where the pain is felt, following the course of this nerve. The job of this nerve is to help you feel sensation and move the muscles in your legs.
Although seemingly quite common during pregnancy – especially in the third trimester – it is not necessarily directly caused by anything to do with pregnancy, although it can be aggravated by your posture during pregnancy. You can also suffer from sciatica without being pregnant.
Sciatica happens when there is inflammation or pressure from your back on the nerve, often caused by a slipped or injured disc. It can also be caused by the growing uterus putting pressure onto the nerve. When suffering from sciatica you will feel a burning shooting pain, quite often in just one of the legs. It can be constant or it can come and go. Although coupled with inflammation, it is important to remember that while pregnant you cannot take Ibuprofen, even at over-the-counter strength.