How physical therapy can help during pregnancy
The human body undergoes many physiological, hormonal, and anatomical changes during pregnancy. As experts in movement and the musculoskeletal system, physical therapists – especially pelvic floor PTs! – can be a wonderful asset to help support you as your body continues to change throughout pregnancy, and get you ready for labor and birth.
Regardless of whether or not you experience pain, leakage, or other symptoms during pregnancy, there are many things a pelvic floor PT can help with throughout pregnancy!
Benefits of prenatal PT to address symptoms
While not everybody will experience pain or other symptoms during pregnancy, certain conditions, including low back pain, are common. However, just because certain symptoms may be “common” doesn’t mean you have to live in pain for the remainder of your pregnancy! Many people assume these symptoms will resolve following pregnancy, and sometimes that’s true! But that’s not always the case.
Addressing these symptoms during pregnancy can help:
make symptoms more manageable during pregnancy
minimize symptoms postpartum
optimize postpartum recovery
Physical therapy can be helpful in addressing not just pain, but a multitude of other symptoms during pregnancy, including:
back pain
hip pain
pelvic pain
urinary incontinence/leakage
nerve conditions, including carpal tunnel syndrome
This is by no means a comprehensive list! If you’re not sure if pelvic floor PT can help with the symptoms you are experiencing, we strongly recommend a consultation with a PT!
Other benefits of prenatal PT
Event without obvious symptoms, there are still huge benefits to seeing a pelvic floor physical therapist during the prenatal period, including (but not limited to) to the following:
Improve postpartum recovery
Learn how to connect with your core and pelvic floor, in addition to managing pressure within the abdomen during functional activities can help address diastasis recti, minimize symptoms postpartum, better support your body while healing after giving birth, and help get you back to all the activities you love!
Guidance from a pelvic floor PT can also help guide return to physical activity, including running, lifting, etc.; stay tuned for another blog to learn more!
Help you continue to exercise
Pregnant people are not fragile! In fact, exercise has many benefits for both the birthing parent and baby. A pelvic floor PT can provide guidance with the following:
assess form to make sure you’re properly engaging the deep core, etc.
provide guidance on when and how to modify core work, pullups, lifting, etc. as your body and energy levels change
teach you how to manage pressure and breathe optimally during lifting, etc. so you can continue to stay as active as you would safely like during your pregnancy
Preparing your body for labor
There is a lot we can do to help prepare our bodies for the birthing experience to help improve our confidence and minimize pelvic floor injury, such as tearing. Here are a few things a pelvic floor PT can educate and guide you in so you can be prepared for the big day!
Perineal massage: this is a technique that helps to stretch the perineum leading up to birth. There are many benefits to perineal massage, including:
reducing risk of perineal tearing during vaginal birth
minimizing the need for an episiotomy
decreasing pain in the pelvic floor area
even improving sexual satisfaction
Improve mobility: of the spine, hips, pelvis, and pelvic floor, which can help improve space and promote pelvic floor relaxation during birth to minimize injury to the pelvic floor
Breathing techniques: for pelvic floor relaxation, pain management and coping during contractions
Pushing strategies: to help minimize pelvic floor injury during vaginal birth
Labor and birthing positions: to help improve pelvic inlet and outlet space to help the baby to descend into and out of the pelvis during labor and birth, while minimizing pelvic floor injury.
Overall, pelvic floor PT can be a valuable tool to help support your body during pregnancy, labor and birth, and postpartum.
To further help guide your pregnancy journey, or further support a loved one during their pregnancy, here are some answers to common questions that our pelvic floor PTs often get asked in the clinic.
Q&A:
Is exercise safe during pregnancy?
Yes!
While we recommend checking with your doctor first, unless specified otherwise by your OB/midwife, those who were active pre-pregnancy can usually continue to lift, participate in cross fit, run, etc., as long as it’s still feeling good for you!
This doesn’t mean you can’t get active (maybe even for the first time) during pregnancy; know that exercise doesn’t have to be long or intense to be effective! We recommend starting with something you enjoy (like walking, etc.), starting slowly, and gradually building up based on your body’s tolerance.
A PT can help guide you through this process!
Is it ok to lift weights during pregnancy?
Yes! Weight lifting, even heavy weight lifting (if you’ve already been doing it) is a great way to stay healthy during pregnancy and prepare for postpartum
Make sure you work with a health/fitness professional to check your form, and give modification suggestions at the beginning and throughout your pregnancy
As your pregnancy progresses, shift to lower weight and higher reps if that feels more comfortable
Build in breaks as needed
Is it ok to run during pregnancy?
Yes! As long as it feels good to you, running is a great way to exercise and move your body during pregnancy!
Listen to your body, take breaks, and hydrate
Shift your mindset to being ok with walking and slowing down
What “red flags” should I watch out for during exercise?
shortness of breath
feeling lightheaded or off balance
pain, especially in the abdominal/pelvic area
cramping
bleeding/spotting
When is it time to modify activity, and how do I know how to modify my exercise?
Shifts in energy levels
If experiencing symptoms, including pain, leakage, coning/doming of abdomen
No longer able to maintain good form
Talk to a pelvic health PT who can provide you with guidance on when and how to modify your specific activities!
When should I start PT for labor prep?
32-34 weeks, but earlier is often recommended, as there is a lot you can do throughout pregnancy
Do I need to come back for PT postpartum?
Our strong stance is yes! Pelvic floor PT is important postpartum to assess pelvic floor healing, coordination, strength, and especially how to incorporate all of these things with your activities at home and outdoor adventures!
This applies to both vaginal and cesarean births
In other countries, pelvic floor PT is standard practice after giving birth. While the US isn’t quite there yet, giving birth is a major event for the body! Just like you would have PT following an ACL repair or other major surgery, PT following giving birth can also help optimize your recovery postpartum.
Keep an eye out for an upcoming blog that will highlight postpartum recovery!
When do I need to come back for PT postpartum?
4-6 weeks is a good timeframe, but it’s never too late!
A pelvic floor PT can further help address other questions you may have, and help support you throughout your prenatal and postpartum journey. Our Upward team would be happy to be a resource and guide as you navigate this journey! Check out our pelvic health page here! As always, feel free to reach out with further questions or concerns, or schedule an appointment with one of our trained pelvic floor physical therapists.