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Pregnancy & Birth Preparation

Pregnancy & Birth Preparation

Pregnancy has been compared to competing in the Tour de France for good reason — the strain on your body is extreme. While your OB focuses on preventing and treating complications, your PT helps you develop strength and flexibility for more effective pushing, shorter labor, reduced risk of injury during childbirth, and much more.

Whether you’re in your first trimester or two weeks from delivery, physical therapy can have life-changing impact.

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Feel Good in Every Trimester

Stay active & strong

During pregnancy, the structure of your body shifts, from the curve of your spine to the width of your pelvis. Starting as soon as your first trimester, your PT can help you minimize pain, condition your pelvic floor, and keep you exercising safely.

Prepare for delivery

As your due date approaches, we’ll help you prepare for a safe, smooth labor and make informed decisions, based on your goals. Treatment may include:

  • Exercises to build pelvic floor strength and flexibility
  • Guidance on safe birthing positions and effective pushing methods
  • Perineal massage to reduce risk of tears
  • Breathing techniques to assist with pain and delivery

Take care of you

Every visit starts with a check-in to surface your most pressing needs. The length of your treatment will depend on your due date, but many patients find weekly visits to be the most helpful.

COMMON & TREATABLE

50% of pregnant women experience pain. Physical therapy has been shown to prevent and treat pregnancy pains, reduce risk of perineal trauma, and shorten labor.

"It feels like my pelvis is splitting in half."
"There’s so much pressure. Will my baby fall out?"
"My lower back hurts all the time."

Sources: Katonis P, et al. Pregnancy-related low back pain. Hippokratia. 2011; Skarica, B. Effectiveness of Manual Treatment on Pregnancy Symptoms. Med Arch. 2018; Stuge B, et al. The efficacy of a treatment program focusing on specific stabilizing exercises for pelvic girdle pain after pregnancy. Spine. 2004; Leon-Larios F, et al. Influence of a pelvic floor training program to prevent perineal trauma. Midwifery. 2017. Sobhgol SS, et al. The effect of antenatal pelvic floor muscle exercises on labour and birth outcomes: a systematic review and meta-analysis. Int Urogynecol J. 2020.

Pregnancy FAQ

Why is lower back pain so common in pregnancy and how can physical therapy help?

During pregnancy, the weight of your belly and breasts causes the pelvis to naturally tilt forward, which results in a larger curve in the low back. This shift forces the muscles in the core and back to have to work harder to maintain balance and posture. When the core is unable to provide adequate support, the muscles in the back can over-activate and go into spasm causing pain. Back pain can arise anytime during your pregnancy from late first trimester all the way to the end of your pregnancy.

An Origin physical therapist will treat your back pain comprehensively with manual therapy techniques, a personalized exercise program, and specific movement strategies. These can include modifying the way you stand up, bend, lift and carry. Your PT can also help you modify the exercises you already love to do, like yoga or pilates. In some cases, we may consider the use of a belt or brace for additional support, particularly as your belly continues to grow during pregnancy.

Is it common to have pelvic pain during pregnancy?

Yes, very common. During pregnancy the pelvis typically widens and the joints become loose due to hormonal changes. It’s common for this change in shape and reduced stability to lead to pain in the pelvic joints. But just because something is common, doesn’t mean it’s “normal” and you have to put up with it. 

At Origin, we treat pelvic pain with a combination of manual therapy techniques, stabilization exercises, and education on body mechanics. Your PT will teach you how to roll, stand up, and get out of bed properly to decrease the strain going through your pelvis. If there is something specific that really bothers you that you want help with, you will work together to modify it appropriately. Your PT may also recommend a support belt to add even more stability to your pelvis while you are getting stronger.

Why does pregnancy cause rib pain? Do I have to wait after I deliver to feel better?

During pregnancy, your growing baby pushes the abdominal organs upward and the ribs flare to create more room. This expansion changes the way the ribs articulate with the spine, which makes the joints more vulnerable. 

At the same time, your hormones change, which can affect the laxity of the joints, including the now vulnerable costovertebral joints. These joints are typically injured due to an excess of pressure on the ribs from inside the body. This pressure can come from increased intra abdominal pressure, like a cough or sneeze, which can alter the position of the rib in relation to the vertebrae. Or added pressure can also come from something more physical, like a kick or punch from the growing baby, which can also alter the posture of the rib. 

When assessing your rib pain, your Origin PT will begin by looking at your posture and the way you breathe. Our treatment plans often include different manual therapy techniques for your mid back and ribs, exercises to improve your postural strength and mobility, and strategies to optimize breathing patterns and posture. Taping techniques are often used to help rib pain as well.

What causes pregnancy-related hip pain? How does physical therapy help?

During pregnancy, the shape of the pelvis and uterus change. The pelvis expands and widens to prepare for childbirth, and the uterus expands as the baby grows. As the pelvis and belly change, the muscles and ligaments that attach to the pelvic girdle and pelvic cavity can move and stretch, causing pain and discomfort. 

Hip pain can start at any point during pregnancy, but we typically see it arise in the middle of the second trimester once the hips widen and the belly pops a little. Pain on the side of your hips may arise even later as the load through your hips increases while sleeping. Round ligament pain is often transient, and will come about during growth spurts.

More often than not, hip pain is caused by a certain movement or position that is putting too much strain or pressure on the muscles of the hip. Your PT will assess your movements and positions and find the driver of your pain. Once identified, your PT will treat your hip pain with a combination of manual therapy techniques to the hips, strengthening and mobility exercises to provide added stability to the hips and optimize range of motion, as well as make corrections to the way you move and position yourself.

Your PT will ask you about your sleeping positions, work set up, preferred exercise, and even how you position your seat in your car. They may make modifications to one of all of those movements to address your symptoms.

Why do my neck and shoulders hurt so much during pregnancy? Can PT help with the pain?

During pregnancy, the breasts grow and get heavier. As a result of this change, the center of mass shifts forward, which can promote slouching and rounding of the neck and shoulders. Because of this change, the muscles of the neck, shoulders, and upper back must work harder to maintain proper posture as well as head and neck alignment. When these postural muscles are weak, the body will compensate and utilize whichever muscles it has available, typically the upper trapezius muscles. When these muscles are overworked, they go into spasm causing neck and shoulder pain. Neck pain during pregnancy can arise at any time, but it typically comes about later in the pregnancy when sitting or finding a comfortable sleeping position becomes challenging.

When we’re treating pain in the neck and shoulders, we look at your posture and positioning in its entirety. How are you sleeping? What is your work set up? What does the curve in your low back look like? We address any movement, position, or body part that could be affecting how your neck and shoulder move.

Your neck pain and poor posture is treated with a combination of manual therapy techniques to your muscles and joints, postural exercises, and strategies to improve the way you sit, sleep, and move. One of the biggest drivers of neck and shoulder pain is the way we move and hold our head. By making meaningful, long term changes to your movement patterns, you can have long term success.

Your PT will show you how to sit, sleep, drive, lift, and carry without overly stressing your neck and shoulders. They may also use certain taping techniques to improve your postural awareness as you get stronger.

Why does pregnancy cause tailbone pain and what can a PT do to fix it?

During pregnancy, the hormones that help your pelvic joints loosen to prepare for childbirth will also affect your tailbone or coccyx. The combination of a less stable tailbone and increased body weight during pregnancy puts more load through the tailbone, particularly with sitting, leading to pain and inflammation in the area. As a result, the muscles that are attached to the coccyx, including the pelvic floor, will tighten, which can make pain worse.

We treat tailbone pain or coccydynia from the inside out. We assess the pelvic floor, the glutes, and the rest of the muscles of your pelvic girdle to find the root cause of pain. We also look at the way you sit, stand up, and walk. Through a combination of manual therapy, specific strengthening and lengthening exercises, and changes to the way you move, we treat coccydynia comprehensively. Your PT may also recommend a pillow to sit on while your tailbone heals.

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The Origin Team

Our pelvic floor and orthopedic physical therapists have helped over 15,000 patients feel better in their bodies.
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