Ask a pregnant woman how she is feeling and you will hear either absolute happiness or absolute discomfort. During the route of pregnancy, there seems to be no in-between. While pregnancy is a beautiful phase, it comes with its own share of distress, for instance – back pain. Approximately 50-80% of women are affected by lower back pain pregnancy. However, there is a very simple solution to this worry – physiotherapy during pregnancy. 

Physiotherapy in pregnancy is an effective practice to reduce painful symptoms such as lower back pain, pelvic pain and involuntary urination. 

In this article, Dr Aruna Kalra, a renowned obstetrician & gynaecologist at the CK Birla Hospital explains the various benefits of physiotherapy for pregnant women. 

What is the importance of physiotherapy during pregnancy?

Physiotherapy, also known as physical therapy, is an evidence-based technique that involves the science of movement to promote healing and holistic fitness. It includes a wide array of exercises and massages. 

While any person, irrespective of age and gender, can benefit from this technique, physiotherapy during pregnancy has well-defined advantages. 

Significance of physiotherapy for pregnant women

Our body produces a hormone known as relaxin. While both men and women form relaxin, this hormone is primarily produced in pregnant women. It is responsible for preventing any damage to a woman’s body during childbirth. 

The production of relaxin increases significantly during the second trimester. Primarily, this hormone is aimed at the loosening of the birth canal and preparing your body for childbirth. However, besides the birth canal, high levels of relaxin result in the loosening of other ligaments in your body. While on one hand relaxin facilitates the flow of blood, it leads to muscle, joint and body pain, on the other. This side-effect of relaxin is the fundamental cause of your lower back pain pregnancy. The transitory loosening during this period of pregnancy can make your muscles and ligaments weak for a long period of time. 

Physiotherapy during pregnancy is a helpful approach in dealing with the pain resulting from an increase in relaxin. This practice can assist in alleviating from muscle pain through the means of specific exercises and massages. The targeted exercises not only help in reducing pain but also maintain the strength of muscles. 

Which issues can antenatal physiotherapy address?

As discussed above, antenatal physiotherapy can help in reducing pain and improving the strength of muscles. While a majority of pregnant women complain of the lower back pain, there are other areas that physical therapy can help with. 

Some common issues pregnancy physiotherapy can deal with are:

• Upper back pain
• Neck and shoulder pain
• Sciatica (pain that radiates from lower back through hips and buttocks to the leg)
• Carpal tunnel syndrome (a condition that causes numbness, tingling, or weakness in your hand)
• Pelvic girdle pain (pain in front and back of the pelvis)
• Bladder issues

It is important to remember that the source of your pain and discomfort is the increase in levels of relaxin. However, the location of your pain can be unique. The role of physiotherapy in pregnancy is identifying the precise location of the pain and addressing it to minimise ache. 

What are the benefits of physiotherapy during pregnancy?

Physiotherapy benefits pregnant women in multiple ways. The role of physiotherapy in pregnancy has both, long and short-term advantages. Some of the top benefits include:

• Reliving lower back pain: During the early stages of your pregnancy, your body prepares itself to accommodate the growth of your child. It further continues to prepare for delivery. In its attempt to assist you during this journey, your ligaments stretch and become soft. Simultaneously, as your child grows inside you, your size increases and you gain weight. Due to this weight gain, your body’s centre of gravity shifts and moves forward leading to additional pressure on your lower back. Physiotherapy and exercise during pregnancy can help in alleviating lower back pain. 
• Strengthening pelvic floor muscles: It is popularly known how pregnancy making you urinate more. During pregnancy, you will experience an increased flow of blood in your body. This increase blood flow puts your kidneys to extra work and releases extra fluid leading to increased urination. Sometimes, however, increased urination and weakened pelvic floor muscles can cause urinary incontinence. Incontinence is a highly common side-effect of pregnancy. Physiotherapy can help in reducing incontinence by strengthening muscles by offering pelvic floor exercises. There is various exercise during pregnancy such as kegel exercises that you can learn from a verified physiotherapist to train your bladder. 
• Preparing for labour and delivery: While the course of pregnancy may be smooth, childbirth is highly taxing event. Your body requires high levels of strength and flexibility to naturally induce labour and deliver a fully grown baby. Due to the need for core strength and flexible muscles, pregnant women are asked to consistently remain physically active (unless advised by the doctor). Physiotherapy is a good alternative to monotonous physical activities. A physiotherapist can train you to push effectively during delivery. You can also practice a range of pelvic floor exercises to help you prepare for labour and childbirth. 
• Assisting in posture changes during pregnancy: As discussed above, the centre of your gravity may shift during pregnancy. The increased pressure on your lower back can cause your uterus to move slightly forward. Similarly, the weakened lower back muscles can cause you to lean forward with bent shoulders, neck and mid-back. The transition in the position of these muscles can change your posture. Physiotherapy is an effective medical tool that helps in correcting posture during pregnancy. 
• Relieving from carpal tunnel syndrome:  Carpal Tunnel Syndrome is a common side-effect of pregnancy. It is a medical condition that causes numbness and tingling sensation in the hand and arm. The increased volume of blood in your body during pregnancy can lead to nerve compression, particularly in the wrist area (because it is comparatively narrow). This nerve compression can cause numbness, pain and tingle in your hand and arm. Physiotherapy addresses Carpal Tunnel Syndrome by focusing on pain management and consistent blood flow. 

Trimester wise physiotherapy in pregnancy

As your pregnancy progress across three trimesters, physiotherapy and exercise during pregnancy also vary. 

1. First trimester: The first trimester is the time when you are just getting used to pregnancy and the various changes it brings. Your physical activity, diet and physiotherapy will aim at assisting you in getting used to these changes. Your physiotherapist will begin by educating you and your partner about maternal and fetal changes and what to expect. 

Physiotherapy in the first three months focuses on your posture, challenges at home and work and pre-existing musculoskeletal problems (if any). 

Your physiotherapist will slowly assist you in correcting your postural at workplace and home. He/she will offer you techniques for safe lifting and mobility and treat any musculoskeletal problems you had been suffering from. 

2. Second trimester: By the second trimester, you are well into pregnancy and accommodating the tremendous changes in your hormones and your body. Physiotherapy in the second trimester of pregnancy helps you in keeping up with these shifts. 

Your physiotherapist will start exercises after completion of the anomaly scan and with clearance from your primary consultant.

Physiotherapy in the second trimester focuses on stretching techniques to improve the flexibility of the lower limbs and pelvis. You will be instructed to do mobility and strengthening exercises for the spine and the abdomen. The goal of this exercise during pregnancy is to enhance fitness and emphasise on pain management. 

3. Third trimester: By the last three months of your pregnancy, your physiotherapist will focus on promoting strength and flexibility. You will be assisted towards labour coping strategies such as relaxation techniques, breathing exercises, positioning to facilitate labour and techniques to use in the pushing stage. 

Physiotherapy in the third trimester of pregnancy involves advanced strengthening for the spine and abdomen, pelvic floor exercises, techniques to improve the flexibility of the lower limbs and pelvis and pain management. 

The concluding note

Your choices during pregnancy will help in deciding the health of your fetus. Physiotherapy during pregnancy is a preferable choice for expectant women who wish to inculcate exercise and relaxation in their life. 

Make sure to visit a verified and qualified physiotherapist and follow their correct instructions to avoid any complications. 

For personalised guidance on antenatal care, book an appointment with Dr Aruna Kalra, the best obstetrician in Gurgaon at the CK Birla Hospital. 

FAQs

Is physiotherapy safe during pregnancy?

Yes, physiotherapy is a completely safe and effective method of pain management, exercises and relaxation during pregnancy. 

How can physiotherapy help in pregnancy?

Physiotherapy during pregnancy has a large number of benefits. It helps an expectant mother to engage in physical activity, relaxes sore muscles, strengthens muscles, improves flexibility and offers pain management. 

Is exercise recommended during pregnancy?

Yes, nearly 30-40 minutes of regular exercise is recommended for pregnant women to have a smooth and safe pregnancy, labour and childbirth. 

Who should not exercise during pregnancy?

A pregnant woman who is suffering from severe anaemia, chronic heart or lung conditions, placenta previa or other complications should avoid doing exercise.