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Growing Pains

Your Body, Does Amazing Things During Pregnancy, But Amazing Things Are Not Always Pain Free 
There are many orthopedic issues that can arise in pregnancy that are quite common. In fact, some are so common, that women tend to think that pain is just part of being pregnant. that's where physical therapist can help. She can teach you what to do to keep little aches from becoming big ones and help to address the issues that are effecting day to day life.

Pelvic Girdle Pain
The size and of the growing fetus creates changes position changes in the woman's lumbar spine and pelvis. The lower spine curves into more extension and the pelvis tips forward which put additional strain on the joints in the back. The pelvis is normally a very structure with relatively little movement, but in pregnancy the ligaments of the body loosen up. Changes in weight, body position, and joint stability all contribute to pelvic girdle pain during pregnancy.

Some women report pain in the Sacroiliac joint which is where the dimples of your lower back are, but others experience pain at the pubic symphysis, which is your pubic bone. The pain is frequently sharp in that area, but it also can refer pain down the back of the thigh similar to up from a chair or rolling over in bed.

Pelvic girdle pain can also present as pubic symphysis pain. Pubic symphysis pain is felt at the pubic bone or into the front of the thigh. It can be quite sharp, particularly when turning over in bed, kneeling, or getting into a car.

Pelvic girdle pain can be addressed through physical therapy. The therapist will evaluate the positions of the pelvis and sacrum and can use different techniques to improve alignment and decrease pain. He or she can then teach you exercises to help your muscles give your pelvis the more stability and decrease pain.

Troracic Pain
The upper back also undergoes changes during pregnancy. The normal curve of the thoracic spine increases partially to compensate for the increases partially to compensate for the increased curve of the lower back, but also because of the increasing size of the breasts. Simply put, your upper back has more weight to support and the muscles result. This can be treated with postural exercises.

Plantar Fasciitis 
The same muscles that loosen the ligaments in the pelvis loosen those in the feet as well. That translates to foot pain in standing and walking. Frequently , all the mom-to-be needs to do for this is wear shoes with a good arch support such as a walking shoe or sneaker. If the pain persists plantar fasciitis is routinely treated by orthopedic or sports physical therapists.

Carpal Tunnel Syndrome
Carpal Tunnel Syndrome can appear in lat pregnancy due to the edema that tends to form in the hands and feet at that time. Symptoms can include pain, numbness, or tingling around the thumb and the index finger, and are frequently worse at night. A simple, effective treatment for Carpal Tunnel Syndrome that arises in pregnancy is the use of a wrist splint.

If you have orthopedic pain arising from pregnancy. Talk to your doctor and discuss if a referral to a physical therapist makes sense for you.


Physical Therapy During Pregnancy And The Post-Partum Period
Physical therapists utilize their specialized medical training to thoroughly evaluate each patient and design treatment programs that address her individual needs. It is the goal of the therapist to empower the patient and make her a partner in her care. Physical therapy is proven to be successful in the care of pregnant and post-partum patients. The carry-over of healthy habits, exercisesand skills the patient acquires through physical therapy treatment help her transition through the childbearing year and prepare her for the constant physical demands of raising a young child.

Pregnancy and post-partum are times in a woman's life that bring about many feelings; excitement, anticipation, joy, nervousness, and sometimes discomfort. A number of changes happen to your body during and after pregnancy. It can take several weeks or months to get back to the condition you were in before you became pregnant, and there are some things that will just never be the same!

Physical therapists are experts in treating the musculoskeletal system (the muscles, joints and the surrounding soft tissues of the body). Physical therapists that are specially trained in women's health can safely and effectively help women overcome issues that arise during the childbearing year so that women can focus on these amazing life experiences without pain or further undue stress.

Physical Changes In The ChildBearing Year And Their Possible Consequences:
• Blood volume increases - swelling
• Hormone level changes - ligament laxity leading to low back or pelvic girdle pain, changes in digestive motility, headaches
• Changes in rib cage dimensions - pressure on nerves and tissues above and between ribs, difficulty deep breathing, abdominals stretched, generalized trunk discomfort, mid/upper back pain
• Weight gain - extra stress on feet, legs and back, forward weight of baby changes spinal curves, weak and overstretched abdominals
• Breast changes - larger breasts may alter posture
• Vaginal delivery - injury to pelvic floor (pain, incontinence, urgency, prolapse, coccyx pain)
• Cesarean delivery - scarring and pain, weak abdominals

A Referral To Physical Therapy Would Be Appropriate For Women With:
• Low back pain
• Pelvic pain
• Tendonitis
• Shoulder/arm pain and tingling
• Upper back and neck pain
• Headaches
• Pain associated with scars (episiotomy or Cesarean section)
• Leg/foot pain, weakness, and/or swelling
• Carpal tunnel syndrome
• Thoracic outlet syndrome
• Hip pain
• Pain with intercourse
• Musculoskeletal issues related to bed rest
• Diastasis recti (separation of the abdominal muscles)
• Prolapse (lack of support in the pelvic area that allows the organs, like the uterus, to fall from their normal position)
• Coccydynia (tailbone pain)

Physical Therapists Can Also Assist Women Who Are Not Experiencing Pain or Discomfort In Pregnancy And Post-Partum. These Services May Include:
• Prenatal and post-partum exercise prescription or classes
• Posture and body mechanics screening and instruction
• Pelvic floor exercise education
• Education and instruction regarding various positions and techniques for labor and delivery
• Women with any pre-existing pelvic pain or dysfunction would benefit from labor recommendations to prevent recurrence or exacerbation of the injury.

How Can Physical Therapy Help?
• Joint and soft tissue mobilization techniques to reduce muscle guarding, scarring, joint dysfunction, and optimize musculoskeletal alignment.
• Exercise to re-educate and strengthen muscles that are not properly supporting the body's alignment and performing the demands placed on the body.
• Education regarding home techniques for symptom management, proper positioning and postures, proper and more efficient performance of activities of daily living to reduce stresses on the body and conserve energy, and relaxation techniques.
• Bracing/ Supports to add external support to the body to allow tissues to heal and strengthen and to reduce stresses on the body.
• Biofeedback to re-educate muscles to reduce pain and guarding and to reduce or eliminate incontinence.
• Modalities (mostly used post-partum) with the goals of reducing pain, inflammation, muscle guarding and increasing soft tissue and/or joint immobility.