PREGNANCY AND NEW MOM

During pregnancy, your core system is compromised due to your changing posture and weight-gain: for example, the stomach and pelvic floor muscles are stretched, and the diaphragm muscle has less room to move, plus pregnancy hormones in your body causes many changes, including increased laxity of the ligaments in the joints, to prepare your body for child-birth. This is when common pregnancy and post-natal conditions like pelvic pain, back pain, diastasis rectus abdominis (tummy gaps) and pelvic floor disorders (dyssynergy) can develop.

Peri-natal package topics:

Feeling fit and well during pregnancy:

Keeping the pelvic floor (PF) and core working optimally throughout pregnancy

The core is your own inbuilt secret weapon. It is 4 sets of muscles, working together around the clock (and does not include your six-pack muscles). The PF muscles are part of the core and are essential in supporting / keeping in place your pelvic organs. It controls the opening of the urethra, vagina and rectum – therefore stops you from leaking wee, wind and poo. The pelvic floor co-contracts and assist with stability of the pelvis, lower back and hips -especially as the pregnancy bump gets bigger.

• Learn how traditional core exercises does not incorporate pelvic floor specific exercises and how to isolate PF muscles and to exercise the PF specifically, together with the core, and how to progress these exercises during pregnancy.
• Learn how to protect your pelvic floor with various strategies.

How to become active,  stay active OR adapt and structure your physical activity and training during pregnancy
Pregnancy is a good time to maintain an exercise regime or even to start one. Exercise supports the health of your heart and lungs, maintain blood pressure (reduce the risk of gestational hypertension) and improves strength, energy levels and blood sugar levels (reducing the risk of gestational diabetes),  help maintain a healthy weight and does wonders for your mental health too in reducing low mood and stress. It improves sleep, relaxation, self-esteem and confidence and improves opportunities to get social.

But how / where to start? Things to know beforehand is the level of risk your pregnancy carries, and the bodily changes that you will go through during each trimester – all these factors dictate what you can and cannot do.

• We can compile, in collaboration with your gynae  / midwife a  suitable,  low-impact activity and training plan (aerobic, flexibility, relaxation and strength training) according to the latest international guidelines, OR
• if you are already on a training programme, collaborate with the trainer / health care professional in moderating the training programme as your pregnancy advances.

Find my community
It is also important as a new mom to “find your community” for support and exercise. Physio treatment aims to help you start an exercise programme with knowledge on why and how to adapt the exercise programme and find your suitable community – may it be Pilates classes, walking clubs, running clubs, strength training and gym work in collaboration with your gynae, mid-wife, fitness instructors, biokineticist or other identified trainers.

Enhancing Post- birth recovery

Strategies and advice on how to return to activity and to heal optimally, including infant care handling strategies:
Learn how to enhancing recovery during the fourth trimester (first 12 weeks after birth), including:

• Post surgery scar management –especially internal scar management for 3rd and 4rth degree tears between 6-12 weeks post-partum.
• Referral and collaboration with a lactation consultant if you choose to breast feed.
• Infant care advice to enhance pelvic floor and core activity and to combat baby blues.
• Gentle stretches and relaxation advice for mental well-being and recovery.
• Advice and guidelines on when and how to start your PF exercises within your normal activities of daily living, incorporating the different advice around optimal recovery following birth-canal or caesarean section delivery.
• Checking and managing gapping of the tummy muscles (Diastasis rectus abdominis).

Facilitating an effective return to structured exercises, group classes and sport

Assessment and advice on when and how to start and progress structured exercises, including return to group classes, gym work or sport:
Plan, progress and reach your exit strategy target of choice (strength training,  gym work or sport such as running), including the use of a suitable screening tool.

In general: It is recommended that you wait until your 6 weeks post-natal check with the doctor / gynae or midwife before commencing a group exercise, return to the gym or to personal training, and to use a suitable screening tool during this time to see if you are ready to commence these activities.  

See the handy checklist Quick pelvic floor checklist on my services page that Emma Brockwell (Women’s health physiotherapist, UK) developed to use at the 6 weeks gynae follow-up as a guide to obtain further advice and treatment post-delivery and to self-refer if needed.

Other physiotherapy treatment that can be offered if needed:

Manage those aches, pains and niggles
Just because you are pregnant does NOT make it Ok that you are in pain.
Common pregnancy related aches and pains that can benefit from physiotherapy manual treatment, including the prescription of suitable orthotics:

Pelvic girdle pain (PGP) is pain or aches that can occur at any of these areas: the front, or the back of your pelvic bone and lower back, the hips, inner thighs and between your legs (perineum). Generally, the pain or ache is felt during walking, turning in bed, when moving from sitting to standing, when standing on one leg (for example putting on clothes), getting out of the shower, while climbing stairs , getting in and out of the car and or when hoovering or shopping.

Lower back pain
Women with a history or any lower back pain or PGP before pregnancy are more prone to develop PGP during pregnancy and various strategies can be proposed together with physio manual treatment to manage your low back pain.

Rib pain
Your ribs  expand and move outwards and upwards during pregnancy and can cause rib pain. Certain stretches and strategies can help manage these symptoms.

Carpel tunnel syndrome
This condition includes symptoms of numbness, pins and needles and pain in the front of the wrists. Throbbing, dull ache, swelling or hot fingers can also occur, and symptoms are usually worse at the night and the morning. This is due to fluid build-up in wrists during pregnancy but can also be exacerbated by your changing posture and neck position. Treatment focus on alleviating the pain and may include referral to the occupational therapist for wrist splints.