Pre and Post Natal Aches and Pains
As your pregnancy progresses you may experience various aches and pains as your body adapts to your growing baby and prepares for birth. Changes in your anatomy and hormones (causing ligaments to ‘loosen’ in preparation for the birth) and the increasing weight of your baby bump can lead to your back and pelvic joints and muscles feeling achy, weak and less mobile.
After your pregnancy and your baby's delivery your body can feel like you've been hit by a bus with various aches, pains and weaknesses!
Pain and weakness during and after pregnancy, are common and most of the time very manageable. A lot of the contributing factors can be easily reduced using simple strategies that we can advise you on to keep you comfortable and strong during your pregnancy and recover and strengthen post-natally. If you were training for a marathon you would be getting regular help with niggles and aches! Pregnancy and birth have far more side effects on your body than running so it is important that you look after yourself as well as your precious bundle!
Here are some common aches and pains you might experience pre and postnatally that we can help you with.
Low Back Pain
What are the symptoms and what does it feel like?
Your low back joints can feel achey and the muscles around the area can feel sore and tight. You may feel that the area is weak and can’t cope with repetitive activities as well as it used to which you are now doing more of as you bend and pick up your baby.
How does it happen?
The balance of the muscles around your trunk (lower back and tummy) will be altered during and after your pregnancy and delivery (whether vaginal delivery or cesarean section). Commonly the muscles at the front of your trunk get stretched and weak during pregnancy and the increasing weight of your baby at the front of your body can cause your back muscles to get tight and overloaded. Add a C-section delivery to this where your tummy muscles are further weakened and there is more overload on your low back joints and muscles. On top of this you will be lifting and bending more to care for your baby.
What is it stopping you from doing?
Aches and pains during and post pregnancy can vary in how they affect you day to day. The symptoms may be manageable or they can be debilitating, tiring and distressing, especially if the symptoms are severe.
How can we get you better?
We will advise you on pain management strategies and work on relieving the pain of overloaded joints or tight, sore muscles with safe hands-on treatments. We can show you safe and appropriate strength and mobility exercises to allow your back to better tolerate daily loads.
Pelvic Girdle Pain
What are the symptoms and what does it feel like?
You can feel pain most commonly in the pubic region but also in the lower back, hips, groin, thighs or even knees. Sometimes you can feel clicking or grinding in the pelvic area.
How does it happen?
Pelvic girdle pain is very common and can affect up to 45% of all pregnant women at some stage but is more common later in pregnancy. Pregnancy causes the ligaments around the pelvis to loosen which can lead to increased or uneven movement around the pelvic area leading to pain.
What is it stopping you from doing?
Common day to day activities like walking on uneven surface or for long distances, moving your hips and knees outwards (like getting in and out of the car), rolling over in bed and activities that involve standing on one leg (like climbing the stairs or dressing) can cause pain.
How can we get you better?
These symptoms can happen at any stage in pregnancy and the sooner you start managing them the more likely you are to feel better and to reduce the likelihood of the symptoms becoming more severe. We can guide you on helpful strategies like wearing a compression belt around your pelvis to provide additional support and show you safe exercises to work on to improve your strength and stability (as well as general wellbeing!). Manual therapy can also help to reduce muscle spasm and pain. It is important to be aware that pelvic girdle pain is also strongly linked with lifestyle factors such as high stress levels, low mood, previous pain experiences and so addressing such relevant factors can have a really significant impact on settling your pain.
Here are some tips that may help with the pain:
changing your position frequently – try not to sit for more than 30 minutes at a time
sit down to get dressed and undressed
try to keep your legs together when getting in and out of the car or when turning in bed
lie on the less painful side while sleeping and use a pillow under your bump and between your legs for extra support in bed
avoid activities that aggravate your pain like going up and down the stairs too often, too much bending or twisting, sitting a toddler or baby on one hip, sitting on the floor, exercises that require you to stand or overload one leg
Pelvic Floor Weakness
What are the symptoms and what does it feel like?
When these muscles are weaker you may find that you have less bladder (or even bowel) control or maybe you may feel excessive pressure or a bulge pressing down between your legs while walking/lifting etc (these latter symptoms can be known as pelvic organ prolapse). Pelvic floor weakness and symptoms of prolapse can vary from mild to moderate to severe symptoms.
How does it happen?
The pelvic floor is a group of muscles that form the base of your pelvis. Your pelvic floor supports the structures inside your pelvis and helps with bladder and bowel control. Carrying your baby while pregnant and potential damage during labour can make your pelvic floor muscles weaker.
What is it stopping you from doing?
Pelvic floor weakness and pelvic organ prolapse can vary in how severe it is and how it impacts your daily life. It can vary from being a nuisance to having a big impact on your sports and activities due to leakage or the fear of leakage or the uncomfortable feeling of prolapse.
How can we get you better?
We can guide you on the correct exercises to build up your pelvic floor muscle endurance. We can also advise you on how to perform other exercises or activities safely without placing too much stress on the pelvic floor. To help prevent problems now and in the future, such as leaking urine, you should regularly practice pelvic floor exercises but remember there is a skill in performing these exercises correctly so precision and control is important. In more severe cases we may need to refer you to a consultant if you have not already seen one.
Tips when you are working on your pelvic floor muscles:
practice breathing techniques before you engage your muscles - lift up your pelvic floor on your exhale and avoid bearing down on your pelvis
avoid heavy lifting if possible
try to activate your pelvic floor muscles when lifting your baby or generally when pushing, pulling, carrying
try to turn on your pelvic floor muscles as best you can when you cough, sneeze or laugh
use feeding times as a chance to work on your pelvic floor muscle exercises (try to sit with your feet on the floor to best recruit these muscles)
Abdominal Separation (DRAM or Diastasis of the Rectus Abdominal Muscle)
What are the symptoms and what does it feel like?
DRAM is the separation or over stretching of your abdominal muscles. With DRAM you might notice a bulge outwards in the middle of your tummy when you contract your abdominal muscles, like when you are getting up from lying. You may also notice at gap along the centre of your abdominals when the muscles are relaxed. You may get some discomfort along the centre of the tummy after you have been active. You can also get back pain.
How does it happen?
During pregnancy your abdominal muscles will get stretched. In some cases, the two lines of muscles down the middle of your stomach get stretched apart. Stretching of the abdominals is normal during pregnancy. Approximately 1 in 3 women on their first pregnancy and 2 in 3 on their second experience DRAM.
What is it stopping you from doing?
A mild diastasis can be more of a cosmetic issue. However a more severe diastasis may be linked to other conditions such as back pain, pelvic floor weakness and pelvic organ prolapse which can affect your day to day activities and sports.
How can we get you better?
The good news is, DRAM can be fixed or at least improved postnatally with appropriate exercises to rehabilitate your deep abdominals. Unfortunately just doing sit-ups will not help and could cause more damage as you add more stress to the abdominals, low back and pelvic floor.
Prevention is better than cure with DRAM. Staying strong in your core during your pregnancy, with safe, light loading exercises can help. We can guide you on the do's and dont's of safe exercises during pregnancy and on the appropriate exercises to do to rehabilitate and build your strength again after pregnancy.
Tips to avoid stressing the abdominal muscles especially as your pregnancy progresses:
avoid high intensity core work
avoid heavy lifting
on rolling in bed or sitting up from lying, activate your pelvic floor and lower tummy muscles
work on your deep abdominal breathing with good lower rib expansion
maintain the mobility of your upper and mid back with gentle stretches
Upper Back and Neck Pain
What are the symptoms and what does it feel like?
You may experience anything from a mild achy discomfort to quite sharp pain in your upper back or neck. It can gradually build up while you are feeding your baby and can be sore to move in certain directions. It may be uncomfortable to laugh, cough or breathe deeply as these actions cause increased pressure on the structures of your upper back.
How does it happen?
The new activities that come with caring for your new baby like repeated lifting, carrying, and of course, long periods of sitting when breastfeeding may result in poor postures and strain/overload of the upper back or neck leading to irritation of the structures in these areas.
What is it stopping you from doing?
Aches and pains during and post pregnancy can vary in how they affect you day to day.. The symptoms can be manageable but they can also be debilitating, tiring and distressing, especially if the symptoms are severe.
How can we get you better?
This type of pain is usually assessed and managed relatively quickly with manual therapy and exercises. We can give also give you tips on easing the symptoms like making sure you are appropriately supported so that you can relax when you are breastfeeding and try to adjust your position if you feel the pain build up.