Physical Therapy in Pregnancy and Postpartum Care

Physical therapy in pregnancy and postpartum

Physical therapists are slowly gaining momentum in the medical field for pain management, rehabilitation, and injury prevention. We often think of PT in response to a surgery, a musculoskeletal injury, or a more severe event like a stroke. So why DON’T we think about physical therapy during or after pregnancy?  Physical therapy can be an effective means of treatment for pain, movement dysfunction, and functional limitation – from issues prior to pregnancy, body changes associated with pregnancy, and the often traumatic process of birth.

Pregnancy is a time of great change

As expecting mothers progress through pregnancy, the pelvis widens, the belly protrudes, and the center of mass shifts forward.  A mother’s sense of stability, center of balance, and overall movement mechanics all change. Hormonal changes contribute to increased ligamentous laxity, especially in the low back and pelvis, which can increase stress and pain in these regions. Postural changes can also contribute to pain in the hips, upper back, neck, and shoulders as well. Hormones can also trigger inflammatory changes leading to increased swelling, gestational diabetes or hypertension, and even carpal tunnel syndrome.

Pregnancy and pain

Unfortunately, because aches and pains throughout pregnancy are so common, they are often written off as “normal”. Little is done to offer relief or management strategies. Physical therapy can actually be very effective at minimizing these symptoms and facilitating a more comfortable pregnancy. Physical therapy can provide education on pain management strategies, facilitate safe and appropriate movement and exercise throughout pregnancy, and help prepare expecting mothers for birth. PT can also address pregnancy-specific issues including abdominal separation (diastasis rectus abdominus) and pelvic pain including internal (vaginal or perineal) pain. 

Postpartum expectations

Physical therapy AFTER birth is just as important as care during pregnancy! Typical postpartum care includes 1-2 follow up visits with a healthcare provider, usually within the first 6 weeks postpartum. At that point, most moms receive clearance for full return to “normal activity” – and they often have no idea where to begin!  Physical therapists can be an EXCELLENT resource during this  “fourth trimester”. We can provide a thorough musculoskeletal assessment, address any lingering or new pains/injuries, and provide education on self-care postpartum. We can also assess movement mechanics for basic child care (lifting or carrying baby, breastfeeding, etc.) and facilitate a safe return to prior level of activity and exercise.

Am I a candidate for physical therapy?

Do you have any pain?

Did you have a c-section?

Do you have difficulty or discomfort with basic baby care? (This includes lifting baby, holding or carrying baby, breastfeeding, pushing a stroller, etc.)

Are you limited with your normal activities including household chores, work, or exercise?

Do you lack confidence in returning to “normal” activities?

If you answered YES to any of these questions, call to schedule a physical therapy evaluation today!

 

Melisa Abesa is a California transplant who has come to love the Pacific Northwest. Since graduating with her Doctorate of Physical Therapy from the University of Southern California in 2014, she has practiced in the Portland/Salem area. She advocates for patient empowerment, individualized care, and a holistic approach to health and wellness.

As a board-certified clinical specialist in orthopedic physical therapy, she enjoys working with a large variety of orthopedic and sports related conditions. Special interests include running, headache treatments, post-operative care, peripartum care, and adolescent athletes.