Pregnancy

There are several common musculo-skeletal disorders which arise during pregnancy due to weight gain and change in posture. 

1)  Low Back Pain

With increasing weight during pregnancy, it is not uncommon for the centre of gravity to be shifted forward resulting in tilting and forward shifting of pelvis. Because our body is like a chain in standing, any forward pelvic shift is going to increase the curvature in low back, which in turn, places additional stress to soft-tissue, muscle, and joints of the lumbar spine.  With repetitive stress, pain and tenderness may result.  


In theory, this low back pain should be temporary because once the baby is born, amount of weight and stress is reduced.  However, many new moms continue to experience low back pain post-partum for lifting & carrying their newborns with their compromised posture.  During pregnancy, the goal of physiotherapy is mostly supportive and compensatory in nature. Supportive treatment may include heat, massage, and gentle stretching exercises. Please note that electrical modalities such as therapeutic ultrasound and transcutaneous electrical stimulation (TENS) should not be used. Supportive measures may include pregnancy belt or even walking aids to help and compensate for excessive loading. For post-partum, in addition to supportive treatment, another goal is postural correction and conditioning through strengthening of core muscles. 

2) Diastatis Recti

This is a musculo-skeletal condition which is closely associated with posture and weight of baby during pregnancy.  It is essentially a separation of abdominal muscles caused by weight and forward shift/tilt of pelvis resulting in bulging of the abdomin.  It is not uncommon for diastatis recti to take place in conjunction with low back pain  because both are caused by excess weight and poor posture. Goal of physiotherapy post-partum is to strengthen the abdominal muscles, increase core stabilization, and reduce effect of the separated/torn muscles.



3) Pelvic Joint Strain

Although the human pelvis is very strong, due to weight of the baby and hormonal changes during pregnancy (which causes weakening of ligaments), sometimes the sacro-iliac (SI) joints or the pubic symphysis (PS), can become overloaded, resulting in joint sprain or even subluxation. The goal for physiotherapy is to provide supportive treatment and compensation during pregnancy. Supportive treatment may include heat, massage, and gentle stretching exercises. Please note that electrical modalities such as therapeutic ultrasound and transcutaneous electrical stimulation (TENS) should not be used. Supportive measures include pregnancy belt or walking aids to compensate for excessive loading.