November 25, 2020
o Separation of the abdominal muscles that can lead to back pain due to overstretching of the belly during pregnancy.
o It affects almost all pregnant women, 66-100% during the 3rd trimester and 53% of women immediately after childbirth.
o Up to 91% of pregnant women report lower back or pelvic region pain
o The weight of the belly shifts the body’s center of gravity causing many new stresses that contribute to pregnancy related pain
o This encompasses urinary or fecal incontinence defined as loss of bladder/anal control. The symptoms range from occasional leakage with coughing to a sudden and strong urge to go before getting to a toilet. Pelvic floor dysfunction includes pelvic pain, pain at incision sites after C-section, or painful intercourse.
o Over 39% of pregnant or postpartum women experience urinary incontinence or unwanted urinary leakage.
Pregnancy creates many changes in the body and these changes can result in imbalances whether that be muscle tightness, abdominal muscle tearing, pelvic floor muscle weakness, or pain due to the increased abdominal weight. Carrying around a baby in your belly or a baby on your hip makes activities of daily life more challenging and causes new kinds of stress on the muscles and ligaments.
Physical therapy for pregnant or postpartum women uses research-based interventions including deep core stabilization, pelvic floor muscle training, stretching, strengthening, balance training, electrical stimulation, and more.3,4,5,6,7 These interventions work to relieve your pain, resolve your dysfunction, or close the abdominal separation.2,3,4,5,6,7 We can also use these techniques to prevent urinary and fecal incontinence during later pregnancy or postpartum.
1. Mallah F, Tasbihi P, Navali N, Azadi A. Urinary Incontinence During Pregnancy and Postpartum Incidence, Severity and Risk Factors in Alzahra and Taleqani Hospitals in Tabriz , Iran, 2011-2012. International Journal of Women's Health and Reproduction Sciences. 2014;2(3):178-185.
2. Thabet AA, Alshehri MA. Efficacy of deep core stability exercise program in postpartum women with diastasis recti abdominis: a randomized controlled trial. J Musculoskelet Neuronal Interact. 2019;19(1):62-68.
3. Tseng PC, Puthussery S, Pappas Y, Gau ML. A systematic review of randomised controlled trials on the effectiveness of exercise programs on Lumbo Pelvic Pain among postnatal women. BMC Pregnancy Childbirth. 2015;15:316. Published 2015 Nov 26.
4. Bhatnagar G, Sahu M. Comparison of Pelvic Floor Exercises and Conventional Regimen in Patients with Chronic Low Back Pain. Indian Journal of Physiotherapy & Occupational Therapy. 2017;11(3):38-42.
5. Bi X, Zhao J, Zhao L, et al. Pelvic floor muscle exercise for chronic low back pain. Journal of International Medical Research. February 2013:146-152.
6. Physiopedia. Low Back Pain and Pelvic Floor Disorders. https://www.physiopedia.com/Low_Back_Pain_and_Pelvic_Floor_Disorders. Accessed September 20, 2020.
7. Piper TJ, Jacobs E, Haiduke M, Waller M, Mcmillan C. Core Training Exercise Selection During Pregnancy. Strength and Conditioning Journal. 2012;34(1):55-62.