The most common problems seen with pregnancy are low back pain and sciatica.  Other conditions seen during the prenatal period are shortness of breath, diastasis recti, leg cramps, carpal tunnel syndrome, sacro-iliac joint dysfunction, pubic symphysis pain, mid back pain, urinary incontinence, and constipation.  All of these are related to neuro-musculo-skeletal changes common with pregnancy.

      A majority of the impairments can be addressed through physical therapy.  Physical therapy consists of education regarding proper body mechanics, breathing mechanics, stretching, strengthening, balance activities, and the use of splints or support belts. Furthermore, women should be educated about perineal massage to prevent perineal tears or the need for an episiotomy.

      Many countries around the world implement prenatal programs to prevent pregnancy complications through patient education.  However, in the USA, these issues are not always addressed.  Health care practitioners can work together to minimize complications and facilitate a faster recovery post-delivery.  From the time a patient is aware that she is pregnant, she can be advised to visit a physical therapist.  The PT will evaluate and educate the patient on prenatal neuro-musculoskeletal changes and various treatment techniques.  One visit per trimester will help the patient adjust to her changing body, thereby preventing muscle imbalances, nerve compression, and joint dysfunction.  

Muscles prone to tightness                                              Muscles prone to weakness

latissimus dorsi                                                                         abdominals

diaphragm                                                                                 gluteii

quadratus lumborum                                                                 levator ani

erector spinae                                                                          coccygeus

iliopsoas

piriformis

obturator internus

TFL

Hamstrings

rectus femoris

adductor   

Postural Changes

Scapular protraction
UE int. rotn.
Cx lordosis
Fwd. head posture
Thoracic kyphosis
Lx. Lordosis
Knees hyperextend
 

PRENATAL PROGRAM GOALS

Education: physiological and physical changes; do’s and don’ts
Body mechanics:  posture, breathing techniques
Relaxation
Stretching
Strengthening