Pelvic Floor Physical Therapy Part 1: Establishing care in Pregnancy

Pregnancy is such an amazing experience. The connection to that tiny blessing inside gleans a new appreciation for life. The amazing process of creating life comes with a lot of stressors on our body, physically, emotionally, and hormonally. There are so many things that can come up in pregnancy, and a pelvic floor physical therapist should be your go-to provider to help you manage this nine-month journey comfortably.

The body requires a lot of hormonal changes to grow that sweet thing, which create a lot of physical and anatomical changes. Ligaments and connective tissues are softened to accommodate the baby, allowing more joint mobility. The pelvic floor muscles that control the bowel and bladder, and provide core stability are under an increased amount of stress. These physical changes put the diaphragm in a compromised position which impacts our breathing. The combination of effects has a very significant impact on how we move, feel, and function during this time.

Let’s talk about the things that may come up that pelvic floor physical therapy can help you address throughout your pregnancy.

Bladder Leakage: Embarrassing as it might be, this symptom is common in the second and third trimester. This is due to the growing uterus pressing on your bladder. Common does not mean normal, and there is help for managing this frustrating symptom. Seeing a pelvic PT can help you improve muscle patterns, learn about bladder and bowel health and give you tools to manage leakage.

Pelvic Organ Prolapse: This can be a very scary word. It is very common during pregnancy for your bladder or rectum to prolapse due to hormonal changes and growing pressure from the baby. Improving pelvic floor muscle coordination, and various movement and postural adaptations can help minimize prolapse symptoms.

Bowel Concerns: Increasing progesterone levels are to blame for increased gas.  Progesterone relaxes all the smooth muscles in your body – including the muscles in your GI system. This slows digestion, increasing gas bloating and constipation. As the baby grows into the abdomen, it slows everything down even further. Pelvic PT can be a big help providing you with tools and movement strategies to help your gut and train your pelvic floor for optimal function for bowel movements to be passed easily.

Pelvic Girdle Pain: This is a catch-all term for pain that arises during pregnancy in any of the joints of the Pelvic Girdle. The Pelvic Girdle encompasses the hip joints, pubic symphysis joint, sacroiliac joints, and the lumbar spine.

It often shows up in the second trimester. The growing size of the baby and hormonal changes create joint mobility and laxity making a perfect storm for joint hyper-mobility. What that means is there is more motion at these normally stable joints, causing discomfort. The extra mobility also signals your muscles to work extra hard to keep these joints stable, which can lead to trigger points and muscle tension. A Pelvic PT will look at your movement patterns and help you develop an individualized program of flexibility, strengthening, movement patterning and postural exercises to help manage any symptoms affecting the pelvic girdle. A Physical Therapist should also provide manual treatments for muscle tension and joint health and there are many modalities to help address this.

Lastly, a pelvic PT can educate you in labor and delivery preparation. Learning how to properly elongate your pelvic floor for delivery, as well as ensuring optimal strength of the pelvic floor can be a big help when the big moment comes. We use many tools to teach women preparation for pushing, including ultrasound imaging of the pelvic floor, manual assessment, and biofeedback to ensure you can recognize and feel what that elongation pattern of the muscle should feel like. Many positions can optimize delivery as well, and education about perineal care to minimize tearing can be additional tools for labor and delivery.

Getting care from a pelvic PT will establish care so that you can follow up after delivery when the rehabilitation phase is most important. Scheduling a visit with a pelvic floor physical therapist after delivery is so important for a safe and healthy recovery. Stay tuned for the next few blogs to discuss how we can help postpartum!

We offer a free, 15-minute phone consultation to discuss any questions you may have about pelvic floor physical therapy and to ensure you find the help you need to heal. Don’t wait to schedule, and make sure you take care of your body during this important time in life, to help you best care for your new bundle of joy!