3 Reasons to do Pelvic Physical Therapy in Pregnancy

Updated: Feb 4



Pregnancy can be a stressful time in a women’s life as she may be experiencing discomfort, pain, and stress due to the many unknowns leading up to birth. Regular physical activity throughout all stages of a woman’s life---especially during pregnancy---can promote many health benefits such as decreased gestational diabetes, decreased rate of c-section births, and improved postpartum recovery time.


Research has also shown that exercise can improve many different types of pregnancy related pains such as low back pain, pubic symphysis dysfunction, pelvic pain, etc. Women’s health physical therapy can even extend into the post-partum period---improving overall psychological well-being and depressive symptoms.


Our goal as a pelvic physical therapist is to reduce any pain a pregnant woman may be experiencing, provide pregnant women with individualized care to prepare them for birth (whether vaginal or C-section), and prepare the pregnant patient for the post-partum period and beyond!


Below is a review of the current research to support "3 Reasons to do Pelvic Physical Therapy in Pregnancy!"

 

1. Reduce Pain during Pregnancy

Pregnant patients should be referred preferably to a Pelvic Physical Therapist or someone who has had extensive training in the musculoskeletal changes that occur during and after pregnancy. Common pregnancy-related pain condition that Pelvic PT addresses:

  • Diastasis Recti (Abdominal Separation)

  • Hip Pain

  • Low Back Pain

  • Pee Leakage

  • Pelvic Organ Prolapse

  • Pelvic Pain

  • Pubic Symphysis Pain aka Pelvic Girdle Dysfunction

  • Sacroiliac Joint Pain or Dysfunction

  • Sciatica


To see an extensive list and definitions of common conditions that are treated in Pelvic Physical Therapy click here


A combination of interventions are prescribed to the patient in Pelvic Physical Therapy and can include therapeutic exercise prescription, manual therapy, education, coordination training, pelvic floor training, and aquatic physical therapy to name a few. Multiple studies have shown that Pelvic Physical Therapy has a positive effect on pain, disability, sick leave, as well as improving overall functional status.



2. Birth Preparation

There is a great deal of research to support not only exercise but Physical Therapy during pregnancy. Specifically, women who exercise during pregnancy:

  • have a higher incidence of vaginal delivery

  • have a lower incidence of pre-term births

  • lower incidence of gestational diabetes mellitus and excessive weight gain


Recent research has also shown support for pelvic-specific exercise and physical therapy which often includes pelvic floor muscle training. Pelvic floor muscle training has been shown to:

  • significantly reduced the duration of the second stage of labor

  • reduced the incidence or urinary incontinence.


Perineal massage and training on self-perineal massage is often a Pelvic Physical Therapy intervention. Research has shown that perineal massage:

  • is associated with a lower rate of perineal pain and tearing


3. Post-Partum Outcomes

Multiple studies have shown that Pelvic Physical Therapy (with incorporation of pelvic floor muscle training) both during pregnancy and after delivery was effective in:

  • treating and preventing urinary incontinence

  • treating and preventing fecal incontinence.


Research has also shown mental benefits from an individualized Pelvic Physical Therapy program to post-partum moms! Specifically, post-partum moms who participated in a specified exercise program had:

  • increased psychological well-being

  • reduction in symptoms of depression

  • overall reducing the rate of post-partum depression

 

As mentioned above, there are MANY benefits for Pelvic Physical Therapy and exercise in pregnancy and beyond. So why choose COM-Physical Therapy?


We have a highly trained and qualified practitioners who can address your pregnant and post-partum concerns. Dr. Amanda has previous experience working in an in-patient setting at a birthing hospital seeing pregnant patients admitted for pain, bedrest, etc. as well as seeing women immediately after birth. Dr. Amanda and Dr. Leslie have also worked at women’s hospitals/birthing hospital in the out-patient setting caring for pregnant and post-partum moms with many of the complaints described above. Dr. Amanda and Dr. Leslie have multiple child of their own and have applied their knowledge and experience to ease the birth and recovery with all of their children! For more information on their experience click here.


Pelvic Physical Therapy and More is affiliated with COM-Aquatics & Physical Therapy--located in Midland, Texas. We accept major insurance carries, have flexible scheduling to accommodate your needs, and have an amazing facility that allows us to provide individualized care for pregnant and post-partum patients. Not only do we have a full gym and private treatment rooms (with various equipment to meet your needs), but we also have a Therapy Pools that can be utilized for Pelvic Physical Therapy. Yes—you heard it right, we can offer BOTH traditional LAND physical therapy AND AQUATIC physical therapy for the pregnant patient and beyond!


Ready to Schedule?

Check out our website or Email Amanda with questions/concerns. We will collaborate with your OB/GYN, Midwife, or MD to get you scheduled ASAP!


**We also offer Direct Access scheduling



 

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2) Norman E, Sherburn M, Osborne RH, Galea MP. An exercise and education program improves well-being of new mothers: a randomized controlled trial. Phys Ther. 2010 Mar;90(3):348-55. doi: 10.2522/ptj.20090139. Epub 2010 Jan 7. PMID: 20056720.

3) Modified from Berghella V, Saccone G. Exercise in pregnancy! Am J Obstet Gynecol 2017;216:335–7.

4) Schreiner, L., Crivelatti, I., de Oliveira, J.M., Nygaard, C.C. and dos Santos, T.G. (2018), Systematic review of pelvic floor interventions during pregnancy. Int J Gynecol Obstet, 143: 10-18. https://doi.org/10.1002/ijgo.12513

5) Mørkved S, Bø K. Effect of pelvic floor muscle training during pregnancy and after childbirth on prevention and treatment of urinary incontinence: a systematic review. Br J Sports Med. 2014 Feb;48(4):299-310. doi: 10.1136/bjsports-2012-091758. Epub 2013 Jan 30. PMID: 23365417.

6) Depledge J, McNair PJ, Keal-Smith C, Williams M. Management of symphysis pubis dysfunction during pregnancy using exercise and pelvic support belts. Phys Ther. 2005;85:1290-1300.

7) George JW, Skaggs CD, Thompson PA, Nelson DM, Gavard JA, Gross GA. A randomized controlled trial comparing a multimodal intervention and standard obstetrics care for low back and pelvic pain in pregnancy. Am J Obstet Gynecol. 2013;208:295.e1-295.e7. http://dx.doi. org/10.1016/j.ajog.2012.10.869

8) Kordi R, Abolhasani M, Rostami M, Hantoushzadeh S, Mansournia MA, Vasheghani-Farahani F. Comparison between the effect of lumbopelvic belt and home based pelvic stabilizing exercise on pregnant women with pelvic girdle pain; a randomized controlled trial. J Back Musculoskelet Rehabil. 2013;26:133-139. http://dx.doi. org/10.3233/BMR-2012-00357

9) Nilsson-Wikmar L, Holm K, Oijerstedt R, HarmsRingdahl K. Effect of three different physical therapy treatments on pain and activity in pregnant women with pelvic girdle pain: a randomized clinical trial with 3, 6, and 12 months follow-up postpartum. Spine (Phila Pa 1976). 2005;30:850-856.

10) Östgaard HC, Zetherström G, Roos-Hansson E, Svanberg B. Reduction of back and posterior pelvic pain in pregnancy. Spine (Phila Pa 1976). 1994;19:894-900. http://dx.doi. org/10.1097/00007632-199404150-00005

11) Shim MJ, Lee YS, Oh HE, Kim JS. Effects of a back-pain-reducing program during pregnancy for Korean women: a non-equivalent controlgroup pretest-posttest study. Int J Nurs Stud. 2007;44:19-28. http://dx.doi.org/10.1016/j. ijnurstu.2005.11.016

12) Mørkved S, Salvesen KA, Schei B, Lydersen S, Bø K. Does group training during pregnancy prevent lumbopelvic pain? A randomized clinical trial. Acta Obstet Gynecol Scand. 2007;86:276-282. http://dx.doi. org/10.1080/00016340601089651

13) Mørkved S, Bø K. Effect of pelvic floor muscle training during pregnancy and after childbirth on prevention and treatment of urinary incontinence: a systematic review. British Journal of Sports Medicine 2014;48(4):299–310.

14) Johannessen HH, Wibe A, Stordahl A, Sandvik L, Mørkved S. Do pelvic floor muscle exercises reduce postpartum anal incontinence? A randomised controlled trial. BJOG. 2017 Mar;124(4):686-694. doi: 10.1111/1471-0528.14145. Epub 2016 Jun 7. PMID: 27272501.

15) Woodley SJ, Boyle R, Cody JD, Mørkved S, Hay-Smith EJC. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2017;12(12):CD007471. Published 2017 Dec 22. doi:10.1002/14651858.CD007471.pub3


© Amanda Moe and COM-Physical Therapy 2021. Unauthorized use and/or duplication of this material without express and written permission from this site’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Amanda Moe and COM-Physical Therapy 2021 with appropriate and specific direction to the original content.

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