Physical therapy (PT) is something that can help you through pregnancy all the way up to postpartum recovery. Despite the numerous benefits of PT for new moms and moms-to-be, many women are unaware that it is an option. Professional organizations such as the American College of Obstetricians and Gynecologists (ACOG) are pushing for the “Fourth Trimester” concept, which advocates for continued care to mothers in their first 3 months post-pregnancy, rather than the current standard which is a single primary care checkup at 6 weeks. To help you understand the benefits of physical therapy as a new or expecting mom, we have created this resource on how physical therapy can be utilized during and after pregnancy.
Benefits of Physical Therapy During Pregnancy
Here are some of the reasons you may want to seek physical therapy care during pregnancy:
According to American Pregnancy Association, as many as 70% of women experience back pain during pregnancy. Hip and pelvic girdle pain are also widely experienced by pregnant women. This is due to a variety of factors, from the effect of additional weight gain on your body’s center of gravity to hormonal changes.
Physical therapists can help you with back pain and other pain due to pregnancy through implementing treatment plans that address strength, flexibility, alignment, and posture. They will work with you on exercises during sessions and also send you home with exercises to do on your own time as part of your treatment plan.
- American Pregnancy Association
- American Physical Therapy Association
- University of Kentucky HealthCare
Adjustments in Day to Day Living
In addition to gaining strength through exercise, pregnant women can benefit from learning how to move in ways that put less stress on the body. For example, if you are expecting and have other small children at home, you may benefit from learning how to carry your other young ones in a way that is safer and healthier for you and the baby. A PT can teach you how to do this
Labor and Delivery
Birthing a baby is demanding on the body, and increasing muscle and strength can help you prepare physically for that process. Physical therapists can help you patients gain strength in the back, abs, and hips, which will help you during the delivery process and will also be beneficial for recovery. PTs can recommend optimal positions for labor and delivery.
Urinary Incontinence Prevention
Many women deal with urinary incontinence after pregnancy. Prevention of urinary incontinence can start before the problem appears. PTs can teach you about how to engage your pelvic muscles and provide you with movements that you can use to avoid incontinence during pregnancy. They can also help you deal with any incontinence you have developed during pregnancy.
As many as 62% of pregnant women suffer from carpal tunnel syndrome. Physical therapists can help you deal with pregnancy related carpal tunnel by education you on how to position your wrists and adapt your posture, and by providing you with hand, finger, and forearm strengthening exercises.
Soon to be moms who are cancer survivors can sometimes have issues with fluid retention due to lymphedema. The lymphatic massage and compression techniques that a physical therapist can apply can address this issue and decrease risk of infection for you if you are experiencing lymphedema.
Condition Specific Considerations
Some moms-to-be have health conditions that impact their needs during pregnancy. For example, if you have a connective tissue disorder, you will need to adapt to the fact that hormonal changes are making your already flexible ligaments looser. If you have a neurological condition such as multiple sclerosis, you may need help with muscle strengthening as well as other considerations such as what to do about heavy baby equipment.
Postpartum Benefits of Physical Therapy
Physical therapy can benefit women in the following ways postpartum:
Often the back, hip, and pelvic pain developed during pregnancy will not go away just because the pregnancy is over – for instance 30% of moms who have pelvic girdle pain while pregnant continue to have this pain chronically after birth. Physical therapy can treat this pain by teaching women how to move, how to adapt movement when necessary, and by helping them gain strength and flexibility.
Regaining Pre-Pregnancy Body
After having a baby, many women want to get back physically to where they were before conceiving. This involves increasing strength and shedding the weight gained during pregnancy. A physical therapist can help you return to exercise safely and restrengthen those muscles.
Some physical therapists can help women with issues related to breastfeeding, such as clogged ducts (stasis). Stasis is linked to inflammation, physical therapists are very knowledgeable about.
If your abs have separated during pregnancy (known as diastasis recti), physical therapists can help you work on core strength to close that separation. They can educate you on the right exercises to do that will help, rather than harm, healing from diastasis recti. They can also offer support to the lower back and abdomen through bracing. Working with your PT on stretching and postural training will also help reduce the issue.
Physical therapists can work with you to recover from pelvic health issues postpartum, including pelvic organ prolapse, pelvic pain, and more. They do this by educating you on how to use your pelvic floor muscles properly and strengthen the muscles. They can also teach you how to increase blood flow to the pelvis. Modalities such as electrical stimulation may also be used to reduce pain.
Women who have given birth may have needed an episiotomy or cesarean section in the process. Both of these procedures result in scarring, which can be painful. Physical therapists can work with you to reduce scar pain.
For those women who experience urinary incontinence postpartum, PTs help the work on reconnecting the relationship between their brain and pelvic muscles and bring back use of the muscle through squats, lunges, and other functional activities. PTs can work with patients to improve anal incontinence as well
Finding a Physical Therapist
Looking for a physical therapist to provide prenatal or postpartum care? The following resources are good places to start:
- The American Physical Therapy Association has a tool you can use to find professionals based on location, specialty, and more.
- The APTA’s Section on Pelvic Health has a similar tool that is more specific to pelvic health issues
In many states, you can look for a physical therapist and begin treatment without referral from a doctor, but depending on where you live you may immediately or eventually need a doctor’s approval before seeking physical therapy services. Always check to see what the requirements are in your state so you can go through the process of finding a PT properly. Furthermore, even if you can see a PT without a doctor’s approval, you will want to make sure that this does not negatively affect insurance coverage, as many PT services for pregnant and postpartum women are covered.
Note: This article is for informational purposes only and should not be treated as medical advice. Please speak to a trained clinician if you have health concerns or are considering physical therapy care.