During pregnancy, a woman’s body goes through enormous musculoskeletal, physiological, and emotional changes. As such, educating pregnant women and new mothers about the role of exercise during this key life transition period is essential as it can have a great impact on their physical and mental wellness, said Dr Sagar Pathare, lead rehabilitation, Mumbai, Nightingales Home Health Services.
He added that during this time, women can also experience back pain. “The physiological and musculoskeletal changes concerning the back are often interrelated. Pregnancy-related back pain commonly occurs because of the postural changes of pregnancy, increased ligamentous laxity, and decreased abdominal muscle function,” he shared.
As mentioned in the editions of Carolyn Kisner’s Therapeutic Exercises: Foundations and Techniques, back pain is reported by 50-70 per cent of pregnant women at some point during pregnancy; which contributes to lost work days and decreased functional ability.
In addition, symptoms may continue in the post-delivery period, with a prevalence in up to 68 per cent of women, for as long as 12 months after delivery. Women who are physically fit generally have less back pain during pregnancy, said Dr Pathare.
Low back pain symptoms can be treated effectively with many conventional low back exercises, proper body mechanics, posture instructions and improvement in work techniques. The best approach is to consult a physiotherapist who can examine you thoroughly and suggest suitable exercises, he mentioned.
How can a physiotherapist help during pregnancy?
A physiotherapist can assess physical health and identify any musculoskeletal or neuromuscular problems that could be aggravated by pregnancy. The physiotherapist should identify and recommend solutions to prevent any problem. Post assessment, they can recommend leg exercises to prevent varicose veins, abdominal contractions are taught to be practiced in various positions.
“Physiotherapists teach pregnant women how to recognise and deal with tension. During labour, relaxation principles including breathing awareness can reduce the severity of pain,” said Dr Pathare.
Back care advice: Back strain is minimised when the spine is held in its normal curves.
Some of the usual recommendations:
*Postural correction exercises are practiced from different positions; standing, sitting, lying and crook lying position.
*Lifting advice: It involves lifting from a height and carrying as well as lifting from the ground level.
The principles to follow when lifting are:
*Legs should be apart to increase the base of support.
*The object to be lifted must be held close to the body.
*When lifting from the ground, it is important to ensure that the weight is light enough to be lifted comfortably.
*When lifting from a height, it is important to hold the object close to the body and to make sure that the height is easily reached.
Pelvic floor rehabilitation
Pelvic floor rehabilitation is a valuable method, regardless of a patient’s medical status or cause of symptoms. Majority of women are unfamiliar with the presence of pelvic floor muscles, and even less aware of their function and role in daily activities. Although lot of data is available on the internet, it is important to get a one-on-one assessment and care planned accordingly, said Dr Pathare.
Improve and maintain endurance
Women who have been doing cardio exercises should continue exercising during pregnancy to maintain their cardiopulmonary fitness. However, these recommendations are for women with no maternal or foetal risk factors, shared Dr Pathare.
It is advised that all women participate in mild to moderate exercise, for both strength and cardiopulmonary benefits. This includes 15-30 minutes/session on most days.
Individualised programs, based on pre-pregnancy fitness levels are preferable. The program helps to improve the overall health of the individual including their psychological aspect.
Most women feel more comfortable to understand, learn and regularise the new process at their homes as it can be done while managing the rest of the errands and helps them avoid the anxiety of travelling to reach a physiotherapy center.
Please note, the exercises and due precautions should be practised only after getting approval by the concerned gynecologist. All the above mentioned instructions and suggestions are in general and need to be tailored according to the individual.