Ensure that your body is ready to carry a baby by addressing before pregnancy any pain or problems associated with posture or weakness. Here are some physical therapist tips for helping to prepare your body for pregnancy and to guard against musculoskeletal pain and dysfunction during and after it.
1. Strengthen your pelvic muscles. To strengthen your muscles, use pelvic floor contractions (commonly referred to as Kegels), which involve gently squeezing the sphincter muscles (rather than the buttocks and thighs). These tightening exercises help prevent leakage when a woman sneezes, coughs, etc, and also can help reduce pelvic pain during pregnancy. However, many women do Kegels incorrectly (perhaps because muscles are too tight and need to be relaxed before strengthening). Doing Kegels incorrectly can worsen conditions such as incontinence, pelvic pain, and even low back pain. This is why it is important to consult a women’s health physical therapist before beginning an exercise program. Physical therapists who specialize in women’s health can instruct women in how to perform these exercises safely and correctly.
2. Prepare for "baby belly" by focusing on your core. Core exercises can help prevent diastasis recti —abdominal muscle separation. As your belly grows, the abdominal muscles that run vertically along either side of the belly button can be forced apart, like a zipper opening. If these abdominal muscles separate from each other too much, the result can be low back pain, pelvic pain, or other injuries as your body tries to compensate for its weaker core. This also can result in the postpregnancy "pooch" many women find undesirable.
Some exercises, such as sit ups, increase the likelihood of developing diastasis recti, incontinence, and back pain during and after pregnancy. It is important, therefore, to work with your physical therapist on the right exercise strategy for establishing a strong core.
3. Take a breath! Learning proper breathing and relaxation techniques from your physical therapist will help prepare your body and mind for a healthy pregnancy. It is important to learn to properly exhale before performing any exercise. With proper technique, your core and pelvic floor muscles will contract automatically, and this will lead to optimal stability and injury protection.
4. Begin a regular fitness routine. Exercise will help reduce the amount of cortisol (stress hormone) in your body and will boost your muscle and cardiovascular strength—strength you'll need to carry that extra baby weight. Once you become pregnant, consider engaging in relatively low-impact activities, such as swimming, walking on even surfaces, biking, or using an elliptical machine. Runners should be aware that loosening of their ligaments may make them more susceptible to knee and ankle injuries. Also, when the muscles and ligaments that support a woman's pelvic organs weaken, the repetitive jarring of running can cause these organs to descend. This is known as pelvic organ prolapse. Physical therapists strongly recommend that, to prevent this condition, women wear undergarments that offer pelvic floor support, or compression shorts that support the pelvic floor, both during and after pregnancy.
5. Practice good posture. Poor posture can have a major effect on every part of your body, particularly with regard to pain during pregnancy. A physical therapist can evaluate your posture and suggest muscle-strengthening exercises and lifestyle education (such as not sitting at a desk for long periods, and carrying grocery bags properly). Establishing healthy posture habits—pre-baby—will better prepare your body for the extra weight of pregnancy and lessen your chances of low back and pelvic pain.
Acknowledgement: Marianne Ryan, PT, OCS