How proactive physical therapy can improve pregnancy and postpartum care
April 25, 2023
Most people think of physical therapy as exercises you do after an injury to relieve pain and restore range of motion. But intentional movements can also prevent injury and improve mobility and function, particularly during or after limited activity for a complex pregnancy.
Physical therapy (PT) for patients with restricted activity can help prepare their bodies for childbirth by strengthening the muscles they’ll use for delivery. It can also help:
- Prevent and relieve common discomforts such as tailbone, back and hip pain, or carpal tunnel syndrome
- Maintain muscle tone, which can deteriorate quickly with limited activity
- Prevent or treat postpartum conditions such as pelvic organ prolapse, incontinence, and diastasis recti, when the abdominal muscles don’t reconnect like they’re supposed to after pregnancy
Acute care physical therapists evaluate patients in the hospital and provide education and techniques that may help. We also refer patients to outpatient physical therapy or pelvic rehabilitation.
While PT has been getting more popular as a part of pregnancy care over the last decade, we still see patients most often after they start having musculoskeletal symptoms, right before they go home with their new baby. So, that creates a tight timeline and means both the patient and providers are working reactively to help relieve a problem that might have been prevented with early PT.
Working with patients before symptoms begin is the most effective way to help more women avoid pregnancy-related musculoskeletal problems.
My colleague Chitra Tirupathur Srinivasan, PT, DPT, and our acute physical medicine and rehabilitation (PM&R) team at UT Southwestern William P. Clements Jr. University Hospital are offering education for Ob/Gyns and patients about the benefits of proactive PT in pregnancy.
How PT works for typical and complex pregnancies
During visits throughout a typical pregnancy, our PTs talk with patients about preventive care and specific exercises to relieve aches and pains. We also teach patients how to do some intentional movements, such as:
- Pelvic floor exercises to strengthen the muscles that support your uterus, bladder, and bowels
- Proper body mechanics as your belly grows and joints loosen
- Good form for pushing in preparation for delivery
- Exercises and techniques to train for childbirth
Using MyChart, we can share educational materials about physical therapy and how it may help during each phase of pregnancy. Patients can communicate easily with us through this platform, allowing them an easy way to ask questions once they leave the hospital.
Complex pregnancies with restricted activity present unique challenges. The patients are asked not to be too active, but they need some exercise because muscle tone diminishes quickly with inactivity. Patients lose about 12% of their muscle strength for each week of activity restrictions – about half their total muscle strength can be lost in just three to five weeks.
For patients with activity restrictions, physical therapy typically focuses on breathing techniques, moving and self-positioning in bed, and light exercises to reduce muscle atrophy.
After delivery, a physical therapist can do a comprehensive evaluation and recommend postpartum PT to help patients safely regain muscle mass and mobility, if needed. This is especially important if you’ve had a C-section. A recent study found that women who got physical therapy after a C-section had significantly lower pain levels and improved ability to exercise.
We can also meet with you during the postpartum period to discuss how to relieve any discomfort and treat conditions such as incontinence or diastasis recti.
A few final thoughts
Your body changes drastically during and after pregnancy. That doesn’t mean you should be uncomfortable or in pain for 40-plus weeks. Physical therapy can help reduce strain on the body, prevent or relieve pain or discomfort, and help resolve issues that emerge, making your pregnancy and postpartum experience more positive.
Don’t be surprised if you are offered physical therapy during pregnancy, even if you are on activity restrictions. As we spread awareness about our acute PT services and the benefits of proactive PT, we hope to start seeing more patients at all stages of pregnancy.
Check with your insurance company about whether you have physical therapy benefits and if they cover wellness visits in addition to injury rehabilitation. To talk to a physical therapist before, during, or after pregnancy, call 214-645-8300 or request an appointment online.
