Using Physical Therapy to Help Relieve Pain and Ailments Following a Pregnancy

Using Physical Therapy to Help Relieve Pain and Ailments Following a Pregnancy:

How my Own Personal Experiences Guide my Perspective

By Pamela G.Guevarra, PT, DPT

My husband and I waited patiently for years to have a baby.  When our doctor told us we were pregnant with twins, like most families of multiples, we were surprised, yet felt extremely blessed.  However, I had a difficult pregnancy.  A herniated disc in my cervical (neck) spine, which existed prior to my pregnancy, worsened.  The pain I felt in my ribs from the extreme amount of pressure is something I cannot soon forget.  I had carpal tunnel syndrome that started on one wrist and eventually both.  Not to mention the pain in my lower back, which actually increased after my pregnancy, creating a radiating numbness on my right thigh, lower leg, and foot.

While physical therapy treats a wide range of physical ailments and conditions for men and women of all ages, many women are not aware of the benefits of physical therapy following their pregnancy.  During a pregnancy, women and physicians often utilize physical therapy to help relieve ailments and symptoms.  However, most women experience residual, or even new, ailments or symptoms after their pregnancy, yet many never even seek professional assistance.

Following the delivery of my twins, I became very ill.  My primary care physician explained I had an infection, my entire body was inflamed, and I was not recovering fast enough following my C-section.  Yet I still had to care for my newborn, premature twins.  I was so ill that I was not allowed to exercise.  I was so weak that standing up took time.  Sleepless nights led to constant fatigue.  I felt and looked like a frail, old lady stooped over from severe weakness.  After two months, I started to feel better, but was still experience neck pain, a stiff thoracic spine (upper back), pain and stiffness in my lower back, and numbness in my right leg and foot.  It is not normal to have symptoms like lower back pain and leg numbness.

Common symptoms that women experience after giving birth include pain in their back, pelvis, neck, legs, and/or arms along with weakness, stiffness, and headaches.  These symptoms, as well as other musculoskeletal conditions, can be intensified during or after birth, and may last for months to a year after delivery.  During pregnancy, the body's ligaments (tissues that connect bones together) become lax from a hormone called relaxin, which is released to allow the body to adapt with the growth of the baby.  This hormone predisposes pregnant women to injuries or can aggravate already existing conditions.  In addition, other reasons why women have musculoskeletal problems after pregnancy include postural changes, symptoms before and/or during pregnancy, a complicated vaginal delivery, C-section, a complication or illness after delivery, and giving birth to multiples.

Throughout a pregnancy, women experience an altered posture to compensate for the baby bump.  Nine months of pregnancy is more than enough time to stress joints and cause women to continue this altered posture after pregnancy.  An altered posture places unnecessary force on the body’s joints causing increased pain and decreased comfort while caring for the child and performing daily activities.  Another cause of symptoms arises from a complicated vaginal delivery.  A lengthy labor adds stress on top of stress to the pelvic floor muscles, leading to pain in the pelvis and incontinence issues. 

Women who choose to have a C-section, or require one following a lengthy labor, may experience weakness in the abdominal and pelvic muscles causing trunk weakness and low back pain.  A C-Section is now the recommended delivery option for women pregnant with twins (triplets, etc.) because it is safer for the babies and the mother.  However, not all women/couples are aware that a C-section is a major abdominal surgery; risks that are not adequately discussed in a birthing class.  The negative result of a C-section can cause emotional changes to some mothers who feel their body has failed in addition to the weakness and pain.

Physical therapy can treat these musculoskeletal conditions and reduce any residual symptoms.  Unfortunately, very few women seek the assistance of a licensed physical therapist because they assume nothing will help or they ignore their symptoms.  Most moms place themselves second, third, or even last after the demands of their family, their job, and other responsibilities despite the pain that they experience.  However, for a woman to give 100% to the demands of her role as a homemaker, mother, and/or a full-time employee, a woman must take care of her body and remove any and all obstacles or ailments preventing her from physically functioning at 100%.

A licensed physical therapist will be able to evaluate and treat the symptoms by addressing the specific problems individually and setting future health goals.  Treatments may include pain relief with manual therapy and modalities like cold pack, hot pack, and electrical stimulation.  Physical therapy will work to strengthen specific muscle groups, improve stability in specific muscle groups, increase endurance levels to avoid fatigue, improve posture through manual therapy and exercises, and relieve joint stiffness with manual therapy and stretching. 

I am a physical therapist, but I definitely needed another physical therapist to help me get back in shape for my husband, my twins, and to be able to return to work.  I was treated for my neck, my lower back, and thoracic spine.  Manual therapy loosened my spine to correct my posture and relieve pain and stiffness.  A home-exercise program was designed to improve my strength (especially in my core) flexibility, and endurance level.  Despite my daily demands, I had to create the time to complete these exercises at home, not only for my family, but for myself.

While every woman’s symptoms and speed of recovery are different, a licensed physical therapist will be able to frequently modify the treatment plan based on goals and improvement.  Some women, especially those who have an infection or other complication(s) during and after delivery, may need to see their physician prior to seeing a physical therapist.  New mothers must take special care of their bodies after giving birth to help regain energy and strength.  The better a woman takes care of herself, the more she will be able to provide the best care for her child.

Questions or comments?  Leave Pamela a comment below or contact AZOPT at (623) 242-6908 to find out how you can benefit from physical therapy.  Pamela will respond directly to your questions/comments within 24 hours.

Stretching for the Active Adult Woman

Stretching for the Active Adult Woman

By Ryann Roberts, DPT and Brooke Smith, DPT

It is hard enough to squeeze a daily exercise routine into your busy schedule.  You may think adding extra time with a before or after workout stretch is something you should just fit in when time permits.  The focus is on the exercise, not the stretch, right?  Wrong.

Stretching is just as important in your workout routine as the actual exercise.  Stretching increases flexibility, which in turn will help to increase your athletic performance and decrease your risk of injury.  For the active adult woman, the emphasis is on decreasing the risk of injury.  Understanding why stretching helps, and what stretches the active adult woman should perform, can help reduce and/or eliminate these injuries.

Stretching can help improve flexibility.  Flexibility may decrease your risk of injury by allowing your joints to move through their full range of motion.  For example, let’s say you are a 60 year old woman with tightness in her hips and ankles.  This tightness prevents your body from going through its full range of motion, which eventually can develop into tendonitis in your knee or lower back pain.  Properly stretching can increase the range of motion in your hips thereby reducing the risk of these micro traumas to your tendon that may lead to overload or injury.

Stretching also increases blood flow to the muscles, sending oxygen to the tendons and ligaments, essentially waking them up and preparing them for your workout.  

There are two types of stretching routines to perform – dynamic and static.  Dynamic stretching is stretching with movement, designed to propel the muscle into an extended range of motion.  This form of stretching prepares the body for physical exertion and performance.  Static stretching is used to stretch muscles while the body is at rest.  It is composed of various techniques that gradually lengthen a muscle to an elongated position (to the point of discomfort) and hold that position for 30 seconds to two minutes, two or three times per stretch. 30 seconds is the minimum duration to get the benefits of stretching, whereas two minutes is the maximum.

Always take the time to make sure you are stretching safely and effectively using proper technique.  Stretching incorrectly can actually do more harm than good.  Stretching cold muscles may cause injury, so we recommend warming up with some low intensity cardio for five minutes before beginning any stretching.  When stretching, do not bounce.  Bouncing can cause small tears in a muscle.  These tears cause scar tissue in the muscle that as it heals tightens the muscle even more, making you less flexible and more prone to increasing pain and causing injury.

To help, we have prepared a stretching routine to perform before and after you exercise.  

The following dynamic stretches are performed prior to exercise:

• Walking Lunge with Overhead Rotation
• Lateral Lunge
• Squats
• Walking Russian Kicks
• Arm Circles
• Posterior Deltoids Stretch
• Triceps Stretch

For a detailed description of these stretches, click here.

The following static stretches are performed after exercise:

• Standing Calf Stretch
• Hamstring Stretch
• Ilio-Tibial Band Stretching
• Standing Abductor Stretch
• Posterior Hip Stretch
• Low Lunge with Twist and Hip Flexor Stretch
• Standing Extensions
• Corner Stretch

For a detailed description of these stretches, click here.

It’s very easy to bypass stretching due to time constraints, but keep up with it.  The benefits of stretching are best when stretching is regular.  In some cases, you may need to approach stretching with caution. If you have a chronic condition or an injury, you may need to adjust your stretching techniques. For example, if you already have a strained muscle, stretching it may cause further harm.  

Lastly, stretching does not mean you cannot get injured.   Overuse injuries may still occur.  If you are feeling pain or are injured, please contact AZOPT for your FREE injury and/or performance screen with a licensed physical therapist.