My son Caelen is just over 16 months and is the most amazing gift my wife and I could have ever imagined. It has been so rewarding being a part of his development – from pregnancy, the short time he was a newborn (I never realised how short a time your baby is actually a new-born!) and to now, a wildly energetic, curious and cheeky 16 month old boy. While fascinated with his development, my wife and I have also become very familiar with the tired, aching bodies that come with having a baby. As a Physio it has been an invaluable learning experience seeing first hand what happens to a woman's body during and after pregnancy and the demands on your body of caring for a baby.
There are two big changes to a woman's body during pregnancy that can have profound effects on how their body feels. The first is an increase in the hormone Relaxin – this causes the ligaments supporting the joints in the body to relax, allowing the baby to pass through the pelvis during birth. It's important to note that it is not just the ligaments in the pelvis that relax, it's all ligaments in the body. There are ligaments supporting every joint, this includes the spine, shoulders, elbows, wrist, knees and ankles. As a result these joints are more mobile and will be affected differently by the loads placed on them.
The other change is a baby growing in your belly, gradually getting bigger and heavier as pregnancy progresses. A growing belly changes your centre of gravity, the curvature of the spine changes to cater for this as does the parts of your body that are getting loaded. In a sport setting, an athlete is more likely to get injured when there is a change to the loads they are exposing their body to. It is no wonder that women experience back, hip and other joint pains during pregnancy with the way their loads are changing. The good news is that although you are sore, generally no significant long-term injury results. However, if you are concerned by the pain and worried you may have a more serious injury discuss this with your GP, mid-wife or obstetrician.
How should you manage this pain – or is it just something you have to put up with? Not every woman will experience discomfort at the same levels or at the same locations. It is possible to attain some relief and try to limit the amount of pain experienced. From listening to mums and mums-to-be and my experiences as a Physio there is a lot of variability in what works and how much relief each individual receives. Again, your GP, mid-wife or obstetrician can provide you some advice on what might work for you. My tips for managing and reducing pain during pregnancy are:
Keep muscles supporting your joints strong to counter the loss of stability provided by your ligaments. Important areas are the core and gluteal musculature, and muscles supporting the shoulders, knees and ankles. You may choose to continue gym training during pregnancy (at the appropriate levels), perform Pilates classes or a Physio can provide you with exercises you can perform at home or in a gym-setting.
Massage and gentle soft-tissue release can help reduce pain and help manage the consequences of the altered loading that has occurred. It is to be expected that certain muscles become over-loaded and tight as the way your body carries load changes. I try to identify and target these areas when treating pregnant women and often there is an immediate improvement.
As joints are relaxing it is unlikely that joint mobilisation is required or would be beneficial. Occassionally I have used mobilisations when I have thought a particular joint may be a little more overloaded than others. Even then it would only require a small amount of mobilisation and would be most likely used for the upper back or neck regions. Considering what is happening to the body strengthening and massage makes more sense to me.
Have some self-management tools available – the ones I believe to be most useful during pregnancy are hot and cold packs, massage balls, foam rollers and natural pain relieving creams. And treat yourself to some relaxation time - find how Total Physiotherapy and Yummy Mummy Day Spa can help with this at the end of the article!