Your body is going through sooooo many changes during your pregnancy. Your organs and ribs are being pushed up and out. Your diaphragm is being pushed up to make room for baby. Your abdominal muscles are stretching out as your belly grows. Don’t worry, this is all supposed to happen and HAS to happen, but can also cause problems during pregnancy and postpartum.
Think about how these changes affect breathing and pressure in your trunk. When you breathe, your ribs should expand out and up. If they are constantly in this state (because of pregnancy) your body is “stuck” in exhalation mode. Have you noticed your bra circumference getting tighter??? This is why. This is supposed to happen, but there are many exercises a pelvic floor PT can do to help with thoracic and rib mobility and try to prevent further issues after baby. Thoracic mobility, in my opinion, may be the single most important thing to work on during pregnancy. Well, that and 360 breathing, but that is another related topic.
Now, lets think about the diagram being pushed up. Your diaphragm and your pelvic floor work together as a system. Think of a can of soda/pop. The top of the can is the diaphragm and the bottom of the can is the pelvic floor muscles. Inside, the can is air/liquid and pressure that helps the can maintain its shape. The diaphragm and pelvic floor muscles create and maintain this pressure in your abdominal cavity. This pressure becomes interrupted if either the diaphragm or pelvic floor isn’t moving like it’s supposed it. When you inhale, your diaphragm actually contracts downward and your pelvic floor should also descend and “lengthen” to help maintain the pressure in your abdominal cavity.
If this process doesn’t happen correctly, then we get urine leaking, hernias, and diastisis recti (abdominal separation) issues. We use thoracic mobility and 360 breathing techniques to assist with preventing pressure issues.
By knowing these 2 problems you can be aware of them and work on them throughout your whole pregnancy to assist with a smoother and more comfortable pre-natal phase, but also to assist with a quicker recovery postpartum. We all want a quick recovery and to “pop’ back to how are bodies were before pregnancy.
The third issue to consider is POSTURE. Our belly is growing forward which means our center of mass changes. We can either tip over or our body compensates by changing our posture. Our body automatically adjusts for our growing belly and changes our posture throughout the whole pregnancy. Our bodies are pretty amazing, however, often this new and changing posture carries over into our postpartum phase. During pregnancy, we tend to tilt our pelvis forward (anterior pelvic tilt) and use our back muscles to support the front belly growth. This causes our back muscles to overwork and may cause low back pain during pregnancy. The anterior pelvic tilt, in Figure 2 below, causes our hamstrings and abdominal muscles to be lengthened and weak.
If we can recognize our posture and perform exercise to be aware of our abdominal muscles, we can decrease low back/hip/pelvic pain and help with the dreaded “mommy pooch.”
The last thing to think about is actually preparing for the delivery process. Yes, a baby has to come through a small hole in our pelvis during a vaginal delivery but your pelvic muscles are also affected during a c-section. You can help yourself by preparing your body and learning how to lengthen and relax those pelvic floor muscles to allow baby to pass through easier. I like to compare this to a balloon. How hard is it to blow a balloon up the first time? The balloon hasn’t been stretched or lengthened and is holding all this tension making if difficult to blow up. After the first time the balloon is blown up, then it gets easier. The balloon is the same as your pelvic floor. If we focus on lengthening and relaxing the muscles, consciously, then delivery of baby can be smoother. Now, I’m not saying you can’t or shouldn’t have an epidural, because I TOTALLY did with both my kids, but by preparing your pelvic floor and your body, you can make the delivery process easier for yourself and maybe have less complications and less tearing.
So let's recap....the 4 reasons you should reach out to a Pelvic Floor Physical Therapist during pregnancy is breath work, mobility work, posture, and preparing your body for the delivery. Momma, you are a hero for dealing with and adapting to all the changes throughout pregnancy, but I am here to make it easier for you.
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