PHYSICAL THERAPY , A BOON TO THE PREGNANT COUPLES! PART 1

DON'T FIGHT PREGNANCY, EMBRACE IT.

Sailing through the most transformational journey of your life.CHECK THIS OUT! 

1.Dealing with increased depth of respiration

Respiratory rate remains unchanged during pregnancy, however depth of respiration increases, a natural state of hyperventilation exists throughout pregnancy.

REASON : With increasing weeks, the diaphragm which is a primary muscle of inspiration is pushed up by 4 cm and the enlarging uterus which is actually an organ of the pelvis, gradually encroaches the abdomen. All these developments increases the sub-costal angle.Such alignment of the diaphragm makes it difficult to increase the transverse diameter of the chest cavity,as a compensation, we start breathing deeply.Without which the required oxygen demand would have never met.

PHYSICAL THERAPY INTERVENTION

Deep breathing exercises decreases the work of breathing ( which is d/t to hyperventilatory state).

2. Dealing with increased trips to washroom.

REASON: The pelvic floor is the base of the group of muscles referred to as your “core”. These muscles are located in your pelvis, and stretch like a hammock from the pubic bone to the tail bone (coccyx) and from side to side.Pelvic floor muscles support the bladder, bowel and uterus. They help maintain bladder and bowel control and play an important role in sexual sensation and function. Imagine the pelvic floor muscles as a round mini-trampoline made of firm muscle. Just like a trampoline, the pelvic floor, when it is working well, is able to move up and down when any sort of pressure is placed on it.With increasing stress on the pelvic floor muscles and no exercise, makes the voluntary control over bladder difficult.

PHYSICAL THERAPY INTERVENTION

Whether you are pregnant, planning a pregnancy or have already had a baby, research shows that when you do your pelvic floor exercises your pelvic floor muscles will recover more quickly after the birth. Pelvic floor exercises will also help reduce your risk of bladder and bowel control problems during or after pregnancy.

Strengthening your pelvic floor muscles helps to actively support your bladder, bowel and pelvic organs. This improves bladder and bowel control and reduces the likelihood of leaking from your bladder or bowel. Like other muscles in your body, your pelvic floor muscles will become stronger with a regular exercise program.(stay tuned to know detailed benefits of pelvic floor exercises and how to perform them correctly in our upcoming posts).

3. Dealing with symptomatic supine hypotensive syndrome.

Although cardiac output increases, blood pressure decreases because of venous distensibility.

REASON : Pressure in the inferior vena cava rises in late pregnancy, especially in the supine position, because of compression by the uterus just below the diaphragm.  The aorta is partially occluded in the supine position.

PHYSICAL THERAPY INTERVENTION

Sleeping on sides, preferably the left side.(Refer the image below).

4. Dealing with leg cramps and feet swelling.

REASON : Venous pressure in the lower extremities increases during standing as a result of increased uterine size and increased venous distensibility along with no exercise leads to swelling in feet a the blood has to pump against the gravity and with distended veins pumping blood back to the main . Leg cramps, occur due to dehydration and hormonal fluctuation influencing the electrolyte balance.

PHYSICAL THERAPY INTERVENTIONS

Active ankle toe movements, and keeping the feet supported on foot stool while sitting.

5. Dealing with haemorrhoids and constipation.

Sometimes women have haemorrhoids for the first time during pregnancy or after the birth.

REASON : They can be caused by the hormonal changes of pregnancy that soften the walls of the veins and cause them to protrude so that you can feel them at the opening of your back passage. The extra weight from the uterus pressing on the bowel and pelvic veins may also contribute to getting haemorrhoids.

Constipation during or after pregnancy can increase the chance of getting haemorrhoids, so it is important that you seek help if you are constipated rather than put up with it.

PHYSICAL THERAPY INTERVENTION

• Pelvic floor exercises can be uncomfortable to do if you have haemorrhoids, so concentrate on gently lifting the back passage and then letting go – don’t try and hold the pelvic floor muscle contraction while the haemorrhoids are very painful. Pelvic floor muscles lift the back passage area and therefore stop haemorrhoids getting worse.

• Avoid standing for long periods of time. A lot of standing may increase the pressure on the haemorrhoids and the effect of gravity may make them swell more.

• Place ice over the area.

• Sit on the toilet with your elbows over your knees, leaning forward, keeping your back straight. This helps to relax your pelvic floor and anal sphincter muscles. Use a footstool to support your feet if this is more comfortable. Gently push, keeping your tummy bulged forward and continue to breathe normally.

Do not hesitate to share your views .

Up next :Sailing through the pregnancy blues & performing pelvic floor exercises the right way, exclusively from the pen of a physical therapist.

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Happy Health!
YUVAAN