Just Orthopedic
Author: Terry K. Gemas

Pregnancy can be one of the most exciting times in a woman’s life. However, it can also be a season marked by periodic aches and pains. Generally, the region of the body where pregnant women experience significant amounts of pain is the lower back. In fact, research studies indicate that roughly 50-70% of women who are pregnant will experience pain in the lower back. The pain can result from a wide range of factors, including an expanding belly that places additional weight on joints and ligaments.

Hormonal changes that increase joint instability or stretch out ligaments can also cause or increase back pain. Yet while lower back pain during pregnancy is a common experience for women, it doesn’t have to be. In fact, attaining physical therapy during pregnancy can help alleviate the physical suffering associated with it.

The Healing Effects Of Physical Therapy for Pregnant Women

The powerful, healing effects of physical therapy for pregnant women are well known. Specifically, physical therapy alleviates pain by strengthening lower back and abdominal muscles, improving posture and stretching tight muscles and joints.

Pregnant Woman Doing Physical Therapy
Physical therapy can also alleviate pain through massage. Studies indicate that 83% of the women who attain physical therapy for low back pain experience a decrease in pain symptoms. It’s also important to note that the physical therapy strengthens muscles, which thereby eases the labor process such that giving birth is less challenging.

Alternatives To Physical Therapy

In some cases, pregnant women are not interested in physical therapy. If this is the case, there are alternatives to consider. One such alternative is exercise. It’s important to note that even women who did not regularly exercise prior to pregnancy can benefit from incorporating physical therapy into their lives.

The positive effects of exercise are researched and well-known and they include decreased back pain, an improvement in sleep, a boost in energy levels,  an elevated mood, better weight management, increased muscle strength and stamina. Women who engage in physical activity throughout their pregnancies can also reduce their risk of high blood pressure and gestational diabetes. The symptoms of postpartum depression can also be decreased.

If you’re interested in using physical therapy to treat your lower back pain during pregnancy, be sure that you consult with a board certified orthopedic physician before you begin your physical therapy program. To help you make the best decisions regarding physical therapy during your pregnancy, consider some of the following information released from the American College of Obstetrics and Gynecology (ACOG).

Contraindications for Physical Activity During Pregnancy:

  • Restrictive lung disease
  • Hemodynamically significant heart disease
  • Multiple gestation with risk for preterm labor
  • Pregnancy induced hypertension
  • Incompetent cervix
  • Incompetent cervical cerclage
  • Placenta previa after 26 weeks of gestation
  • Persistent bleeding during the second or third trimester
  • Rupture of membranes
  • Premature labor during the current pregnancy

Relative Contraindication for Physical Activity During Pregnancy:

  • Intrauterine growth retardation
  • Current or recent sedentary lifestyle
  • Poorly controlled hypertension, insulin-dependent diabetes, and seizure disorder
  • Chronic bronchitis
  • Severe anemia
  • Poorly controlled thyroid disease
  • Maternal cardiac arrhythmia
  • Extremely underweight
  • Morbid obesity
  • Heavy smoker
  • Orthopedic limitations

Physical Activity Recommendations During Pregnancy

Pregnant women who wish to engage in exercise during pregnancy are encouraged to avoid high altitude activities, scuba diving and activities that present risks of abdominal trauma, and activities that involve susceptibility to falling. Exercise participants are also advised to be cognizant of the FITT principle. This acronym stands for frequency, intensity, time, and type.

Here are the recommendations based on activity level:

Sedentary Exercisers

Sedentary women are encouraged to exercise at least 3 times per week at a moderately hard level of exertion. The activity should last for 30 minutes and should be low impact.

Regular Exercisers

Regular exercisers should exercise from 3 to 5 days per week at a moderately hard to hard level of intensity. The duration of the exercise can be from 30 to 60 minutes. The physical activity should be low impact.

Those More on the Athletic Side

Pregnant women who are more athletic than most should exercise from 4 to 6 days per week. The intensity level should be from 70% to 80% of their maximum heart rate (or “hard”). The duration of the physical activity should be between 60 to 90 minutes. Pregnant athletes can participate in competitive activities as they are tolerated.

Just Orthopedic

Terry K. Gemas , MD

While Dr. Terry Gemas was doing his sports medicine fellowship training at the University of Miami, he treated varsity athletic teams and served as a fellow orthopedic surgeon to the Tampa Bay Buccaneers professional football team.

He has a special interest in sports related injuries as well as cutting-edge arthroscopic and other minimally invasive procedures, total joint replacement, and general fracture ...

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