Over the past 5 years, we have guided many patients and even a few staff of our own on their journey through pregnancy. While each pregnancy is a unique experience, some discomfort and pain are to be expected as your body goes through changes to accommodate the growing fetus.

At The Stretch Clinic, we have several pre & postnatal physiotherapists who are experienced in dealing with the most common ailments pregnant women tend to face during their 9-month journey and we’ve asked them to shed some light on their go-to treatment advice.

We hope you will find this article helpful in understanding the common conditions pregnant women encounter and ways to alleviate them, as well as what signs to look out for that may indicate the need to schedule an appointment with your Ob-gyn doctor.

1. Lower Back Pain

Back pain rarely spares anyone during pregnancy. It can happen at any stage but is especially prevalent in the 2nd and 3rd trimesters; it’s where the body experiences the biggest physiological changes and an increase in bodyweight and abdominal size can be seen. 

One main contributor to lower back pain is the hormone relaxin. Significantly increased in your pregnant state, relaxin causes ligament laxity in the pelvis. This is very much necessary to accommodate your growing baby and to prepare your body for childbirth. However, relaxin also acts on the ligaments of your spine, leading to lumbar instability and progressively to lower back pain. As a result, pregnant women will often complain of stiffness and discomfort felt at the sacroiliac joints and tailbone. Moreover, as your baby grows and your weight increases, your center of gravity shifts forward and affects your posture. This puts extra pressure on the spine and causes strain. 

For some, lower back pain can even move further downwards; pregnant women may experience a sharp shooting pain or ache down one of their legs. This is a condition called sciatica, where the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg, is compressed. The usual suspects here could be the shift in your center of gravity, your growing uterus, and/or your baby who has decided to rest his/her head on the nerve itself. If not, it can simply be due to fluid retention that’s always present in pregnancy.

What can I do?

These problems can be temporary, occurring on and off throughout the 3 trimesters. A good way to combat these common pregnancy discomforts is by staying active and engaging in doctor-approved physical activities. Moreover, the benefits of staying active carries over into a healthier pregnancy for both you and your baby as regular exercise may help prevent gestational diabetes, reduce stress and physically prepare you for labor. If you have access to a pool, we highly recommend swimming and exercising daily in the pool as it’s one of the best and safest activities to do while pregnant. Prenatal yoga and pilates with a certified prenatal instructor may also work wonders on your ever-changing pregnant body.

In some cases, these problems can continue to cause pain or extreme discomfort till you deliver. If the pain becomes unmanageable, then physiotherapy and prenatal massages can be very effective therapies. In recent years, chiropractic care has also been growing in popularity as a safe and beneficial way to relive the tension and provide relief for prenatal lower back pain.

At The Stretch Clinic, we emphasize strengthening the stabilizing muscles of the hips and lower back. We also ensure clients spend time re-educating the postural muscles for daily movements like bending, lifting, sitting, and improving back support in various sleeping positions.

2. Symphysis Pubis Dysfunction (SPD)

Commonly referred to as pelvic girdle pain, SPD is a painful condition occurring in about 25% of pregnancies. It is caused by the separation of the pubic bone due to the ligament laxity in your pelvis. The culprit? The hormone relaxin. While the loosening of the connective tissue is intended to help the pelvis expand in preparation for birth, it can also cause too much laxity and the joint (your pubic symphysis) becomes too mobile and unstable. Coupled with the baby’s weight, positioning and the overall physical and physiological changes taking place throughout the 3 trimesters, the symptoms of SPD can vary in severity; some women experience mild discomfort while others feel debilitating pain in the pelvic region that can radiate to the perineum and upper thighs.

With SPD, pregnant women typically experience discomfort or pain when walking, changing positions in bed, using the stairs, as well as doing daily tasks like getting in and out of the car, getting dressed and lifting heavier loads like groceries and laundry.

While SPD isn’t harmful to your baby, dealing with discomfort or pain daily for months and not finding relief can cause a buildup of negative emotions like stress, frustration, helplessness and even depression for the pregnant mother, which can further increase the difficulty of her pregnancy journey.

What can I do?

To treat SPD, you need an experienced physiotherapist. Physiotherapy treatments can help improve pelvic positioning and joint stability, strengthen surrounding muscles and minimize pain.

At The Stretch Clinic, we focus on pelvic alignment and its relationship with the hips and spine while addressing mobility issues of the joints through manual therapy. Our physiotherapists also emphasize strengthening the muscles of the pelvic floor, glutes and abdominals through a variety of positions. We also recommend incorporating prenatal massages and chiropractic care to manage the instability and discomfort or pain you will feel in this condition.

As a preventative measure, it’s always a good idea to book in with a licensed chiropractor or physiotherapist specializing in prenatal care (once you have been cleared by your Ob-gyn) in the early stages of pregnancy to check your pelvic alignment.

3. Swollen feet, Circulatory disorders & Cramps

It’s pretty normal to get swollen feet and occasional cramps when you’re pregnant, more so in the later trimesters as movement becomes more impaired. By the 3rd trimester, your blood volume may increase by up to 50%, causing excess fluids to accumulate in your extremities. What further exacerbates this condition is that your expanding womb will start to put pressure on the inferior vena cava which is the large vein that brings blood back to your heart. When this occurs, blood flows back more slowly from the legs, causing it to pool at your feet and ankles.

Although normal and usually harmless, it often causes discomfort and cramps. The swelling tends to get worse at the end of the day and more so if you sit or stand for too long without moving. The compression of your inferior vena cava can also lead to varicose veins, which are enlarged and twisted veins. Symptoms include further swelling in your lower legs, a throbbing ache or heaviness in your legs, itchiness and discoloration around a varicose vein and worsened pain when immobile. It’s crucial to note that if there is a sudden increase in swelling, redness, pain, and/or swelling in one leg, these symptoms warrant immediate attention from your doctor.

What can I do?

The fastest way to ease your discomfort is to help your circulatory system pump pooling blood and lymph back up towards your heart. You can do this by elevating your legs when you’re resting, and walking from time to time if you’re sitting for long periods. During movement, muscle contractions help to pump the blood up your veins and back towards the heart. Additionally, we recommend a combination of Active Isolated Stretching (AIS) and lymphatic massage; both of these techniques are excellent in helping your circulatory system and they play a big role in our prenatal therapy services. The results can be felt immediately and can last for days, so long as you keep up with the home exercises your physiotherapist prescribes for you.

Compression stockings may also help prevent the development of varicose veins to some extent or the worsening of it, which is important as women are at risk of deep vein thrombosis (DVT) if the swelling isn’t addressed.

Another key step is to ensure proper hydration throughout all stages of pregnancy as muscle cramps can be caused by dehydration as well as low electrolyte levels. Most pregnancy supplements include sufficient levels of magnesium and calcium; though if you’re getting regular cramps, include more magnesium and calcium-rich foods such as dark leafy greens, dairy products and sardines.

Lastly, sleeping on your left side helps to reduce the pressure of your womb on your inferior vena cava so grab some extra pillows for optimum support and learn to get comfortable on your left side.

4. Breathing restrictions & Rib pain

Shortness of breath or feeling restricted in your breathing is also common for expecting mothers and again more prevalent in the 2nd and 3rd trimesters. Firstly, an increase in the hormone progesterone will cause you to breathe more often, creating a feeling of hyperventilation. As your pregnancy develops, your growing uterus will push upwards and outwards, compressing organs like your lungs and increasing pressure against your diaphragm. When the diaphragm can’t fully expand, you may find that it’s difficult to take full, deep breaths and resort to breathing shallowly from the upper ribs. Finding a good breathing program that works well for you, pacing yourself and taking plenty of breaks are good ways to manage breathing restrictions.

Rib pain, on the other hand, can keep you up in the night. With the expansion of the abdominal cavity to accommodate the growth of your baby, your ribs will start to flare outwards. The connective tissues that keep the ribs firmly in place loses its shape, causing a dull ache or stabbing pains that just won’t go away.

What can I do?

There are a few breathing techniques we use at The Stretch Clinic to restore normal breathing patterns, bringing almost instant relief. Any time you feel anxious or short of breath, focus on taking slow, deep breaths; inhaling through the nose and exhaling out through the mouth until you’re able to bring your heart rate down to normal resting rate. After that, breathe in and out through the nose only. Lifting your shoulders and purposely expanding your ribcage as you inhale will give your lungs and diaphragm more space to expand.

The reason why our physiotherapists spend so much time emphasizing good posture is that it is often the key to easing many of the problems discussed above. Other good practices include sleeping propped up with pillows, which can allow your womb to be pulled downwards by gravity, similarly giving the lungs and diaphragm more space.

We also believe spinal realignment is a crucial part of prenatal care. Chiropractic sessions can be very effective in easing rib discomfort as spinal mobilization creates space for your baby to readjust their position as well. Your therapist will also give you exercises to practice daily at home to help open up areas of tension and keep your muscles strong and stable. Regular practice during your pregnancy will help alleviate not only your rib pain but also other aches you may be feeling.

5. Fatigue & Energy lows

It’s only natural to experience fatigue over the course of your pregnancy as you navigate hormonal cycles and emotional shifts. You can expect to start feeling energy lows in the first few weeks of pregnancy as your body recruits the nutrients it needs to grow the baby’s placenta. By the 2nd trimester, your energy levels may return to normal as your body adjusts to pregnancy. With your baby’s biggest growth spurt taking place in the 3rd trimester, expect energy dips again as your weight increases and your mobility becomes impaired.

What can I do?

Even though there are many causes of pregnancy fatigue, the basis of treatment remains the same: sleep! The body needs deep restorative sleep to nurture both you and your growing baby. If you didn’t get enough sleep during the night, make time for a 30 to 40-minute nap the next day. Blood sugar levels also have a huge impact on energy levels so consume a good balance of protein and healthy fats (like avocado and olive oil) and make sure you don’t skip meals. Morning sickness can be a huge obstacle to your eating plan but you may be able to ease it by eating frequently in small quantities.

If you do find yourself feeling sluggish or in need of a recharge, the best remedy for that is to get up and get moving. A good walk with long deep breaths or some prenatal yoga are fabulous for pumping oxygenated blood around the body and flushing out toxins from the lymphatic system. Exercise will also boost serotonin levels, making you feel a sense of purpose that can’t be found on the couch or in front of the TV. At the Clinic, we put great emphasis on incorporating healthy nutrition and lifestyle practices as part of our prenatal services.

We also believe it’s important to be able to talk to your ob-gyn or a therapist and share your pregnancy experiences. Emotional fatigue can feel a lot like physical fatigue and while you might never need professional counselling, it’s always reassuring to know that it’s available and what the benefits are. Setting goals and making preparations for the birth can ease the mind and lift burdens that you were not aware you were carrying.

We hope that you enjoyed this article and learned some useful tips. Always remember that adding a new addition to your family should be an exciting and wonderful experience, and our team of therapists enjoy being a part of your pregnancy journey.

It is our goal to offer the best pre & postnatal care available and provide expecting mothers with the knowledge and care required to get you through your pregnancy comfortably.

For more information on our pre & postnatal services, do contact us at info@thestretchclinic.com or drop us a text/call at 011-3303 0220.