A pregnant woman undergoes many changes during her journey towards having a baby. These changes can be postural, hormonal, emotional, functional or even a simple change to the type of shoes you now happily justify wearing.
Each experience of pregnancy is different and thus an osteopathic approach to pregnancy will always be a tailored to the mother, her baby, and her current state of being.
An osteopathic approach is to support the body through it’s changes and address any aches, pains or restrictions that may arise. Osteopaths recognise that the structure and function of the body intimately rely on each other and thus treatment is focused on maintaining balance through the body, especially the pelvis, and also maintaining freedom of joints, ligaments and muscles to be able the body to be able to perform to it’s usual capacity as much as possible.
Some common complaints during pregnancy are explained below. These can arise due to both mechanical and hormonal factors.
Rib and upper back strains
To make room for the growing foetus, abdominal contents are displaced upwards and outwards. This can push directly against the ribs and also places stress on the diaphragm muscle. The diaphragm is a large dome-shaped muscle, which attaches to the lumbar spine (low back) and lower six ribs, and is the major muscle responsible for breathing (see previous blog). This can lead to rib or back pain and/or shortness of breath, especially later in the pregnancy. Osteopathic treatment here aims to increase rib and back range of motion and release the diaphragm and intercostal muscles.
Heartburn is also a common complaint in pregnancy. This can occur from mechanical and hormonal reasons. Pressure pushing up against the diaphragm and the stomach can cause pressure on the sphincter of the stomach. Similarly, a hormone called progesterone is released which causes relaxation of this muscle. This can lead to stomach contents moving up into the oesophagus and causing heartburn and reflux.
Postural changes develop as the baby grows, causing the woman’s center of gravity to move forward and thus may demand more from muscles to adequately control your posture, gait or other functional movements.
The body also releases a hormone called relaxin, which causes the ligaments in the body to become more flexible and lax in preparation for childbirth. It is important to remember that this is a naturally occurring phenomenon and treatment and exercise should be around supporting this change and not necessarily trying to counteract it.
Pelvic Girdle Pain (PGP) is pain of the joints, ligaments or muscles, which make up the pelvic girdle. The pelvis is complex as it is the connection between the legs and torso, it allows for gross movement and also stability. Pain can occur at the back through the sacroiliac joints, at the front through the symphysis pubis, and also in the coccyx, low back, groin or hip regions. Both the mechanical and hormonal changes affecting the pelvis can lead to excessive stress and pain is often an indication that the body is not adequately coping with the changes. Osteopaths assess for restrictions and imbalances through the pelvis and associated areas. It is very important that a woman’s pelvis is balanced and free of restrictions to support the change in mechanical and hormonal stress it has to undergo. Think of it like preparing for a sporting event – a mobile and pain free body will usually be more comfortable and perform better!
Post partum PGP can often occur due to pre-existing restrictions through the pelvis, ongoing relaxin release during breast feeding, and also the pressures and strains, which are put on the pelvis and pelvic floor muscles during childbirth.
During pregnancy, a woman experiences increased fluid retention throughout the body. This happens at a cellular level, and can be seen in various ways. Carpal Tunnel Syndrome occurs when fluid collects around the wrist and puts pressure on the median nerve, which runs down to the hand. Symptoms include numbness and tingling in the thumb and middle three fingers, visible swelling, and potentially weakness of the hand especially to grip. This usually resolves a few moths after the birth when fluid levels readjust. Osteopathic treatment promotes blood flow and fluid drainage of the wrist, arm and will also assess the neck and shoulder girdle to address any other causative factors.
Various factors contribute to foot and ankle swelling during pregnancy. As discussed above, fluid retention occurring during pregnancy can lead to swollen feet. Also, your growing uterus puts pressure on your abdomen and the large veins of the body, which can alter the return of blood to your heart. Osteopaths will treat the pelvis, low back and lower limb for any restrictions to encourage blood flow and fluid drainage.
Each pregnancy is different and thus each management plan should also be tailored to the individual. Osteopathic treatments are encouraged for both symptomatic and preventative approaches – to ease pain, to support the body through its changes, and to prepare the mother for childbirth.