Physiotherapy during pregnancy

What is physiotherapy?

Physiotherapy is a branch of medical science that studies how humans move. It uses physical therapy to promote healthy movement and reduce pain. Physiotherapists are trained health professionals who assess, diagnose and recommend treatment options to help restore proper body functioning. They must be registered with the Australian Health Practitioner Registration Agency (Ahpra).

Common goals of physiotherapy are to increase joint movement, increase muscle and tendon flexibility and reduce stiffness. Physiotherapy is also a technique to prevent injury and build muscle strength and tone.

Physiotherapists can specialise in different areas, for example sports medicine, paediatrics and musculoskeletal rehabilitation. Women’s health physiotherapists focus on pregnancy and disorders of the pelvis and pelvic floor.

Why might I need physiotherapy during pregnancy?

It's not uncommon for women to first see a physiotherapist when they become pregnant. Pregnancy, or prenatal, physiotherapy helps to reduce pain in the main joints that are commonly strained during pregnancy.

Pelvic girdle pain is one of the most commonly experienced pregnancy-related musculoskeletal conditions. It generally occurs because of changes to the posture and increased pelvic pressure due to the weight of the baby. Hormonal changes are also a major influence in causing pelvic girdle pain since they soften the ligaments that support the pelvis.

Physiotherapy during pregnancy also helps to reduce the likelihood of:

• birth trauma
• urinary incontinence during pregnancy and after birth — up to 67% of pregnant women will leak urine (incontinence) when they laugh, sneeze, cough or exercise
• lower back pain — around 50% of pregnant women experience low back pain
• pelvic floor dysfunction, including incontinence, sexual dysfunction and prolapse
• birth complications

You may see a physiotherapist during your pregnancy to prevent issues or treat new conditions. There can also be benefits in learning about helpful labour and birth positions. Some positions during pregnancy can be helpful to move a baby into the right position for labour and birth.

What are some common physiotherapy techniques?

When you first see a physiotherapist, they will ask you about any health issues you may have. They may use a range of techniques and recommend exercises to help improve your movement and reduce discomfort. Generally, a series of appointments is necessary to help develop a treatment plan and to review its effectiveness.

It can take time to feel the benefits of physiotherapy treatment, and you may be advised to do exercises at home.

Common physiotherapy techniques include:

• massage or ultrasound to parts of the body
• manipulation of certain joints
• stretching muscles — commonly side and forward stretches, a ‘cat’ stretch and pelvic circles
• being guided on different ways to move which won’t aggravate an existing problem
• exercise recommendations
• advise around wearing a supportive belt or compression pants

How will I know if I need physiotherapy?

You may not know if seeing a physiotherapist will be helpful. Many women just accept that a certain amount of discomfort is normal during pregnancy. However, a tailored exercise plan can often help to reduce a range of symptoms and improve a woman’s mobility and her enjoyment of pregnancy.

You may feel changes in the strength of your pelvic floor and can’t ‘hold on’ to your urine (wee) when you’re pregnant. Having an intensive, supervised pelvic floor exercise program helps to reduce the likelihood of leaking urine, both before and after having a baby.

A common condition of pregnancy, but which is less well known, is carpal tunnel syndrome. This is caused by an increase in fluid levels which create extra pressure on the median nerve supplying the wrist and fingers. Symptoms of carpal tunnel syndrome include tingling or numbness in the fingers or hand, swelling and weakness, making it hard to grip onto things. Physiotherapy treatments for carpal tunnel syndrome include splints, resting and avoiding hand movements and median nerve and tendon stretches.

Physiotherapy is not just beneficial during pregnancy. Pelvic floor exercises are recommended for women of all ages, particularly when pregnant and after birth.

It’s very common for women to experience strain on their back during and after pregnancy. A physiotherapist can guide you on how to maintain a good standing and sitting posture.

Another common pregnancy complication is the widening of the abdominal muscles, called diastasis. Around 66% to 100% of women will experience this change and notice a gap down the centre of their tummy when they move or get up from a lying down position. Abdominal muscle exercises can help to build muscle tone and restore core strength.

Are there any risks to having physiotherapy during pregnancy?

There are generally no risks in seeing a qualified and registered physiotherapist. Sometimes, there is a temporary increase in muscle discomfort after massage and focused movements. Your physiotherapist will advise you on what to expect and ways to manage any discomfort.

How do I find a physiotherapist?

Your maternity care provider will be able to refer you to a physiotherapist, or you can go to one yourself. You don’t need to have a doctor’s referral to see one. Most maternity hospitals have a physiotherapy department and many also run antenatal classes.

Medicare covers the cost of seeing a physiotherapist based at a public hospital. You will need to pay to see a private physiotherapist, though you may be eligible for a rebate if you have private health insurance.

You can find a physiotherapist online through the Service Finder.