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Physical Changes During Pregnancy

By Dr. Brooke Meinema, DPT, FAFS

Pregnancy is not for the faint of heart. Pregnancy has so many physiological changes occurring that can lead to a myriad of symptoms, such as urinary frequency/urgency, acid reflux, shortness of breath, and various aches and pains. While some of this may be unavoidable, there are usually things that can be done to reduce the symptoms.

  • Bladder changes:
    • The growing fetus increases pressure down on the bladder which can make it more difficult to prevent leaking.
    • When the bladder fills, it physically takes up more room in the pelvis. As pregnancy progresses, the amount of room available decreases making the bladder able to hold less urine thus increasing the frequency of urination.
    • What to work on:
      • Keep working on pelvic and hip mobility and strength as well as breathing coordination. Taking a deep breath in before coughing or sneezing can help reduce some of the pressure down and prevent some leakage.
      • If you have foot and leg swelling, be sure to work on reducing this before bed. If you go to sleep with swollen feet, the fluid drains into the bladder and will make you have to get up in the night more frequently.

  • Reflux and GERD
    • In the image above, take a look at the stomach (the kidney bean-shaped organ just above the baby. You’ll notice the position of the stomach changes. This change I important to note if you have been struggling with acid reflux. With the change in position, when you go to lie down, acid has an easier time going back up the esophagus leading to reflux.
    • What to work on:
      • Try different positions such as lying propped up and on your left side (see the image below for why lying on your left side is better than your right for reflux issues).

  • Breathing and rib cage changes:
    • During pregnancy, the rib cage gets wider to make more room for the expanding belly. When the angle of the bottom of the rib cage widens, this changes the position of the diaphragm. Pairing the different position of the diaphragm with the increased pressure for the growing baby can make breathing much more difficult. This can lead to feeling short of breath much easier than you normally would experience with the same level of activity.
    • What to work on:
      • Thoracic mobility! Keep your mid-spine flexible by working on trunk rotation and extension.

  • Postural changes:
    • With the belly growing, this increases the curve of the lumbar spine (lower back), rounding of the thoracic spine (mid/upper back), rounding of the chest and shoulders due to increased breast size and weight, and forward head posture.
    • The increased curve in the lower spine can lead to achiness in the lower back and potential sciatic-type pain.
    • Increased thoracic rounding and forward rounded shoulders can lead to discomfort with the upper back and shoulders.
    • Forward head position can lead to neck pain and headaches.
    • What to work on:
      • Keeping your hips and thoracic spine flexible.
      • Chest opening stretches.
      • Keeping your head in a more neutral position (I like to pretend I am eavesdropping on something behind me to subtly pull my head and neck back).

 

 

  • Pelvic/pubic pain
    • During pregnancy, the hormones our bodies produce allow for increased mobility and a little less stability. With this change, the pelvis can expand and shift more to prepare for delivery. Excess mobility can lead to pain through the pubic symphysis (called symphysis pubis dysfunction), especially with rolling over in bed, shifting weight from one foot to another, or standing on one foot.
    • What to work on:
      • Avoid positions involving being on one foot as much as you can.
      • Roll with your knees together.
      • Strengthen your hip and groin muscles!
          • The further along in pregnancy, the more we develop “the pregnant waddle” which reduces strength in our glutes, adductors (groin muscles), and outer hip muscles. This weakness can allow even more shifting and reduced stability.
      • Try a belly-band for extra support.

 

While a bit of increased achiness and fatigue may be normal, if you are dealing with pain or limited tolerance to activities due to your pregnancy, working with a physical therapist to help develop a plan can be a really important step! We can not only help you improve your symptoms but also prevent other symptoms from occurring and prepare you for labor and delivery and postpartum recovery. Call to request your appointment!

 

Resources:
https://www.whattoexpect.com/wom/pregnancy/this-is-how-your-organs-move-to-make-room-for-baby-every-week-of-pregnancy

Heartburn Keeping You Up at Night?


https://anatomy.app/article/obstetric-anatomy/rib-cage-changes-during-pregnancy

Posture During Pregnancy & Motherhood

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