Pregnancy and giving birth place significant stress on the body, causing several physical and physiological changes. During pregnancy, estrogen and progesterone levels increase, additional weight and volume are added to the front of the abdomen, circulation slows, and metabolism speeds up – the impacts of these changes to the body linger after pregnancy. Vaginal birth and C-sections each put certain stresses on the body as well. Discomfort after childbirth, also known as post-partum discomfort, is common. Several post-partum conditions benefit from physical therapy.
Post-partum discomfort can result from normal physical and physiological changes during pregnancy and birth along with less common conditions. Some of the common post-partum conditions are:
- Diastasis recti: pressure within the abdomen during pregnancy and childbirth can increase the gap between the two sides of the abdominal muscle, leading to muscle weakness
- Pelvic joint pain: changes in joint stability due to pregnancy hormones, posture, and center of gravity can cause pain and inflammation in the joint and impair movement in the hips and legs
- Cardiovascular deconditioning: the post-partum period is associated with reduced endurance, reduced strength, and weight gain
- Carpal tunnel syndrome: tingling, numbness, and/or weakness in the hand and wrist due to nerve compression, which can be caused by post-partum inflammation of the retinacular ligament
Treatment for post-partum discomfort should be tailored to the specific symptoms that each patient is experiencing. In general, physical therapy often focuses on regaining muscle tone and overall endurance. For diastasis recti, treatment typically involves core-strengthening exercises, muscle activation, and patient education. Pelvic joint pain can be treated with pelvic floor muscle exercises. Physical therapy for post-partum cardiovascular deconditioning involves breathing exercises, cardio exercise prescription, and the use of the treadmill test. Carpal tunnel syndrome is generally treated with active stretching, electrical stimulation, muscle-strengthening exercises, and nerve-gliding exercises.