• Cara-Lee Goullee

The Pregnancy Files #2: Advice From a Pregnant Physio


Hello, Cara-Lee here. You may recall I *started* to do a blog series about 6 months ago about training for the Rottnest Channel Swim in 2020. If you read that, you will know that the plan came to an abrupt end when I got the delightful news that my partner and I were pregnant...oops (but yay!!). So to keep you updated with my time in the pool, as well as the normal trials and tribulations and highs and lows of pregnant life while treating, I give to you....

The Pregnancy Files!

If you haven't read it already, click here to read Part 1, then come on back for...

Part 2 - Advice

Pregnant women and women’s health are two areas I’ve dealt a bit with in my career as a physio. One of the big things we learn back at university is the importance of empathy with clients – putting ourselves in their shoes and trying to understand how they’re feeling and what they’re going through.

If you read my previous Pregnancy Files Blog you’ll know I’m pregnant myself and that takes my ability to empathise with you to a whole other level. I mean; back ache? Leg cramps? SIJ pain? Difficulty sleeping? I. FEEL.YOU.

My previous blog chatted about how it can be tricky not only being pregnant but being a pregnant health professional. In this blog, I want to focus on some of the more specific bits of advice for pregnant women. Advice I probably would have given before I was pregnant but can now relate to a bit more as I’m going through it myself. So let’s get started.

Our bodies change drastically during pregnancy. We have 9 whole months of our body growing and making room and adjusting to this new being that we’re creating. Really, our bodies never cease to amaze me – were we to suddenly be given a 4kg medicine ball and told that we had to carry it and pick it up and push it around and hold it for majority of the day, our bodies would fail us. We wouldn’t have the strength or the endurance to tolerate this for very long at all. Yet, our body prepares us for this by slowly getting us used to carrying a bigger and bigger weight (as bub grows) over a 9-month block. Graded strengthening at its best! So by the time bub comes out, we have the endurance and strength already to bear the weight of this little human. Not only that, but all our ligaments loosen and slowly allow our body to expand along with the bub so that we can actually accommodate this growing bowling ball, let alone have the laxity and capacity to push it out of us.

The reason it’s important to know all this is that our aches and pains are related to this. We get SIJ (sacroiliac joint) and pubic symphysis pain because our ligaments are stretching and allowing space for our joints to move to accommodate our bub. We get low back pain from our back arching to counteract the weight of our belly as it grows. We get rib pain and upper back stiffness and pain because our ribs are getting pushed out as everything expands to make room for the little being. We get leg cramps and swollen feet because we’re now pumping a lot more blood around our entire body plus, boy, we’re lugging a lot more weight around with us day in and day out. Basically, a lot of the niggles we get, whilst we can manage them, unfortunately may not completely go away until after our pregnancy. By all means, there are things we can do to help these symptoms and make our 9 months a bit more comfortable but being aware that our body is achy because all of the phenomenal changes it’s making to grow this human being is a huge thing to be aware of, and may make dealing with the discomfort a bit more bearable.

Let’s discuss some really common niggles:

SACROILIAC JOINT PAIN

If you have a bruise-y, tender spot at the very base of your spine, commonly a bit more on one side, that is really achy when you roll over in bed or perhaps move from lying to sitting, then you likely have SIJ pain. The ache may also refer around to the front of your hip. SIJ pain is a really tricky one to treat during pregnancy. You can try things like a trochanteric belt which is a belt you wear around the hips/top of your buttocks to provide the SIJ with a bit more support. Gluteal activation work is usually one of our first port of calls in trying to deal with SIJ pain. Read our SIJ pain blog here for a bit more info on this and a very basic bridge style exercise to start with.

Personal Experience Tip: I definitely have been suffering from SIJ pain and find that lying flat or even with bent knees on the ground or a firm mattress to be incredibly uncomfortable. My hips feel like they click out of place every time I attempt to move out of this position or roll over. To deal with this, I try avoid lying on anything hard and sleep with a pillow between my knees at night. I squeeze my butt when I do go to change position or roll over and sometimes this is enough to give me some relief. Other times I just groan and moan as I roll over and remind myself not to lie in that position again.

SCIATICA

This one is awful and another really tricky one to treat during pregnancy. Sciatica is when the nerve down your leg that runs through your buttock gets inflamed from being compressed and you suffer from this constant ache down the buttock and back of your leg, perhaps with tingling or numbness too. Read out sciatica blog here for more info on the symptoms and treatments of sciatica.

Personal Experience Tip: Another symptom I’ve struggled with – most commonly after flying or sitting for long periods. Pressure on our gluteals or increased tension in this area can kick this niggle off, so gentle, regular movement, light massage or stretching and avoiding sitting for too long without moving are my top tips for trying to manage this pain. Oh, and get in the water - pool, ocean, bath.

MID BACK STIFFNESS/PAIN

(Often accompanied with shortness of breath or difficulty taking deep breaths).

This is from our ribs being pushed out a bit as bub grows and runs out of room – our ribs and mid back (where our ribs start from) all get really stiff. Foam rolling, or gentle rotations of the spine can help with this, however, as you get bigger you do want to be a bit cautious about rotating too deeply.

Personal Experience Tip: Deep breathing is a fantastic way to ‘stretch’ out the mid back and ribs from the inside (plus also helps to calm you down and forces you to stop for a second during the day). Try cycling through a 4 count breath cycle:

  • Breathe in deeply through your nose for the count of 4

  • Hold your breath for the count of 4

  • Forcefully breath all the air out your mouth for a count of 4

Feel yourself expand, open and relax as you do this which will help with the tension in the mid back. Gentle opening rotations in sitting or lying can help too. Massages and gentle joint mobilisation by a physio. And as always, floating in some water to help relax the body and take the load off the spine.

LEG CRAMPS

Ugh. These. Not only are they so painful, but they wake you up at night and make sleeping (already hard when you’re pregnant), even harder. Magnesium (powder is often best and if you take it before bed it’ll help with the cramps plus can help with your sleep!), epsom salt baths (if you’re comfortable taking baths – the jury is out on this one with pregnant women as there are some people who suggest baths are not a good idea for pregnant people), and calf stretching/foot rolling.

Personal Experience Tip: Magnesium has been a life saver. Water! – Drink it+, Float in it, swim in it, take baths with Epsom salts in it.

Those are just a few the common niggles you can experience when pregnant!

The biggest thing to remember with all your aches and pains is that they WILL (mostly) go away after bub arrives (maybe because we’ll be so distracted and exhausted that all other aches will fade in comparison). You may just have to have a regular massage, or go to a regular yoga class, or get a regular foot rub during those 9 months. After all, you’re growing a human- it’s hard work. Expecting to get away scot-free is a bit unrealistic so look after yourself during this period so that your body can continue to do its job of growing and expanding and making accomodations to prepare you for life with a newborn.

Do you have any aches or pains that you want to get checked out? Book in online here to see one of our Physio's today, or call us (08) 9448 2994.

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