Bump Watch: Physiotherapy in Pregnancy

As I approach my 33rd week of pregnancy (eek!) I am starting to have a lot of aches and pains. I suffer with back twinges anyway but added to that I now have quite a concerning pain between my legs, particularly at the end of the day. I think this could be an early symptom of SPD but I am not at all sure. Jo Hellier, Physiotherapist at The West Bay Club on the Isle of Wight thinks that these pains could be warning signs that I need to start to slow down a little bit and find ways to get through a normal day with Esther and William without too much lifting and to ensure that any lifting I am doing is done correctly. Safely.

During our recent Antenatal and Parenting Weekend with expert midwife Nikki Khan we also met Jo, a wonderful physiotherapist who advised us on exercises that we could and should be doing throughout our pregnancy to prevent any pain and injury from the extra baby weight and the change in our centre of gravity, amongst other important things.

Jo Hellier is one of the nicest ladies I have ever met with one of the most soothing voices. She is also incredibly knowledgeable and personable. She made me feel completely at my ease as she told me that I am basically in rubbish shape and need to do some exercise!

Jo was with us throughout the weekend workshops and then on Sunday morning she led a specialised physio session which taught us all so much.

Jo, a chartered physiotherapist and acupuncturist, began by telling us that though pain in pregnancy is quite common there are things you can do to ease it and more importantly to prevent it.

During pregnancy our back and pelvis are particularly vulnerable, our circulation also suffers. This is one of the main reasons that posture and positioning are so important, and remembering not to cross our legs!

Jo showed us the best way to position ourselves when sitting on a chair and also when standing.

Sitting
When sitting on a chair your bottom should be to the back of the chair. You can use a rolled up towel in the small of your back for extra support and to help keep you upright. You should not cross your legs!
To help your posture and to develop strenght in your core muscles it is good to sit on a birthing ball throughout pregnancy and particularly in the latter stages as it encourages good posture. Poor posture can lead to Baby being in the back to back position which can lead to a longer and more painful labour. The lovely people at The Miracle Box are sending me a birthing ball to review along with some of the exercises that Jo Hellier taught us on the Isle of Wight. I can’t wait to share them with you through photos and video. Watch this space!

Standing
When standing your weight should be spread equally between the legs. You should hold your tummy in as though you are trying to make yourself look a couple of months less pregnant. Your shoulders should be down and back.

When changing nappies it is best to do so on a cot top changer or at least on a higher level surface to protect your back and pelvis.

Hormonal changes during pregnancy soften ligaments and the joints become less stable; the resultant increase in movement couldlead to aches and pains in the back and pelvis. As a result of the increasing weight of your baby and a change in your centre of gravity, your posture may also change, which may place further strain on your back.

As well as nappy changing consider your position when performing other daily tasks such as ironing, working on a computer, carrying shopping and getting in and out of bed.

Thanks to Jo I now have a safer way of getting in and out of bed that should minimise any damage to my stomach muscles during the remainder of my pregnancy.

Getting Out of Bed
To get out of bed safely, roll onto your side with your legs together and then push up with your arms to a sitting position.

Your tummy muscles will stretch naturally as your baby grows. As they stretch they become weaker. It is important to use these muscles correctly to maintain their strength, to provide support for your back and your baby, and to encourage good posture.

Your body has its own natural ‘support’ tummy muscle which acts like a corset to support your growing baby.

It is important to locate this muscle and strengthen it every day through exercises. This can be done perfectly in combination with working your pelvic floor!

Pelvic floor muscles enable you to control your bladder and your bowel. They can also enhance sexual satisfaction when they are in good shape. Vitally your pelvic floor holds all your organs in place. There are whole books written for women about the importance of exercising their pelvic floor muscles. The discovery of these muscles and the rewards for training them have been life changing for so many women. You ignore your pelvic floor at your peril!

The main problem for pelvic floor muscles is not giving birth but pregnancy so even if you know that you will be having a section you will need to workout your pelvic floor.

If you are already having control problems during pregnancy this is a good indicator that you will have incontinency problems during the menopause unless you do some work. If you are concerned about control problems then you should see your GP who can refer you to a specialist pregnancy physiotherapist for advice and support.

There is really good evidence that exercise prevents further, future problems and also that exercise can heal pelvic floor damage from previous pregnancies. That is good to know!

It is good to exercise your pelvic floor muscles throughout pregnancy to prepare your body for recovery after the birth.

During our session with Jo as part of the antenatal weekend I discovered that my deep abdominal muscles and my pelvic floor are weak and I have been gvien some specific exercises to do. These I will share with you later as part of my birth ball review.

For now if you would like to begin exercising your pelvic floor then you can find some simple exercises to try here.

Pelvic floor exercises can be done in any position and at any time. It is so so important to do and it truly has changed women’s lives.

Throughout our physio session Jo showed us a range of ways to use a birthing ball which I am going to share with you as part of my Miracle Box Review. For me it was a challenge just to sit on the ball so I am looking forward to it arriving and really starting to develop my strength in preparation for birth using the techniques that I have learned from Jo.

As well as covering exercise Jo also taught us about relaxation and how important making some time to rest your body is during pregnancy.

Jo shared with us The Mitchell Method of Simple Relaxation which really worked for me. I am not into yoga really, it is just not for me, but this simple relaxation technique I really enjoyed and importantly I found that for me it worked. I felt completely at peace and relaxed.

Stress can cause growth retardation in your baby so no matter how busy you are you need to make time each day for you, time to relax both your body and your mind and really connect with your growing baby.

This simple Mitchell Method I believe would be the perfect place to start.

I cannot thank Jo Hellier enough for the time that she spent with us this weekend. She had taken the time to get to know each of our stories and was familiar with our pregancy histories. She knew what we had struggled with before and had come prepared to address our individual needs. Jo was wonderful and I hope that we will stay in touch.

Jo works at The West Bay Club on the Isle of Wight.

Photos to follow

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