Physiotherapy in Pregnancy
Jan 14, 2016
Physiotherapy in Pregnancy
WHAT ARE THE CHANGES DURING PREGNANCY ?
Changes during pregnancyAnatomical changes
-Stretching abdominal muscles-Decreased in ligamantous strength-Hypermobility of joints -Pelvic floor drops as much 2.5 cm
Physical changes -lordotic posture -COG shifts forward and upwards -Balance – mother walks with wider BOS
Stages of pregnancy
•Pre natal stage•During labour•Post natal stage
Problems during pre natal stage
-Faulty posture
-Upper & lower extremity stress
-Varicose vein ,LL oedema
-Urine incontinence & Stress incontinence
-Abdominal muscle stretch & diastasis recti
-Development of musculosketal pathologies-knee pains ,back pains
How to minimize these complications ???? Posture
Standing -stretch head up and out of shoulders and pull in abdominals -tighten buttocks -lean back against a wall for support if standing prolong time -try to go up & down for several times
Sleeping-quarter turn from prone ,pillow under the abdomen and between knees
-avoid supine positions-when turning in the bed ,keep knees flex together to decrease the strain
-Turn to a side ,put off the bended leg out of the bed ,put weight on to a one hand and slowly come to the sitting position
Sitting - Sit back into the chair with well
support - keep the feet well on a stool if
necessary - Do pelvic tilt regularly - Small cushion should be kept back
to maintain slight lumbar curve
Postures in ADL activities-playing with children kneeling position
-cleaning-ironing -cutting vegetables
Feet apart ,one foot forward possibly on a low stool.
At intervals of this activities it is important to ease the spine by
placing the hands on the iliac crest and easing the spine into
extension.
Exercises to prevent varicose veins ,oedema and lower limb strain
- Do not hang off the legs for prolong period of time
- Move feet up-down ,in-out and circle
- buregers’ exercises
Pelvic floor muscle strengthening
* Important in pre & post natal period
Abdominal strengtheningConcern on rectus abdominis specially
* Prior to abdominal strengthening , pelvic floor muscle strengthening is important
Important exercises during pre natal stage
Stretching exercises
Legs ,ankle hip adductors ,back , shoulder girdle
Strengthening exercises
• Abdominal• Back • Pelvic floor
Relaxation exercises
Breathing exercises
Mobilization exercises
Important exercises during labour
Breathing & relaxation exercises
• 1st stage –relax diaphragmatic breathing with short duration of pains
• 2nd stage –concentrate on expiration.
Important exercises in Post – natal stage
Normal delivery caesarean section
Normal delivery
-care of perineum & reliving perineal pain
-Sitting on ring cushion or folded pillow, side sitting during breast feeding
Advices on posture to prevent back strain with activities related to the baby
Awareness of stress incontinence
Advice on bed mobility, avoid straight sit ups and lifting techniques
Caesarian section
1st weekBreathing exercisesHuffing with pillow support Ankle & toe exercises Move on bed &getting out of bed
After 1 weekDeep breathingStrengthening exercises – pelvic
floor ,abdominalPelvic tilting
Pelvic tilting exercises
Crook lying position
Tilt- Relax-Tilt – Relax Exercise
6 weeks -6 monthsProne kneeling Back humping &hollowing
Back care and lifting
- avoid transferring weight through one leg for long time
-never stoop ,feet apart ,and the lifting object must be held in close to the body
lifting steps floor chair upright
Postures during post natal stage
• Breast feeding
• Carrying the baby
What not to do in Pregnancy???
• Bilateral SLR.• Unilateral wt. bearing activities.• Driving.• Heavy weight lifting.
THANK YOU !!!