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Caring for yourself in pregnancy - physiotherapy advice

physiotherapy; back; pelvis; leg; cramps; exercise; relaxation; abdomen; abdominal;

Contents

Congratulations on your pregnancy! Pregnancy can have a profound and lasting effect on your body, with many women experiencing physical discomfort at differing stages of their pregnancy. The following information will help you prevent and/or manage this discomfort, and provides a method of relaxation you can practice at home.

Back care

Many women experience back and/or pelvic discomfort during their pregnancy. The activities you do in your day, and how safely you do these activities, can have a significant effect on your level of discomfort.

  1. Your pelvis likes symmetry in the child bearing year. Stand with your weight evenly through both legs, back straight, bottom tucked under slightly and your chest proud. Try to avoid climbing up/down ladders, stairs and hills.
    back care - standing position
  2. When sitting down, try to sit up straight with your bottom to the back of the chair. You may need to rest your feet on a foot stool, and use pillows/cushions for support behind your back.
  3. When getting in and out of bed, always roll through your side with knees together. Use your arms to push yourself up or lower your self down as your legs swing off/on the bed.
    back care - getting out of bed
  4. Sleep on your side, with pillows under your belly and between your knees.
    back care - sleep on our side
  5. Avoid heavy lifting during pregnancy. If you must lift, make sure you bend your knees, keep your back straight and brace your pelvic floor and deep tummy muscles. Keep the object you are lifting close to your body. Avoid lifting and twisting movements.
  6. Take care with your housework:
    • Try not to flex your spine e.g. when vacuuming.
    • Take regular rest breaks when you feel that you need to.
    • Work at a height that is comfortable for you – you may need a stool to sit on to wash the dishes, or a laundry trolley to help with the laundry basket.
  7. If you have other young children, try the following tips to help reduce lifting:
    • Allow your toddler to climb into your lap when you are sitting down – you may need a little step to help him/her.
    • Encourage your toddler to climb in/out of the bath, into the pusher or into the car seat, if it is safe to do so.
    • Squat or sit on the floor next to your toddler for cuddles, instead of lifting him/her.

Varicose veins

Varicose veins commonly occur in pregnancy due to the increased weight and pressure on your blood vessels.

  1. Avoid standing still for long periods. Sit down to rest your legs when you can.
  2. Wear support stockings if your legs ache.
  3. Wear flat, supportive shoes.
  4. Rest lying down at least once during the day.
  5. Varicose veins in the pelvic floor area can be uncomfortable:
    • Rest lying down as much as possible.
    • Support from a sanitary pad and well fitting underwear can help.
    • Ice packs or cold compresses may provide comfort.

Pelvic floor exercises may also provide relief.

Leg cramps

Many women experience foot/leg/thigh cramps during pregnancy, especially at night.

  1. Ensure you are drinking adequate fluids. Aim for 1.5–2 litres per day – water is best.
  2. Rest lying down at least once per day.
  3. Gentle exercise and walking can help.
  4. When sitting, bend and stretch your feet often.
  5. Try to stretch your calf muscles daily. Hold each stretch for 20–30 seconds.
    leg cramps - stretch your calf muscles

Key exercises

Every woman should learn and practice these exercises during pregnancy. They are important during pregnancy but are also recommended after birth to aid your postnatal recovery.

Pelvic floor muscle exercises

Your pelvic floor muscles stretch like a trampoline across the floor of the pelvis, running from the coccyx (tailbone) at the back through to the pubic bone at the front, and sideways to the sitting bones.

The pelvic floor muscles play a large part in bladder and bowel control, as well as sexual function. Your pelvic floor muscles also help to provide support and stability around your pelvic joints. These muscles are normally firm and thick.

pelvic floor

Tighten your pelvic floor muscles by squeezing around the birth canal, front and back passages all at once, lifting up and inwards (squeeze and lift). Try to hold each contraction for 2–3 seconds and then release and relax – you should definitely feel the muscles letting go. Repeat (squeeze and lift) and relax, resting for about 5 seconds between each contraction. Repeat this as many times as you can, up to a maximum of 8–10 squeezes. Aim for quality exercises, not quantity!

Abdominal exercises

  1. Pelvic tilt exercises are important for keeping your tummy muscles strong and helping with your posture when you are pregnant and they can also help to reduce low back and/or pelvic discomfort.

    With knees bent and feet flat, gently flatten the curve of your lower back by tilting your pelvis/hips backwards. Hold for 3–5 seconds, if possible. Do this in standing, lying or on a gym ball.
    pelvic floor - tilt exercise
  2. Abdominal bracing uses your deep tummy muscles to help protect your back and pelvis from pain and injury.

    Gently draw your low tummy (belly button and below) in towards your spine – please remember to keep breathing. Do this often during the day and gradually increase the length of hold.
    abdominal bracing

Pelvic floor and abdominal muscle bracing

It is important to use your tummy and pelvic floor muscles to brace and protect your pelvis and back when you are doing activities that may possibly strain the joints.

Whenever you lift/push/pull anything or change position (e.g. roll over in bed, get out of a chair), remember to first tighten your pelvic floor muscles and brace your tummy muscles.

This technique should be continued throughout your life whenever you push/pull or lift anything to protect your pelvic floor and spine from strain.

Relaxation

We all experience stress and tension in our every day lives to differing degrees. Being able to relax and reduce the effects of stress can be of huge benefit to all aspects of your life. Relaxation can also be extremely useful in labour as being relaxed causes your uterus to contract more efficiently, your pain levels are reduced, you will have more energy for labour and you are more likely to be able to enjoy your labour experience.

There are many ways to relax. This is just one method that you might like to try:

  1. Make sure you are comfortable, and your body feels well supported.
  2. Slow your breathing down a little. Breathe in slowly and deeply through your nose, exhale completely through your mouth. Imagine tension flowing out of your body with each outward breath:
    • allow your jaw to soften and your mouth to open slightly
    • let you shoulders drop and feel your neck lengthen
    • keep your fingers open and long
    • notice how your thighs may feel heavy
    • focus on your body tension flowing out through your feet
    • notice how your body relaxes and feels heavy
  3. Continue to focus on your breathing.
  4. You might also like to think of pleasant images in your mind to help you relax. This might be a favourite colour, a past memory, for example:
    • walking in the warm sand with the sound of the waves crashing
    • you may like to think of your baby growing safely inside waiting to be born.
  5. Stay in this position for 5–10 minutes before slowly allowing your mind and body to return to the present. Open your eyes, wriggle your toes/fingers and slowly stand up. You should feel refreshed and revitalised.
  6. Practice this technique often during the day. It can also be useful to practice this before you go to bed at night to help you sleep.
  7. Be aware of tension in your body during the day e.g. jaw clenched, fingers fisted. Learn to release this tension during the day.

Reference

The content of this topic was provided by the Women's Physiotherapy Department at the Woman's and Children's Hospital, South Australia. 
http://www.wch.sa.gov.au/services/az/divisions/wab/physio/index.html

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The information on this site should not be used as an alternative to professional care. If you have a particular problem, see your doctor or midwife.

 

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