Physiotherapy During Pregnancy

Keeping Active During Pregnancy 

Pelvic Girdle, Hip and Lower Back pain 

Around 1 in 5 pregnant women may experience discomfort in the area around the pelvis and up to 1 in 3 may experience lower back pain. Symptoms can vary from woman to woman.  

If your symptoms are affecting your ability to complete everyday activities or to continue working, please explore the advice and resources listed below. These may help you to manage your symptoms and improve your overall strength and fitness. 

It is important to remember that symptoms can often be improved and managed during pregnancy with advice and exercises. 

However, if your symptoms becoming unmanageable then your midwife, GP or obstetrician can refer you to your local physiotherapist for assessment and further help in managing your pain. You can also self-refer to physiotherapy during pregnancy by completing this form and returning it by post to MSK Physiotherapy Co-ordinator, Physiotherapy Reception, Ground Floor, Borders General Hospital, Melrose, TD6 9BS or dropping it in to your local health centre post-box for forwarding to the same address.  

What can I do to help myself? 

• Read the following booklet on Pelvic Girdle Pain During Pregnancy for lots of practical tips and advice. 

• Practicing relaxation during pregnancy is often an effective way at helping reduce pain. The Mitchell Method of Relaxation is simple to follow. Taking 10 minutes to relax, especially towards the end of the day, can also help reduce tension. 

• Accept help with tasks that may be difficult e.g. caring for older children or certain household chores that are provoking your pain. 

Abdominal Muscle Separation

(Also known as Diastasis Recti, Diastasis Rectus Abdominus Muscles, DRA, or DRAM).  

During pregnancy all the abdominal wall muscles stretch and lengthen to accommodate your growing baby. Diastasis refers to the thinning and widening of the linea alba. Linea alba is the connective tissue down the middle of the abdomen between the two sides of the six-pack muscle (the rectus abdominis muscle). This thinning and widening can appear as a gap or doming or bulging of the tummy. The doming may be more obvious when you do things which put more strain on your abdominal muscles such as sitting up from lying, lifting something heavy, coughing or straining on the toilet. It is completely normal for there to be widening of this gap and all women will have some degree of separation towards the end of pregnancy. This separation very often resolves naturally in the weeks following birth, however, for reasons not fully understood about a third of women will have a degree of separation which is ongoing.  

If you notice abdominal separation during your pregnancy, there are some things you can do to help.  

• As far as it is possible try to reduce activities and exercises which make the doming in the middle of your abdomen more obvious. This may mean reducing heavy lifting and doing alternatives to “sit- ups.” 

• To get out of bed, bend you knees up first then roll onto your side to help minimise the doming shape. This video from colleagues in NHS Fife demonstrates helpful ways of Getting In and Out of Bed 

• Try to prevent constipation and /or straining on the toilet. Be sure to drink plenty of water and increase fibre intake. Do speak to your midwife or GP for advice if you are struggling with constipation. 

• Practise relaxed breathing exercises to help reduce abdominal tension. 

If you would like more information or notice the separation is ongoing after delivery you may benefit from a course of rehabilitation. You can discuss this with your midwife, health visitor, GP or may self-refer to physiotherapy. 

Leaking urine during pregnancy affects around 40% of women during pregnancy. Women often report leaking urine with coughing or sneezing or sometimes when vomiting.  

Pelvic floor muscles support the bladder, uterus (your womb) and the bowel. They help close the urethra (where you pass urine from) to help prevent urine leaking. They allow urine to pass when you want to. 

As your baby grows there is more pressure and stretch on your pelvic floor muscles. This can make it more difficult for these muscles to work. 

Whilst leaking urine can be distressing, there are lots of thing you can do to help. 

What can I do to help prevent this? 

• Start practising pelvic floor exercises regularly as soon as you know that you are pregnant. This can help prevent urinary leakage but also help improve symptoms. 

• Explore the Squeezy App for more hints and tips on how to exercise these muscles and how to stay in the habit of doing them regularly. 

• Try to prevent constipation as this can cause added strain on the pelvic floor muscles. 

• Speak to you midwife if you are experiencing urinary leakage. It may be appropriate to refer you to a specialist physiotherapist at the Bladder, Bowel and Pelvic Floor Service for further assessment and advice. 

Carpal Tunnel Syndrome During Pregnancy 

Carpal tunnel syndrome is a common problem in pregnancy and affects the wrists and hands. It occurs in approximately 60% of pregnant women.  

For more information and help in managing your symptoms please read our Carpal Tunnel Syndrome Leaflet.

Sometimes it may be beneficial to try using wrist splints at night to help manage your symptoms. Please speak to your midwife so that you can be referred to physiotherapy for provision of these. Some local health centres provide these too. 

Rib Pain During Pregnancy 

Some women experience discomfort in the lower ribs. It is caused by your growing baby pushing your ribs away from their normal position. It usually resolves once your baby is born. 

What can I do to help? 

• Try to change position often. 

• Avoid sitting on low chairs and in other positions which bring your ribs close to your pelvis.  

• You may find temporary relief by lifting your arm on the affected side and bending sideways away from the ache.