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Musculoskeletal Disorders in Pregnancy and Postpartum

This Is Samia Farooqi, a Registered Pakistani Physiotherapist. I would be sharing some chunks of useful information through my writing.

Women experience some bodily changes during pregnancy. The changes are hormonal, postural, and physiological in nature. Postural changes are physically observed such as dropped shoulder and stooped posture due to breast enlargement, increase in lumber curve due to weight gain, and wide base of support. Some hormones specific to pregnancy like relaxin are released due to which ligaments that provide support to the joints become lax. Physiological changes include breast enlargement of the breast due to duct system infiltration, breathing difficulties, and an increase in heart rate.

An increase in weight and size of the abdomen increases the load on the spine which causes an increase in lumbar curvature( lumbar lordosis). Flattening of the feet also occurs due to weight gain. In the last trimester, the increased size of the abdomen often causes overstretch on the abdominal muscles causing weakness and muscular displacement ( diastasis recti). Ligaments and muscles of hip and lower limbs are also weakened due to overburdening caused by weight gain. Some neurological disorders like Sciatica and Carpal Tunnel Syndrome (wrist pain) are also common during pregnancy.

Changes during pregnancy

Changes during pregnancy

Among all the disorders, back pain can be the most challenging to cope. Back pain can be constant, dull, or intermittent in nature. It can affect daily living activities like doing house chores. It can also cause sleep disturbances which eventually result in mood disturbances.

Here are some tips to manage and take care of your back pain:

  • Don't lift heavy weight objects
  • Don't try to lean on your back
  • Try to sleep on the right or left side.
  • Use some extra pillows or a pregnancy pillow for an extra comfort
  • When doing dishes or cooking, resting your one leg on the footrest helps ease the strain on your back.
  • Avoid prolonged standing or upright sitting, especially in the Third Trimester.
  • Take adequate amount of rest
  • Keep a check on your weight to avoid putting on extra kilos.
  • Eat healthy food, Avoid junkies, and hydrate enough.

Pelvic Girdle Pain (PGP) in Pregnancy and Postpartum

PGP can be debilitating during and after childbirth. The pain can be sharp in nature involving the lower back and hip. It can also radiate towards the leg. The pain is usually caused by Sacroiliac Joint Dysfunction. Weak pelvic floor muscles and abdominal muscles fail to support the Sacroiliac joint and the ligaments around it which results in dysfunctional movement of the pelvis causing pain.

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Here are the signs and symptoms of PGP:

  • Difficulty in walking
  • Pain in prolonged standing
  • Pain in turning side to side on the bed
  • Pain radiating towards hip and leg

Pelvic Floor Dysfunction

Pregnancy may cause your pelvic muscles to get weak especially if you are a multi-gravida ( given birth to more than one child). Pelvic floor muscles hold in place our pelvic organs like the vagina, uterus, bladder, and rectum. During pregnancy, a continuous strain is being placed on the pelvic girdle and its musculature which can cause the muscle to overstrain. Pelvic floor dysfunction is usually experienced by women after childbirth (postpartum). It can cause urinary incontinence, constipation, and pelvic organ prolapse in worse cases.

Kegel exercises are recommended to strengthen your pelvic floor muscles. these are simple exercises that every woman should do during pregnancy and after childbirth. Here is how to perform Kegel exercises:

  • First, you have to feel your muscles because pelvic muscles are located inside the body( pelvic cavity)
  • The exercises can be done in various positions i.e. sitting, side-lying or standing
  • It's basically a 'hold/relax' exercise
  • In sitting, move your feet apart to create a wide base of support, now squeeze and uplift your vaginal and urethral openings, hold and relax.
  • You can do the same steps while standing or side-lying
  • Side-lying is recommended in the last trimester.
  • You can do a maximum of 10 repetitions at a time.

Seeking Help of a Physiotherapist

If you have any musculoskeletal conditions during pregnancy, your Gynecologist may refer you to a Physiotherapist. Visiting a Physiotherapist can be very helpful. Your doctor may refer you to a specialist according to your condition. They do pain management and advice some exercises to do at home as well.


This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2022 Samia Farooqi

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