5 Signs You Need to See a Pelvic Floor Physical Therapist During Pregnancy

Many women benefit from seeing a pelvic floor physical therapist during pregnancy. Pregnancy is usually an exciting time for most women. For others, it can also be a time of aches, pains, leaking, and just feeling all around miserable. Speaking from personal and clinical experience, being miserable doesn’t have to be your norm. Thankfully, pelvic floor therapy during pregnancy can be extremely helpful for most of the things that make us uncomfortable in pregnancy. So here are the top 5 signs that you should be seeing a pelvic floor therapist in your pregnancy. 

Pregnancy Back Pain

Pain is a sign that something is not moving well in the body. While transient aches and pains are to be expected (we are stretching and growing a human at a rapid pace after all), we shouldn’t be having back pain that persists for weeks and months. Common reasons that back pain sticks around in pregnant women include: 

• Abdominal muscle weakness

• Glute weakness

• Pelvic floor weakness

• Lack of hip and pelvic mobility

A pelvic floor therapist is the person to see to help you get to the root of your back pain. As movement experts, we can assess each part of the system to get to why your back hurts and how to best support you. 

Hip pain

Hip pain is a very common complaint for moms at my clinic. It often strikes at night and affects a lot of women when they are laying on their side. It will also become apparent when women start doing mobility work in preparation for their births, or they start to notice that they are stiffening up very quickly when they stay in any position for too long. Here are the big reasons why this happens: 

• Pelvic bone widening to accommodate for a growing baby

• Abdominal muscle weakness causing over activity in the hip muscles to keep you stable

• Ligament laxity from pregnancy hormones

While we can’t necessarily fix the fact that your ligaments will become more lax and your bones will shift, we can make sure you are staying strong and mobile so that your entire body is working in harmony, not causing undue strain and pain in the hips. 

Leaking urine

There will come a time in pretty much every woman’s pregnancy that she has a small loss of urine in response to a cough or a sneeze. A one-off incident isn’t a big deal, but when there is a pattern, we need to be taking that seriously. Frequent losses of urine with coughing, sneezing, or even exercising are signs that your body is not handling pressure well during your pregnancy. Here are the top reasons women tend to struggle with managing pressure during pregnancy, causing them to leak:

• Growing baby and less room for all of their organs

• Pelvic bone shifts making it more difficult for the pelvic floor muscles to activate in a timely fashion

• Stretched out abdominals causing compensatory patterns like bearing down instead of proper abdominal bracing

• Altered rib cage posture placing the diaphragm and pelvic floor muscles in poor orientation to one another

We don’t need to just accept this as normal. Pelvic floor therapists are the experts in helping you stay dry, despite the changes that are happening to you in your pregnancy. Seeking out pelvic floor therapy during pregnancy can help you regain control over your bladder so you can move and function confidently in your daily life. 

Pubis symphysis pain

This one is an absolute doozy, and my heart goes out to every woman who has ever experienced pubis symphysis dysfunction (aka SPD). Essentially what this means is that the joint where the two sides of the pelvis come together in the front to make up your pubic bone becomes irritated. The most common reasons I see causing an angry pubis symphysis in my clinic are: 

• Hypermobility that preexisted the hormonal laxity of pregnancy

• Weak glutes

• Overactive inner thigh muscles

• Pelvic bone orientation asymmetries

• Unresolved open birthing patterns from a previous pregnancy

At our clinic, we have a pretty good track record of treating pubis symphysis pain. Most women experience significant relief within their first few sessions when they seek out pelvic floor therapy during their pregnancy. We primarily target the bony position of the pelvis, and then work to strengthen and stabilize the pelvis. We also make sure that if you are really struggling, we discuss birth options to best protect your pubis symphysis during labor and delivery.

Your baby is persistently kicking you in the same spot and it’s causing pain

This isn't an immediately obvious referral to a pelvic floor specialist. At our Waukesha clinic, we do things a little bit differently in that we look at how baby is positioned in the womb. It’s been my experience that if baby is persistently hanging out in the same spot and kicking you in the same spot, this often means they are asking for more room- basically, mom’s body is holding restrictions and tension somewhere. Common restrictions spots are:

• Sacrum

• Round ligaments

• Broad ligaments

• Uterosacral ligaments

• Lower abdominal fascia

• Obliques

• Diaphragm

• Pelvic floor muscles

We spend much of our time in our prenatal sessions addressing restrictions in these areas so that moms go into labor with babies who are  aligned head down and in the middle (not headed off into a hip) and are also free to move, wiggle, and shake as they need to in order to help labor go smoothly. 

If you’ve been struggling with aches and pains during your pregnancy, please hear me when I say this: It doesn't have to be that way. At Foundation PT we support early intervention when you have a problem and are happy to see you proactively to prevent problems too. 

Interested in working with us during pregnancy to address pain, leaking, or prep for labor? Our Waukesha, WI clinic is currently accepting new patients. We'd love to support you on your motherhood journey to help you live pain free, move well, and thrive!

To schedule online visit our page here or give us a call at 262-627-0425.

FAQ

Is pelvic floor therapy safe during pregnancy? 

Yes. Pelvic floor therapy during pregnancy focuses on safe exercises, movement training, and gentle manual therapy designed specifically for pregnant women. 

When should I start pelvic floor therapy during pregnancy?

Many women benefit from starting early in their second trimester, but therapy can be started and helpful at any point during pregnancy.

Do I need pelvic floor therapy if I’m not in pain?

Not necessarily, but many women choose to seek out pelvic floor therapy proactively to prepare their bodies for labor and postpartum recovery. 

Dr. Sabrina Thorpe is a Doctor of Physical Therapy with a decade of clinic experience. She specializes in treating pregnant and postpartum women and their infants at Foundation Physical Therapy in Waukesha, WI.