Category Archives: Women’s Health

PT News PTandMe

PT News May 2018

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PT News PTandMe

This Month in PT News. Featuring articles from PTandMe partnering clinics!

 

2. Hands-on physical therapy effective for common shoulder conditions
Written by the Therapy Team at Rehab Associates of Central Virginia 

Shoulder problems are one of the more common issues that affect the musculoskeletal system, as its prevalence in the general population has been reported as high as 4.8%.  Read more

3. What to expect on your first visit with a pelvic Physical Therapist
Written by the Therapy Team at Ability Rehabilitation – Central Florida

You may be wondering how this will help with your concerns and symptoms. You may be wondering “how does this work”. What will happen during the first visit and follow up treatments? Read more

Lymphedema

What are the Signs and Symptoms of Lymphedema?

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Lymphedema

Lymphedema can occur in any body part. Some common early symptoms include:

  • Tightness, swelling or thickening anywhere in the extremity. Initially the swelling may fluctuate but over timeit worsens.
  • A burning sensation or tingling sensation radiating down the extremity.
  • Complaints of heaviness or aching of the extremity.
  • Inability to wear rings, jewelry, watches or clothing secondary to edema.

STAGE 1 – Reversible Lymphedema

  • Lymphedema disappears with bed rest and/or elevation especially over night.
  • Edema is soft and pitting, no resistance is felt. Indentations are easily made.
  • No or little fibrosis. No alteration of tissues.

STAGE 2 – Irreversible Edema

  • Protein enriched edema which does not decrease with elevation/nights rest.
  • Connective and scar tissue formation (i.e. fibrosis). Fibrosclerotic changes.
  • Non pitting edema, strong pressure is able to produce pitting.
  • Edema becomes hard. Indentions are difficult to make.

lymphedema

Precautions and Guidelines

  • Maintain a well balanced diet, with low sodium intake. Keep a healthy weight, avoid obesity. Good nutritional guidelines are provided by the American Heart Association and the American Cancer Society.
  • Keep the affected arm or leg, clean, and well moisturized. Lotion should be at a relatively low pH balance. The goal is to prevent skin breakdown.
  • Use antibacterial and hypo-allergenic soap when washing.
  • Avoid injections, vaccinations, flu shots, blood draws and IV lines in the affected extremity. Remember, if this is an emergency, it is more important to treat the patient than to worry about putting an IV in the affected arm.
  • If at all possible, avoid having blood pressure taken in the affected arm.
  • Many people enjoy having a manicure. There is always a risk with this but you can decrease your risk by keeping your cuticles moist with lotion and push them back instead of cutting them. You could also consider buying your own manicure set and have the salon use only your tools.
  • When cleaning the house, wear a good quality rubber glove when handling harsh chemicals such as ammonia, bleach, furniture polish, abrasive cleansers etc.
  • Avoid using a razor or depilatory creams for the armpit or leg hair. The safest tool would be an electric razor.
  • When cooking, wear long protective mitts (to the elbow) when taking food out of the oven and when boiling a pot of hot water.
  • It is important to avoid pet scratches, insect bites, spider bites etc. Using an insect repellent may be necessary but remember some brands are very harsh. Look for a natural insect repellent if possible.
  • Avoid sunburn at all cost! Especially if you have received radiation therapy.
  • Be aware of items that can cause a burn such as a curling iron, an iron, space heaters etc.
  • Avoid saunas, hot tubs, and hot showers. Avoid extreme temperatures, very cold or very hot.
  • Avoid lifting or moving heavy objects.
  • Avoid tight fitting clothing or jewelry.
  • Exercise, and be knowledgeable of how exercise effects the lymphedema.
  • Check your skin daily, and call your physician immediately if you notice any adverse changes in your lymphedematous body part or if you have fever and redness.

 

Additional Precautions for Leg Lymphedema

  • Proper shoe wear is essential in avoiding blisters and ingrown toenails, avoid high-heeled shoes.
  • Do not walk bare foot, especially outside.
  • Get all fungal infections treated immediately.
  • Do not receive injections to remove varicose veins in the affected leg.

This information is for educational purposes only. This information should not be used without consultation with your healthcare professional. If you have questions regarding the material or its application, seek professional assistance from your provider. This information is not intended to diagnose any medical condition or to replace healthcare professional consultation.

 

breast cancer physical therapy

Breast Cancer Awareness Month 2017

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October is Breast Cancer Awareness Month. There were 1.7 million new cases of breast cancer diagnosed in 2012 worldwide. In honor of Breast Cancer Awareness Month, we are providing this helpful information, facts and statistics about breast cancer.

What is breast cancer?
Breast cancer occurs when cells in the breast divide and grow without their normal control. Tumors in the breast tend to grow slowly. By the time a lump is large enough to feel, it may have been growing for as long as 10 years. (Some tumors are aggressive and grow much faster.) Between 50-75 percent of breast cancers begin in the milk ducts, about 10-15 percent begin in the lobules and a few begin in other breast tissues [4].

Learn more about breast anatomy.

Non-invasive breast cancer – ductal carcinoma in situ (DCIS)
Ductal carcinoma in situ (DCIS) occurs when abnormal cells grow inside the milk ducts, but have not spread to nearby tissue or beyond. The term “in situ” means “in place.” With DCIS, the abnormal cells are still inside the ducts. DCIS is a non-invasive breast cancer. You may also hear the terms “pre-invasive” or “pre-cancerous” to describe DCIS. Although DCIS is non-invasive, without treatment, it can develop into invasive breast cancer.

Learn more about DCIS and the risk of invasive breast cancer.

Learn about treatment for DCIS.

Did you know?
In 2017, it’s estimated that among U.S. women there will be*:

  • 252,710 new cases of invasive breast cancer
  • 40,610 breast cancer deaths
  • 50,000 cases of ductal carcinoma in situ, a non-invasive breast cancer

There are more than 3.1 million breast cancer survivors in the U.S. today. Thanks in part to Susan G. Komen’s investment in research in early detection and treatment, breast cancer mortality (death) in women in the U.S. declined by 38 percent from 1989-2014 [1].

*American Cancer Society. Cancer Facts and Figures 2017. Atlanta, GA: American Cancer Society, 2017.

Content provided by Susan G. Komen. For more information visit the Susan G. Komen website by clicking here.

SI pain physical therapy

Women’s Health: The Sacroilial (SI) Joint and How It Affects You

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It has been estimated that about 95% of the population will experience low back pain at some point during a lifetime. Low back pain may be due to many different causes and anatomical structures, one such structure is the SI joint. Here is some pertinent information about the SI joint and how it may affect your general health.

8 FUN FACTS:

What is the SI joint?
It is a joint connecting the sacrum and the ilium, 2 bones included in the pelvis. The pelvis connects the upper body to the lower body, more specifically the spine to the hips.

What does the SI joint do?
It helps to stabilize your core during functional and work activities and helps with shock absorption during weight-bearing activities including walking. Stability is also assisted by the ligaments, fascia, and muscles that attach to the joint. This includes back, gluteal, hip, and pelvic floor musculature.

Who feels SI pain?
People with leg length discrepancies, asymmetrical lower extremity weakness, scoliosis, pregnant women due to increased ligamentous laxity, women > men due to pelvic anatomy, and those who have experienced a traumatic event such as a fall or a motor vehicle accident or that perform repetitive activities with poor body mechanics including lifting and bending.

Where would you feel SI pain?
Directly over the SI joint, in the buttock, lateral or posterior thigh, or sometimes in the groin.

When may you feel SI pain?
Rolling in bed, rotating your trunk, walking, stair ascent or descent, standing from a sitting position, single leg activities

What positions/activities should be adopted?
Sleep with a pillow between your lower extremities, perform slow, controlled movements, maintain equal weight-bearing through lower extremities with transitional movements and standing, log roll during bed mobility to keep lower extremities symmetrical, swing lower extremities out of the car before standing up to prevent trunk rotation.

How can PT help?
Physical therapy has been found to help patients with SI pain get pain relief, reduce inflammation and muscle spasms, improve healing, muscle extensibility, joint mobility and range of motion, strength, muscle control, and gait mechanics.

What does PT treatment for SI pain involve?

Stretching, mobilization techniques, education on proper body mechanics with functional activities, massage, myofascial release, modalities including electrical stimulation for pain modulation and ultrasound to assist with healing and inflammation, muscle energy techniques, and a core stabilization and strengthening exercise program, tailored to the individual patient. If a leg length discrepancy is found, a heel lift may be helpful to restore abnormal forces being placed through the SI joint with weight-bearing activities. An initiation of a home exercise program is also an integral part of physical therapy treatment.

Baby Mechanics

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Proper lifting mechanics is important for everyone, especially for a new mom. Caring for a young child/infant significantly increases the strain to one’s low back. Luckily, there are steps that one can make to decrease that strain and reduce the risk of injury.

Always remember to: lift the child/infant close to you and bend through your legs versus your back.

As your baby begins to gain more independence and mobility, lower the height of his mattress to keep him safe. Be aware that the lower mattress height can increase strain on your back, so lower the mattress height as gradually as possible. When lifting your baby in or out of the crib, keep baby as close to your body as possible while keeping your back straight and bending through your legs. For older babies, help him get into a sitting position before lifting him out of the crib. Once baby can stand, lift him out of the crib from a standing position.

Just like lifting baby out of the crib, keep her as close to you as possible, bend through your legs and keep your back straight. Keep your abdominal muscles tight as you lift her up. If possible, get into a deep squat position to lower your center of gravity before picking up baby.

Avoid the “hip shift” position with baby propped on one hip while shifting your body to that side. Instead hold baby in front of you with his legs out on either side of you. If you are going to be holding baby for an extended period of time, use a baby carrier to keep your baby supported in a neutral alignment.

Tummy time isn’t just good for babies! During tummy time, get down on your stomach too. Stretching out on your stomach is good for you, and it also allows you to better interact with your baby.

During story time, be aware of your posture and always sit up straight. Place a pillow behind your back for extra support.

Use a nursing pillow under baby to help prop her up closer to you. Bring baby to you instead of leaning forward towards her to avoid strain. Placing a pillow behind your back can provide extra support and help you maintain the proper posture. If you are bottle feeding or for older babies, place a pillow under the arm that is supporting baby’s head to decrease the strain on your shoulder and neck. Although making eye contact with baby during a feeding can help strengthen your relationship with baby, it can cause strain on your neck. Be sure to bring your head to a neutral position throughout the feeding to decrease the tension on your neck.

baby car seat

When lifting a car seat, be sure to keep the car seat as close to your body as possible. Bend through your legs and keep your abdominal muscles tight as you pick up the car seat. Instead of carrying the car seat in one hand at your side, use both hands to hold and carry the car seat in front of you whenever possible.

Getting the car seat in and out of the car can be tricky. Remember to keep the car seat as close to your body as possible, keep your abdominal muscles tight and your back straight. If your car seat is placed in the middle position in your car, put one leg up into the car to protect your back while keeping the car seat close to your body.

This information was written by Metro Spine & Sports Rehabilitation, an outpatient physical therapy group with locations in the Chicago Loop and Lakeview areas. At Metro Spine & Sports Rehabilitation, their number one priority is the patient. For more information click here.

women's health

The Benefits of Physical Therapy for Women’s Health

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Women’s health can cover a multitude of subjects, from pregnancy to aging – the female body undergoes many changes. Physical therapist’s most common women’s health clients come in experiencing incontinence, osteoporosis and pregnancy related back pain.

URINARY INCONTINENCE
Urinary incontinence is a loss of bladder control that results in leakage when the muscles of the pelvic floor are weak or overactive. Causes include child birth, hormonal changes, surgical trauma, pelvic fractures, chronic cough, obesity, muscle weakness or even repetitive lifting. Physical therapy can help decrease or resolve urinary leakage, identify bladder irritants and strengthen pelvic floor muscles through an individualized exercise program.

OSTEOPOROSIS
Keeping the bones strong as you age, especially after menopause, is a challenge many women face. An excessive decline in bone mass is called osteoporosis, and it is a leading health care concern for women. A physical therapy program can help improve your posture and strength, prevent falls, and decrease your risk for fractures.

A physical therapist that specializes in women’s health treating pelvic floor dysfunction can help as well.

older_woman

PELVIC FLOOR DYSFUNCTION 
Exhibits Several Symptoms: 

Urinary Incontinence
Fecal Incontinence
Constipation
Diarrhea
Pelvic Floor Pain

PREGNANCY RELATED BACK PAIN
Many women experience low back pain during pregnancy. This is due to several factors such as:

Hormonal Changes – this causes increased looseness of the pelvic ligaments to prepare your body for birthing your baby.
Increased Weight Gain – This places increased stress on all the joints of the body. Increased breast weight can overload
the neck and upper back.
Postural Changes – Body weight shifts forward as the baby grows and this increases the arch in the lower back. Stomach
muscles and the lower pelvic muscles become weaker which decreases support for the lower back.
Altered Movement Patterns – Due to your changing body, women often begin to move in different patterns that can increase stress to the low back or pelvic joints.

This information was written by Advance Rehabilitation Physical Therapy, an outpatient physical therapy group with 24 locations in Georgia and Florida. Advance Rehabilitation is a physical therapy practice that focuses on providing the highest quality rehabilitation services. We specialize in physical therapy, sports medicine, industrial rehabilitation and athletic training. Our staff includes highly-trained professionals that serve as a bridge between injury and recovery to help patients get back to pre-injury status as quickly as possible. For more information click here.

bladder control during pregnancy

Bladder Control During Pregnancy

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Aside from a growing belly, you may notice other changes in your body now that you are pregnant. One thing you may notice is the loss of urine when you are not trying to urinate. Loss of bladder control, also called incontinence, is common during pregnancy and after childbirth. Needing to run to the bathroom often or leaking urine can make you feel embarrassed. Do not feel shy about asking for physical therapy for incontinence. They can help you understand and manage bladder control, and make sure there are not other conditions causing your incontinence. Here is some information to help you learn more.

HOW DOES THE BLADDER WORK?
Urine is stored in your bladder, which is an organ located in the pelvis. The muscles of the pelvis help keep your bladder in place. When you urinate, urine travels from your bladder and out of your body through a tube called the urethra. Ring-like muscles (sphincter muscles) keep the urethra closed so urine does not pass until you are ready to urinate. Muscles at the end of the urethra (sphincter muscles) and in the pelvic floor also help to hold back urine.

HOW CAN BEING PREGNANT CAUSE BLADDER CONTROL PROBLEMS?
The weight of a baby in your belly and the act of giving birth will put pressure on your bladder and may cause your pelvic muscles to stretch and weaken. This causes your bladder to sag, and your urethra to stretch. Nerves can also be damaged. It is this damage to muscles and nerves that can cause bladder control problems to persist.

pregnant woman

HOW CAN I CONTROL MY BLADDER?
The good news is that incontinence may go away once your pelvic muscles heal, usually 6 weeks or so after giving birth. But you can take steps after childbirth to minimize bladder control problems by doing exercises to strengthen your pelvic floor muscles. Kegel exercises are one type of pelvic floor muscle exercise.

Kegel exercises do not require equipment and can be done anywhere—while sitting at your desk, standing in line at the bank, or even lying down in bed. They are done by squeezing your sphincter muscles in the same way you would when stopping urine flow. After 6-8 weeks of doing the exercises, you may find that you have fewer leaks.

Talk to your doctor to learn more about how to correctly do Kegel exercises. Following pregnancy, if Kegel exercises do not control the incontinence, your doctor may discuss other treatments or refer you to a specialist who can help.

Here are some general steps for doing Kegel exercises from the American Pregnancy Association:

• Squeeze your pelvic floor muscles as if you were trying to stop the flow of urine. Do not squeeze the muscles in your belly, legs, or buttocks.
• Hold for 5-10 seconds, then relax.
• Repeat 10-20 times.
• Try to do at least 3 sets per day.

If incontinence is still bothersome, talk to your doctor about other options, such as wearing absorbent pads or briefs. With support from your healthcare team, you will be able to manage incontinence, as well as other bodily changes that come with pregnancy.

by Marjorie Montemayor-Quellenberg, MA

RESOURCES:
American Congress of Obstetricians and Gynecologists
http://www.acog.org

Office on Women’s Health
http://www.womenshealth.gov

CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca

Women’s Health Matters
http://www.womenshealthmatters.ca

REFERENCES:
Kegel exercises. American Pregnancy Association website. Available at: http://americanpregnancy.org/labor-and-birth/kegel-exercises. Updated Aug. 2015. Accessed Feb. 10, 2016.

Treatments of common complaints in pregnant women. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 1, 2016. Accessed February 10, 2016.

Urinary incontinence fact sheet. Office on Women’s Health website. Available at: http://www.womenshealth.gov/publications/our-publications/fact-sheet/urinary-incontinence.html. Updated July 16, 2012. Accessed February 10, 2016.

Urinary incontinence in women. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 9, 2015. Accessed February 10, 2016.

What I need to know about bladder control for women. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/health-information/health-topics/urologic-disease/urinary-incontinence-women/Pages/ez.aspx. Updated June 2012. Accessed February 10, 2016.

3/5/2013 DynaMed’s Systematic Literature Surveillance: http://www.ebscohost.com/dynamed: Boyle R, Hay-Smith EJ, Cody JD, et al. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2012;10:CD007471.

Last reviewed February 2016 by Michael Woods, MD Last Updated: 2/10/2016

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

aquatic therapy

Is Aquatic Therapy For You?

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Aquatic therapy offers an alternative environment for therapeutic exercise. If you have tried traditional physical therapy, or have restrictions on your physical therapy program, aquatic Therapy may be the perfect solution for your physical therapy needs.

Why Aquatic Therapy is Beneficial

Less pressure: The buoyancy of the water decreases the amount of pressure, or compressive forces, on your joints and spine. When you’re immersed in water up to your neck, the weight pressing down on your body is reduced by 90%. When the water is up to your waist, the pressure is reduced by 50%.

Reduced swelling: The pressure of the water helps to move fluid from the injured area back into the body. Decreased swelling is essential for regaining the strength and motion needed for recovery.

Ease of movement:
Water is an element that supports and assists movement. It offers a safe setting for regaining strength and joint range of motion.

Faster progress: Aerobic conditioning can often be performed in the water, even when it may be too soon or too difficult to do in the clinic. Staying stable in the water, challenges your core and balance. Plus, sports specific activity can begin earlier than on land.

old man swimming

Who Can Benefit From Aquatic Therapy

• Chronic pain patients requiring a more gentle form of therapy
• Patients at risk of falls due to balance and gait disorders
• Patients with severe arthritis or other weight-bearing restrictions
• Prenatal and postnatal patients
• Patients with general deconditioning
• Sports medicine and orthopedic patients requiring an accelerated component to their rehab protocol

This information was written by Life Fitness Physical Therapy, a privately-owned, outpatient physical therapy practice operating 14 clinics in the metro and surrounding Baltimore, Maryland area. Life Fitness Physical Therapy was founded in 2000 based on the core values of providing the highest level of customer service and clinical excellence in outpatient physical therapy. For more information click here.

physical therapy during pregnancy

Physical Therapy for the Pregnant and Postpartum Woman

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If you are encountering problems during your pregnancy, don’t stress. Many women are able to find pain relief by going to physical therapy during pregnancy. A licensed physical therapist, specifically trained in women’s health, can evaluate and address the physical issues affecting you. Some of the techniques a PT would use in alleviating these discomforts are postural awareness/education, individualized stretching and strengthening programs, soft tissue mobilization/myofascial release (types of massage), breathing exercises, bladder education and pelvic floor strengthening. A PT can also assist you in implementing an exercise regimen that is safe and easy to take part in no matter what your level of fitness. All of this is performed in concurrence with your OB/GYN’s care.

Musculoskeletal complaints of the Pregnant Woman:
• Postural stresses (accentuated lordosis)
• Pelvic girdle instability pain
• Back pain or SI joint dysfunction
• Round ligament pain
• Nerve entrapment syndromes: carpal tunnel, tarsal tunnel, thoracic outlet syndromes
• Neck pain
• Foot or Ankle pain (especially overuse of the gastrocnemius muscles due to COG shifted anterior)
• Tendinitis: lateral epicondylitis and trochanteric bursitis
• Circulatory problems:
• Lower leg cramps
• Edema in lower extremities
• Groin / coccyx pain
• Urinary complaints (due to reduced bladder capacity as the fetus pushes on the bladder ): stress or urge incontinence

Musculoskeletal complaints of Postpartum Woman (effects of hormonal laxity):
• Diastasis Recti
• Symphysis pubis separation
• C-section scar or episiotomy scar adhesions/pain
• Pelvic floor Dysfunction: pain with sexual activity
• Postural stresses: nursing, holding and carrying baby
• Low back pain or SI joint dysfunction
• Urinary complaints (due to weakness of the pelvic floor muscles / trauma during labor and delivery)
• Stress Incontinence
• Urge incontinence

baby

EXERCISE CONSIDERATIONS:
Goals and benefits of exercise for the Pregnant Woman:
• Promotes good posture
• Increases or maintenance of aerobic fitness
• Improves muscle tone
• Improves sleep
• Prevents low back pain
• Reduces risk of gestational diabetes
• Improves physiological and psychological health
• Prepares mom for labor and delivery

Goals and benefits of exercise for the Postpartum Woman:
• Faster recovery from labor and delivery
• Increases endurance for taking care of self and baby

Make the right choice today. Ask your doctor how physical therapy can help you!

This information about physical therapy during pregnancy was written by by Rachna Mehta, PT, DPT, CIMT – Hamilton Physical Therapy Services, L.P. in Hamilton, NJ. Hamilton Physical Therapy Services is a well established provider of rehabilitation services in Mercer County since 1978. They take pride in offering personal and compassionate care with a patient-centered approach helping transform lives, one life at a time. For more information click here.

low back pain in pregnancy

Low Back Pain in Pregnancy?

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low back pain in pregnancy

Pregnancy and new motherhood should be times of joy and promise – not pain. Fortunately, times have changed, you don’t have to live with pain or other problems related to pregnancy or delivery.  That’s because physical therapy has changed too. It is no longer solely for joint problems; it’s also a safe, proven and widely prescribed treatment for pregnant women and new mothers.

Physical Therapy can help you manage your low back pain in pregnancy safely!
Many women experience low back pain during pregnancy. This is due to several factors such as:

  • Hormonal Changes – this causes increased looseness of the pelvic ligaments to prepare your body for birthing your baby.
  • Increased Weight Gain – This places increased stress on all the joints of the body. Increased breast weight can overload the neck and upper back.
  • Postural Changes – Body weight shifts forward as the baby grows and this increases the arch in the lower back. Stomach muscles and the lower pelvic muscles become weaker which decreases support for the lower back.
  • Altered Movement Patterns – Due to your changing body, women often begin to move in different patterns that can increase stress to the low back or pelvic joints.

A physical therapy evaluation will include an assessment of:

  • Pelvic/Sacro-iliac joints
  • Abdominal Musculature
  • Spinal Alignment
  • Strength/Flexibility
  • Posture
  • Body Mechanics

Treatment objectives are to:

  • Reduce Pain
  • Promote improved posture
  • Education re: safe movement patterns
  • Teach proper exercises for strengthening and flexibility and guidance toward cardiovascular fitness

The physical therapist may also plan a specialized exercise program for a pregnant or postpartum patient.
The goals and benefits of exercise for pregnant women include:

  • Promotes good posture
  • Increases or maintains aerobic fitness
  • Improves muscle tone
  • Improves sleep
  • Prevents low back pain
  • Reduces the risk of gestational diabetes
  • Improved physiological and psychological health
  • Prepares mom for labor and delivery

The goals of an exercise program for new moms (postpartum patients) are.

  • Faster recovery from labor and delivery
  • Increased endurance for taking care of self and baby

If you are experiencing low back pain in pregnancy please check out our Find A PT Page to find a women’s health specialist in your area.