Physiotherapy in Pregnancy. WHAT ARE THE CHANGES DURING PREGNANCY ?
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Transcript of Physiotherapy in Pregnancy. WHAT ARE THE CHANGES DURING PREGNANCY ?
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Physiotherapy in Pregnancy
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WHAT ARE THE CHANGES DURING PREGNANCY ?
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Changes during pregnancyAnatomical changes
-Stretching abdominal muscles-Decreased in ligamantous strength-Hypermobility of joints -Pelvic floor drops as much 2.5 cm
Physical changes -lordotic posture -COG shifts forward and upwards -Balance – mother walks with wider BOS
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Stages of pregnancy
•Pre natal stage•During labour•Post natal stage
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Problems during pre natal stage
-Faulty posture
-Upper & lower extremity stress
-Varicose vein ,LL oedema
-Urine incontinence & Stress incontinence
-Abdominal muscle stretch & diastasis recti
-Development of musculosketal pathologies-knee pains ,back pains
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How to minimize these complications ???? Posture
Standing -stretch head up and out of shoulders and pull in abdominals -tighten buttocks -lean back against a wall for support if standing prolong time -try to go up & down for several times
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Sleeping-quarter turn from prone ,pillow under the abdomen and between knees
-avoid supine positions-when turning in the bed ,keep knees flex together to decrease the strain
-Turn to a side ,put off the bended leg out of the bed ,put weight on to a one hand and slowly come to the sitting position
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Sitting - Sit back into the chair with well
support - keep the feet well on a stool if
necessary - Do pelvic tilt regularly - Small cushion should be kept back
to maintain slight lumbar curve
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Postures in ADL activities-playing with children kneeling position
-cleaning-ironing -cutting vegetables
Feet apart ,one foot forward possibly on a low stool.
At intervals of this activities it is important to ease the spine by
placing the hands on the iliac crest and easing the spine into
extension.
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Exercises to prevent varicose veins ,oedema and lower limb strain
- Do not hang off the legs for prolong period of time
- Move feet up-down ,in-out and circle
- buregers’ exercises
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Pelvic floor muscle strengthening
* Important in pre & post natal period
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Abdominal strengtheningConcern on rectus abdominis specially
* Prior to abdominal strengthening , pelvic floor muscle strengthening is important
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Important exercises during pre natal stage
Stretching exercises
Legs ,ankle hip adductors ,back , shoulder girdle
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Strengthening exercises
• Abdominal• Back • Pelvic floor
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Relaxation exercises
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Breathing exercises
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Mobilization exercises
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Important exercises during labour
Breathing & relaxation exercises
• 1st stage –relax diaphragmatic breathing with short duration of pains
• 2nd stage –concentrate on expiration.
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Important exercises in Post – natal stage
Normal delivery caesarean section
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Normal delivery
-care of perineum & reliving perineal pain
-Sitting on ring cushion or folded pillow, side sitting during breast feeding
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Advices on posture to prevent back strain with activities related to the baby
Awareness of stress incontinence
Advice on bed mobility, avoid straight sit ups and lifting techniques
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Caesarian section
1st weekBreathing exercisesHuffing with pillow support Ankle & toe exercises Move on bed &getting out of bed
After 1 weekDeep breathingStrengthening exercises – pelvic
floor ,abdominalPelvic tilting
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Pelvic tilting exercises
Crook lying position
Tilt- Relax-Tilt – Relax Exercise
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6 weeks -6 monthsProne kneeling Back humping &hollowing
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Back care and lifting
- avoid transferring weight through one leg for long time
-never stoop ,feet apart ,and the lifting object must be held in close to the body
lifting steps floor chair upright
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Postures during post natal stage
• Breast feeding
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• Carrying the baby
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What not to do in Pregnancy???
• Bilateral SLR.• Unilateral wt. bearing activities.• Driving.• Heavy weight lifting.
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THANK YOU !!!