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  • Deborah Thomas BPT MCSP MAPPI Chartered Physio

Physiotherapy for Preganancy and the Post-Natal Period

Women’s Health physiotherapy can play a vital role in the prevention and management of the physical discomforts and problems that can arise from the way in which the body adapts and changes during pregnancy and after childbirth.

Pregnancy ‘MOT’

Physiotherapy can help you manage the changes that occur during your pregnancy, give you advice on how to keep fit and treat problems or discomforts that can arise. Altered body shape, hormonal changes & weight increase can place abnormal loading stresses on parts of a woman's body, which can lead to significant discomfort and altered function, with even basic tasks such as sitting and walking.

Common conditions experienced during pregnancy include:

• Low back pain

• Pelvic girdle pain (PGP) (once known as SPD), Sacro-Iliac Joint & hip pain, sciatica

• Pelvic / Coccyx (tail bone) pain

• Upper back, ribcage, thoracic, shoulder, neck pain

• Rectus diastasis (abdominal muscle separation) DRAM

• Incontinence and prolapse, perineal and sexual pain

• Morning sickness

• Wrist and fingers pain and tingling (Carpal Tunnel Syndrome and de Quervain’s)

Physiotherapy for Mothers

Post-Nataly, back and pelvic problems can continue due to the soft tissue and joint changes that have occurred during pregnancy. Postures adopted by new mums can contribute to the incidence of joint and muscular pains following childbirth. Bladder and pelvic floor complaints can persist after. Both Caesarean section and vaginal deliveries can significantly affect the pelvic floor, pelvic and back muscles.

I recommend a Women’s Health physiotherapy Postnatal ‘MOT’ Check before returning to abdominal exercises, high impact class and sports. This is suitable for women who just want a check-up with advice and preventive information as well as for women who have symptoms of pain or other pelvic floor and abdominal problems and would like to discuss treatment options.

Common postnatal-related conditions treated:

• Difficulty to feel and strengthen Abdominals and Pelvic floor muscles

• Diastasis Rectus Abdominus Muscle (DRAM) – rehab & return to exercise

• Return to running or high impact activities advice, rehab and fitness programmes

• Postnatal back, neck, Sacro-Iliac Joint and coccyx pain treatment

• Scar & soft tissue treatment: Caesarean scar, perineal tears, and episiotomy

• Wrist and Hands pain and numbness – Carpal Tunnel Syndrome & De Quervain's tenosynovitis

• Bladder and Bowel problems: incontinence, frequency, pain

• Prolapse or bulging sensation in the vagina or rectum

• Perineal pain, haemorrhoids

• Coccyx pain

• Painful sexual intercourse or decreased sexual sensation

• Preparation for active labour

How can physiotherapy help in both pregnancy & post-natal period?

I will perform a multi-system assessment of your posture, pelvic joint movements, muscles, lumbar spine (lower back) and hips, as necessary. We will look at breathing patterns, pelvic movement and function, abdominal muscles, and digestive function; Gut, bowel and bladder behaviour; I can then explain the reasons for your symptoms and offer a variety of treatment that may help.

These treatments may include:

• A bespoke exercise & rehabilitation programme – all emailed to you

• Manual therapy: joint & soft tissue mobilisation techniques

• Fascia and muscular release techniques

• Scar tissue massage & release

• Pelvic floor rehab & manual therapy

• Bladder drill & retraining

• Taping, strapping and belts if required

• Acupuncture (pregnancy & post-natal)

• Information, education, and advice

• Relaxation & mindfulness

Combining 20 years’ experience in the musculoskeletal (MSK) field, with in depth, specialist knowledge & skills in Women’s Health enables me to address MSK, pelvic, respiratory and continence issues as they arise during and after pregnancy. I am delighted to be able to offer such specialist ante and post-natal services.

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