Physiotherapy in the Child Bearing Year and Beyond – the final count down, third trimester.

Tamara MatulickPhysiotherapy, Pregnancy

Tamara Pregnant

I wrote a blog late last year about the top 3 things I’d learnt so far during my first child-bearing year. I’m now 37 weeks (baby is fully cooked!) and I’d thought I’d update you on how things are going and share even more information that I have learnt on this journey so far.  

1. Managing pelvic pain

In my last update, my pelvic pain had improved considerably, after finishing the netball season and having a couple of treatments with a Women’s Health Specialist Physiotherapist. I had some wonderful days when my pelvis felt more stable and aligned than it has at any time during the pregnancy. However, overall, the front of the pelvis (pubic symphysis) has continued to be troublesome. If I do too much in the day it aches at night, an indication of an inflammatory response to the activity of the day. Never fear, I’ve found even more helpful things to try for the stubborn, and often hard to treat, pubic symphysis pain. I continue to modify activities that I know stir it up (squatting, standing on one leg etc.), wearing an SIJ belt for walking and standing during the day and a scarf tied just below my pelvis at night. Using a hot water bottle at night and massage for tight muscles has been bliss! Unexpectedly, I also found relief with exercises and stretches suggested in the ‘Spinning Babies’ program and acupuncture. Nothing has provided a cure but understanding that my body is doing it’s best to accommodate a fast-growing little human gives me hope that the pelvic pain should change in the fourth trimester.

2. How to get and stay physically active during pregnancy

I am still thoroughly enjoying swimming two times a week and pregnancy yoga once a week. I am chuffed to report that I can swim up to 16-30 laps of the pool, whereas when I first returned to swimming at the end of my first trimester I was stuffed after 8 laps and had to get out! The Christmas break meant yoga (like Pilates) wasn’t on and I missed my regular routine. I have tried to pick-up more yoga and Pilates at home, but like a lot of people, I get distracted by other priorities at home! I haven’t been as good at walking as I’d like to be, partly due to the pelvic pain, however I have discovered the flat tracks at Mt Barker’s Laratinga Wetlands to be great to explore at a slow pace and I even consider walking up and down the isles at the supermarket with a trolley on a hot day to be part of my step count! I can’t wait to be able to return to some of the activities I’ve put on hold but I’m not in a rush either, I’ll give myself up to three months of recovery time after birth to ease back into things – despite my husband already talking about entering our unborn child into a fun run.

3. Pelvic floor

In this regard things are travelling okay. There are two main types of urinary incontinence – urge and stress. Urge is when there is a sudden uncontrollable need to wee (e.g. when putting the key in to unlock the door at home) and stress is loss of bladder control when there is an increase in abdominal pressure (e.g. sneezing or jumping). I have now experienced both – thanks body and baby! Interestingly, I’d say my urgency has improved with pelvic floor relaxation techniques suggested by the Women’s Health Specialist Physiotherapist. The theory being that an overactive pelvic floor that never completely rests is not necessarily weak but does fatigues meaning it can’t be as strong when we need it to be strong (e.g. when we get the urge to wee or sneeze). Another interesting fact, like other muscles in our body, our pelvic floor can work unevenly (e.g. one side more or less active than the other side). Luckily pelvic floor exercises are one of the first exercises that can be started after the birth of baby and can be incorporated into the day with activities like breastfeeding or nappy changes.

One final thought, the biggest thing I’ve learnt in the final trimester, is not so related to physiotherapy – but can be useful in life in general. There is such a skill in ‘letting go’ of the unknown and taking each day/step as it comes to us. I’m getting to develop this skill as I near birth day.