Chapter 14 Therapeutic Exercise in Obstetrics. Why Therapeutic Exercise for Pregnant Women?. Primary conditions unrelated to pregnancy Disorders related to physiologic changes during pregnancy Physical and psychological benefits Preventative measures.
Endocrine system – Alterations in hormone levels, GI function, etc.
CV system – Changes in blood volume, hemoglobin levels, vasodilation.
Respiratory system – Increased mucus in respiratory tract, predisposition to coughing, sneezing if pelvic floor and associated muscles are weak.
Musculoskeletal symptoms should not be considered normal.
Moderate aerobic exercise (carefully monitored and prescribed) is safe and beneficial for the mother and fetus.
Snow and water skiing
Heavy weight lifting
High-resistance activitiesActivities to Avoid
Balance of muscle length and
strength in key postural
muscles is important!
Hot packs – Safe for back, neck,and extremities.
Ultrasound – Sites away from uterus.
Ice – Used on joint pain and inflammation.
NMES/TENS – Contraindicated (except for TENS during labor and delivery).
Goal– Improve muscle balance, posture, support of uterus via pelvic floor, stabilization of trunk and pelvis via lumbopelvic core.
Importance cannot be overemphasized!
Attention to pelvic floor strength should occur early
in the pregnancy and continue throughout the duration
and into postpartum.
Greater degree of joint laxity throughout the body during pregnancy.
If coccyx pain is related to pelvic floor tension myalgia, pelvic floor relaxation must be emphasized.
Restore ideal alignment
Pregnant Woman are particularly susceptible to:
Nerve Compressive Syndromes
Common during pregnancy due to:
Described as intermittent pain in the rib cage or chest from flaring of the rib cage.
Intervention includes spinal elongation with arms overhead in supine, sitting, or standing postions,
and trunk sidebending away from the pain.
Discourage prolonged squatting during
exercise and delivery.