During pregnancy, women experience great physical changes that can be accompanied by discomfort and pain, and sometimes those changes accompanied by pain lead to the woman having to contact a doctor. There are ways for these states to be prevented with many activities. It is important that, during pregnancy, women take the time to care for their body, walk, massage, light stretching and exercise in the form of yoga or pilates, and if the woman is actively working out, she needs to adjust exercises to her pregnancy.
We asked professionals from the Clinic for Physical Medicine and Rehabilitation Fizio Vracar, what kind of physical changes it comes to women during pregnancy and what problems are most commonly occurring.
“During pregnancy, the entire organism and its systems are adapted to the requirements of the fetus that develops, as well as the musculoskeletal system. What affects the musculoskeletal system most is the mechanical factors – increasing the weight of the pregnant woman, changing the position of body segments and, therefore, moving the body’s focus. Indirectly, and the endocrine system affects mechanics by secreting a hormone called relaxin, which affects the ligaments structure. Because of this, due to the above, mechanical pressure on the joints and soft-tissue structures is changing, pregnant women often feel pain in the areas of the foot, knees and hips (as these joints carry the highest body weight) as well as the spinal column (the axis providing the base both for statics and for the dynamics of the body). In addition, one should emphasize another very common problem, which is the “splitting” of the front abdominal muscle along the longitudinal axis, which is termed a diastase (diastasis recti).
“Because of the growth of the fetus, the body of the body moves forward. In the lower part of the spine, we have a natural curve that is protruded forward. During pregnancy, this curve increases. Also, due to hormonal changes, the ligaments that stretch from the back and the front of the spinal vertebrae are weak. The pressure in the abdominal cavity changes and the pressure between the vertebrae is arranged differently. Because of this, there is a pain in the lower part of the spine in most pregnant women. The better the physical readiness and stability of the spinal column before pregnancy, as well as during pregnancy, the chance of pain in the lower part of the spine is smaller. It is individually how much this chances will be reduced, depending on the pregnant woman’s pregnancy, the age of the pregnant woman, the number of babies she is carrying, the weight of the fetus, the weight of the pregnant woman before and during pregnancy, nothing can be accurately determined but physical preparation in cooperation with the doctor and physiotherapists before and during pregnancy certainly have a very positive effect on the prevention or reduction of various disorders “, advises Fizio Vracar team.
”The joints suffer from increased pressure and improper pressure distribution due to the increased weight of the pregnant woman, changes in body weight, swelling of the joints in pregnancy and changes in the body’s position (and thus stretching of one, and shortening of other soft tissue structures or increased compression in certain places). In women who already have some degenerative changes in the joints, these problems are more easily occurring and more pronounced. Depending on the cause and intensity of pain in the joints, which your doctor will determine, therapy is also prescribed. When it comes to physical activity, light walks and other aerobic activities, exercise exercises and muscular flexibility tailored to pregnant women, it is possible to reduce the pain and the impact of mechanical factors on the body. ”
“Pelvic floor muscles, like all other muscles, must have the ability to contract and relax. In order to give good support to the internal organs of the pelvis, especially during pregnancy and fetal growth, they should have satisfactory tonus. During pregnancy, under the influence of the weight of the fetus, these muscles are stretched, the weakening and therefore the risk of subsequent urinary and fecal incontinence. Because of this, the tone of these muscles is of exceptional importance and its quality is achieved by specific exercises. On the other hand, it is equally important to develop the ability to relax the pelvic floor muscle that is necessary during labor, which develops through the learning techniques of relaxation of these muscles. “
What is a diastase and how does it occur?
“Basically speaking, the diastase would be a fissure in the middle of the abdominal wall, the tension that can be felt best in the contraction of the abdominal muscles (elevated to the abdominal position). Expertly speaking, the diastase is actually a separation of the two abdominal muscles, that is, the left and right rectus abdominis, and therefore it also carries the Latin name diastasis recti abdominis or only diastasis recti. This separation occurs because of the uterus that is enlarged and the abdominal muscles grow. In the aesthetic sense, the front abdominal wall creates a “bump” due to this separation, which is also the most visible when making the classic abdominal. In the medical sense, the diastase is important because of the possible consequent hernia or the appearance of pain in the abdomen. “
“Factors that influence whether a diastase will be created is the weight of the fetus, the age of the pregnant woman, the individual quality of the soft tissue (genetically predetermined), and the inadequate exercise and training.”
How to reduce the chance of creating a diastase?
“In order to reduce the chance of developing a diastase, you need to have as strong core as possible, the hull stabilizers, the deep muscles of the abdomen (specifically the most important transversus abdominis located below the rectus abdominis, the one that we practice with classic abdominals). There are specific exercises that strengthen these muscles, as opposed to abdominal muscles that only strengthen superficial rectus abdominis and can even contribute to the formation of a diastase. These exercises do not guarantee complete protection against diastase but reduce risk. Women with strong deep and superficial muscular hull (core) are certainly less likely to get a diastase. ”
How is the diastase treated?
”The diastase is treated conservatively (exercises) or surgically, depending on the extent of its diaphragm. The success of conservative treatment also depends on many other factors. In any case, specific exercises will help prevent a hernia or other symptoms as a consequence of the diastase. Exercises are very specific and require persistence to give the best results. In agreement with the physiotherapist, the exercises are combined and dosed “, advises the Fizio Vracar team.