Why We Love Physiotherapy For Pregnancy & Postpartum

Ultimately our mission at Baby2Body is to help you feel good in your body and optimize your health at a really important time in your life. Your dietary and fitness habits have a massive impact on how your body feels during pregnancy and in your postpartum recovery, and eating well and exercising often can definitely make you feel better during those times -- which is what we're here to help you do!

However, pregnancy and postpartum can also come with a lot of... unexpected aches and pains. From sciatica to pelvic girdle pain to diastasis recti and even carpal tunnel syndrome -- the process of growing and birthing and taking care of a baby can do a number on your body. And sometimes you need more targeted treatment to help manage those pains.

But there is good news if you're suffering from any of the above, and it's called physiotherapy.

Physiotherapy is the treatment of injury, disease or existing conditions through physical methods -- including stretching, massage, exercise, and heat. It offers an incredible drug-free way to manage pain, improve mobility, and better your quality of life overall. And that's why we love recommending it for pregnancy and postpartum, because as incredible a time as it is, it can also be really... painful at times.

We're so excited to be teaming up with physiotherapists to bring you new Baby2Body programs (hint hint!) and one of the incredible experts we've been working with is Francesca Da Costa (our lucky London-based mamas can find her here!). We snagged some time with her for a quick Q&A to discuss why physiotherapy can be so beneficial in pregnancy and postpartum. Here's our chat with her!

Hey Francesca! Tell us a bit about yourself. What was it that made you want to pursue physiotherapy as a career?

Corny I know but from a young age I always knew I wanted to be a Physio. I think it was probably from my Granny drumming it into me that I should be (she wanted one in the family to help with her aches and pains!) but also because I had a keen interest in it after receiving some myself. When I was younger I used to frequently sprain my ankle and also suffered with hip pain. Physiotherapy helped strengthen my ankle, correct my posture and any muscle imbalances I had around my hip.

So I qualified as a physiotherapist 11 years ago, 8 of which I’ve been specialising in musculoskeletal and within that also on pre and postnatal populations. I find it a very rewarding area of physiotherapy seeing the week on week improvement clients make and I also gained an increased interest when I started my own family!

Why do you think physiotherapy can be so valuable during pregnancy and postpartum?

There’s a lack of routine help and guidance going through pregnancy and after giving birth too. Many women are often confused and a bit scared about what is safe/unsafe to do, what is ‘normal’ or not and don’t know who to ask to seek help. It’s extremely rewarding and a great privilege going through this journey with women.

What is the most common thing your pregnancy clients come to you for?

It’s probably Pelvic Girdle Pain or PGP (formerly known as SPD). This is pain that occurs in any of the joints of the pelvis and can be caused by a number of things. Hormones, posture and change in walking pattern as your bump grows, core muscles weakening along with pelvic floor and therefore reduced pelvic stability. Unfortunately 1 in 5 women experience this during pregnancy.

And what do you find helps them most in managing PGP?

I wish there was a one size fits all approach but intervention is individualised after assessment so this is generalised guidance. Early intervention is always advisable so speak to your GP or midwife to get a referral on the NHS or you can refer yourself privately to a physiotherapist (at least in the UK!).

While nothing can compare to an individualised assessment, general movement really helps as long as it is not a movement that brings on pain during or afterwards. Exercises that strengthen your glutes and tummy muscles typically help too. In addition upper back strength and mobility​ ​is also important as any misalignment at the pelvis can affect everything above and below.

There are also a number of other tips that may help with pelvic girdle pain, such as:

1. Try slowing down your walking and taking smaller steps

2. Taking stairs slowly and one at a time

3. Keeping your legs as close together as possible when getting in and out of the car (there's a theme here in being mindful of your hip movement!)

4. Wearing a support belt

5. Sitting down to get dressed / put your shoes on

6. Avoid crossing your legs and try to avoid holding your toddler on one side of your body (easier said than done, I know!)

7. Wear flat but supportive shoes plus try and stand with equal weight on both legs

8. Place a pillow under your bump when sleeping on your side and one in between your legs

9. Swimming can be a beneficial form of exercise but aim for a front crawl motion rather than breaststroke as that leg motion can aggravate PGP

9 tips in one, we love it! And what about the most common thing your postpartum clients come to you for?

You might not be expecting this answer but it’s actually wrist pain! Something called De Quervain’s tenosynovitis. This is inflammation of the sheath that surrounds tendons that are involved in moving the thumb. It can be caused by repetitive movements and as you all know with a newborn there’s lots of lifting, holding and feeding your baby!

What should someone expect to get out of a physiotherapy appointment? And maybe what should they not expect?

A physio appointment always starts with an in-depth discussion on what is the issue (called a subjective assessment). This is to learn about your concern, your history and also your goals from physiotherapy. From this, your physio is already shaping their views on what might be going on and uses the information you have given to shape their physical assessment (the objective assessment).

Your physio will ask you to perform some functional tasks and tests which may aim to re-create your pain or concern in order to assess where it’s coming from. From here, they will explain their findings along with advice and a treatment plan which will typically involve exercises for you to do and sometimes hands-on therapy if it will help.

Generally your area of concern / pain won’t be cured in one session - I wish we were miracle workers! It’s usually a project that you work on together which you need to be actively engaged in to see the goals that you desire. Passive treatment alone in general will not solve where the issue is stemming from.

We also work closely with other healthcare professionals and always refer on if necessary so we’re often a great first port of call for assessment. Remember prevention is always better than cure so early intervention is important if you start noticing something new.

How have you seen physiotherapy change the way people live and feel about themselves and their body? And off of that -- do you think it creates a stronger sense of self care?

Definitely! Lots of people find themselves seeing a physiotherapist for an acute injury and from there develop a different mindset about how they should be looking after their body. For example, we see lots of ‘weekend warriors’ who sit at a desk all week and then expect their body to run a marathon at the weekend!

With physiotherapy they begin seeing it as something that needs nurturing and not just expect it to put up with the demands we place on it. These people then have a lower threshold for seeking advice, making any niggles that crop up more straightforward to treat, rather than something that has developed into a chronic issue. We also see lots of clients who come for ‘maintenance’ work to ensure they stay in tip-top condition and reduce the risk of picking up their injuries again.

Are there specific exercises that you wish every woman going through pregnancy and childbirth knew to do every day?

Pelvic floor exercises! (Almost) everyone knows it but very few do it! During labour your baby can sit on your pelvic floor for hours so it really needs to be strong. It’s also useful to​ ​be more aware of how to contract it as this helps when you need to (eventually) push baby out.

It’s also important to know that after giving birth you can re-commence your pelvic floor exercises generally as soon as you’ve done your first wee. Pelvic floor exercises increase the blood flow and helps to heal the perineum as well as supporting the urinary system.

Do you have specific questions on common pregnancy aches and pains? Leave them in the comments below and we'll follow up with another post from Francesca soon!

Francesca Da Costa qualified as a Chartered Physiotherapist from the University of Birmingham in 2009. Since then she has gained a wealth of experience working in the NHS, a charity and for the past 7 years a busy private clinic in Marylebone before setting up her own home visit Physiotherapy service. Francesca specializes in pre and postnatal and also treats conditions from work related issues, to traumatic injuries or post operative rehabilitation. She combines clinical pilates with her physio treatment to achieve the best possible outcome. She aims for everyone to take something away from her sessions transferring new skills and body awareness into everyday life and functional activities. 

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