During pregnancy, the body undergoes significant anatomical and hormonal changes in order to accommodate the developing foetus. These changes affect the musculoskeletal system and can cause pain and predispose women to injury. In this blog, we will discuss the changes that occur during pregnancy and their effect on the musculoskeletal system.
During pregnancy, a woman’s centre of gravity will shift posteriorly to accommodate the weight of the developing foetus. As a result, women tend lean back to find equilibrium. Compensatory changes to postures of the cervical and thoracic spine will also occur in order to maintain stability. These changes cause disruption to the natural curvature of the spine and can lead to discomfort and pain.
There are significant changes to hormone levels during pregnancy, namely progesterone, oestrogen and relaxin. The hormone relaxin causes our ligaments to become lax which results in an increase in passive joint stability. Joint laxity is required to allow the baby to pass through the pelvis during birth, however this often causes pubic symphysis and sacroiliac joint pain for the mother during pregnancy.
The pelvic floor is a band of muscles, similar to the shape of a hammock, that extends from the pubic bone to the tail bone. These muscles support your pelvic organs, which include your bladder, uterus and bowel and function to maintain good bladder and bowel control. The pelvic floor muscles are put under additional demand during pregnancy as they must not only support the weight of the growing baby, but also the amniotic sac and placenta. The increasing downward pressure is one factor that can weaken the pelvic floor musculature. As as mentioned above, altered hormonal levels also causes the muscles to become softened to allow the allow the baby to birth, which can further weaken the pelvic floor musculature. As a result, some women can experience an onset or increase in symptoms such urinary incontinence and urgency, pelvic organ prolapse and less commonly, faecal incontinence, during pregnancy.
In summary, the human body undergoes significant change during pregnancy and often this can lead to pain and other symptoms for women. There is a lot that can be done, such as hands on therapy and pilates based exercise, to manage symptoms and make pregnancy more comfortable. The earlier these issues are addressed the more comfortable you will feel. Have a chat with your physiotherapist early in your pregnancy to create an effective management plan specific to you and your body.
References:
Queensland Government, 2023, What you should know about your pelvic floor: pre-pregnancy, during pregnancy and after giving birth.
Physiopedia, Physiological Change in Pregnancy, https://www.physiopedia.com/Physiological_Changes_in_Pregnancy
