Physical Changes To The Body During Pregnancy
To say the body goes through a lot of changes during pregnancy would be an understatement. Not only is the body working overtime to create a tiny human, but it has to adapt to changes in growth everyday. These changes can sometimes cause aches, pains, or a worsening of previous issues. I’ve found that being aware of these changes while staying active during pregnancy can not only alleviate aches and pains, but set you up for success for delivery and into the postpartum period. Let’s dive in!
Physiologic Changes
In the pregnant body, internal changes are happening rapidly. Hormones are working overtime, and the entire autonomic nervous system ( that part of your nervous system that regulates your body without you knowing it) is thrown through a loop while trying to adjust to rapid changes. For purposes of this discussion, we will focus on the hormone relaxin. Relaxin levels change throughout pregnancy, peaking during the first trimester and then right before delivery. This hormone acts on several parts of the body to mediate changes required to progress the pregnancy. It acts on blood vessels, uterine tissue and your connective tissues. Connective tissue is present all over the body, but for now, think of it as the main component keeping your skeleton stable (ligaments and tendons). Relaxin acts to relax ( get it 😉) your connective tissues to allow for the bodily changes associated with pregnancy. This doesn’t mean that you will feel super flexible, it means that the ligaments keeping your joints stable may become a little bit more lax. The muscular system will actually have to work harder to stabilize the body because of this (!!), which is why staying stable and strong can be so important.
Postural Changes
As the baby grows, the abdomen starts to stretch. While it seems like a slow process, it’s a lot for the body to adjust to in a relatively short amount of time. Ask any pregnant woman- sometimes she can feel the baby grow overnight. As the belly starts to grow to accommodate the baby, postural compensations have to occur. Since the weight of the baby is distributed primarily in the abdomen, gravity is essentially pulling the body straight forward and down. In order to not fall over, your body has to adjust its posture. This can lead to an increased forward tilt of the pelvis, increased sway of the back, or a weight shift onto the toes. The legs may also start to toe out and widen to increase their base of support and improve stability. Postural tendencies that existed pre-pregnancy may also be exacerbated during pregnancy because of the increased demand to the system.
Muscular Changes
What does this change in posture do to your muscles? When compensations occur, muscles have to work to keep the body in its new position. In general, muscles like working within their optimal length (they don’t love being over stretched or compressed). When changes to posture occur for a prolonged period of time, certain muscles can become short and potentially overworked, while other muscles can become over stretched and underused. In pregnancy, the heavy hitter is the abdominal wall. It becomes over lengthened by the growing baby, and is responsible for helping to keep the ribcage and pelvis stable. Your pelvic floor also plays a key role stabilizing the pelvis during pregnancy. Sitting at the bottom of the pelvic bowl, it is constantly adjusting for the increase in weight of the growing baby and changing shape of the pelvis. This is a simplified version of what the pelvic floor does for us- for more info, check out another blog I wrote here. Your hamstrings and inner thighs also can become over lengthened and under worked by that pull of the pelvis forward. When certain muscles are under working, other muscles will take over to stabilize- hello low back and hip flexors! They can become tight, overworked, and be a source of pain in pregnancy. Additionally, the over lengthened muscles discussed above have increased strain on them which can also cause discomfort in pregnancy. A lot of the time, these strains take a little longer to heal because your body has to give a lot of its energy to the growing baby. How do we avoid all of these aches and pains? Stay active, and work to keep all your muscles strong and healthy. Working on strength will not only keep you stable and avoid injury, but it can help to prepare you for delivery and the postpartum period. If you run into a roadblock or issue, reach out to your PT. :)
A short note about labor and delivery..
Labor and delivery are no joke. Think of the process just as any other major athletic event. We want the body to be as prepared as it can be to properly deliver the child and recover quickly. I sometimes reference “prehab” that athletes tend to receive before an ACL or other major orthopedic surgery. The point of prehab is to gain as much strength and mobility before surgery to improve outcomes post operatively. Delivering a child is no different. If the abdomen, pelvic floor and surrounding muscles are healthy with blood flow, mobility and strength, both delivery and recovery may not be as traumatic. Bottom line- if you’re experiencing any sort of ache or pain that may be limiting your function or ability to stay active during pregnancy, don’t be afraid to reach out to a physical therapist! There is a lot that can be done to not only make the pregnancy period more enjoyable, but improve your ability to recover from labor and delivery quickly.
