Monitor BP at rest and during activity and check for signs and symptoms of emerging hypertension, such as headache, altered vision, significant shortness of breath
Diastasis Recti
Separation of rectus abdominus at linea alba; Diagonistic criteria is >=2cm; condition is not exclusive to pregnancy; may result in abdominal herniation requiring surgical intervention
Postural Back Pain
Prevalence is 50-70%. Treatment plan is similar to treatment in patient population where instability, body mechanics, and postural compensations are primary impairments. Deep heating agents, electrical stimulation and traction are generally contraindicated.
May also present as peripartum posterior pelvic (SI) pain
Coccydynia
Pain in coccyx (tailbone) region; painful sitting; may require manual adjustment for pain relief
Symphysis Pubis Dysfunction and Diastasis Symphysis Pubis
Pubis separates; Pain when lifting one leg at a time, in/out of bed and car, walking up stairs, and transitional movements. Symptoms may not be relieved with rest or decreased WB. Emphasis is on exercise and activity modification and stabilization to decrease torsion.
May benefit from a stabilization belt or Mother-to-Be corset
Varicose Veins
Increased leg discomfort or "heaviness". Increased risk for DVT due to stasis in LEs. May need compression stockings to facilitate venous return. Can also affect pelvic floor vessels (hemorrhoids)
Joint Laxity
Decreased tensile strength during pregnancy and up to 5+ months post-partum;
Emphasis is on activity modification and aerobic exercise which minimized WB stresses
Nerve Compression
Attributable to postural changes, fluid retention, hormonal changes, circulatory changes.
Carpal tunnel incidence is higher during pregnancy.
May benefit from splinting as well as activity modification to decrease stress/strain to nerve pathways
Cesarean Birth
Gentle mobilization of soft tissue and postural/body mechanics education; instruction in anterior lumbopelvic splinting techniques during acute healing phase to protect incision from strain
Urinary Incontinence
Diastasis Recti Test
Although predominantly related to pregnancy, diastasis recti, a separation or stretch of the linea alba can occur in men
Activity Modification for Posterior Pelvic Pain and Pubis Dysfunction
Goal is to increase symmetry through the pelvic region to minimize strain to joints
sidelying with pillow between knees
avoiding hip abduction positions/exercises
avoiding/minimizing activities which require WB through a single leg (ex. instruct on step-to vs. step-over-step during stair climbing)
avoid sitting on soft surfaces to decrease demand on static and dynamic posterior and anterior pelvic stabilizers
instruct in moving both legs together in/out of care and in/out of bed
