Physiotherapy During Pregnancy

A pregnant woman or a woman who just put to birth requires a whole new extra and special care level. Changes in hormonal levels cause most of the body’s supporting ligaments to soften and become more elastic during pregnancy and about six months after childbirth.

The tummy and pelvic floor muscles of a woman stretch alongside a child’s growth and birth; In this period, it is effortless to get a back injury or leg cramps because the joint becomes less-well supported. This also causes urinary incontinence resulting from loosed pelvic floor muscles.

Physiotherapy is a medical treatment approach that entails physical solutions like massages, exercises, heat therapy, and electrotherapy. It is used for most conditions and does not involve any medication or surgery.

This type of treatment is the perfect approach to treat aliments disorders during pregnancy as medications and surgery might be detrimental to a mother and her child’s health.

As a physiotherapist, the primary objective for exercises during pregnancy is to help patients’ (expecting mothers) bodies deal with mobility, flexibility, musculature, circulation, and respiration (breathing).

Before commencing an effective antenatal physiotherapy (physical activity) program, evaluations are made to recognize which exercise may best suit a ‘soon-to-be mother’s needs.

However, physiotherapists have some frequent complaints associated with most pregnant women right from the first to the third trimester.

These include:

  • Lower-Back Pain: Complaints about this condition are common with pregnant women. It mainly increases during the third trimester as the center of gravity shifts due to increased stomach size. In such cases, manual and passive physiotherapy such as back support, postural education, and pilates exercises are employed as treatment.
  • Sciatica: Sciatica is due to continuous strain on the sciatic nerve that leads to backache and weakness and sometimes numbness and tingling in the leg or associated areas. Physiotherapy treatment includes stretching and manual therapy to relieve patients of these symptoms.
  • Sacroiliac Joint Pain: This type of pain also exists in the back but at the lowest region of the lower back. This pain is associated with the buttock region. As earlier mentioned, when a woman is pregnant, her connective tissues relax to allow the muscles to stretch more to ease childbirth. This change also happens to the sacroiliac muscles and ligaments, causing them to become more mobile, leading to extreme joint movements.
  • Urinary Acrasia: Because of hormonal changes in the body of a pregnant woman, the pelvic floor relaxes and becomes weak compared to before, especially during the third trimester. This weakness makes the pelvis supple and ready for delivery. Weaken pelvic muscles can also be strained during child delivery, which may cause urinary incontinency and temporary pelvic floor dysfunction. Physiotherapy during pregnancy, against this course, uses strengthening exercises and a Pilate-based exercise program to reduce muscle weakness that occurs after childbirth.
  • Carpal Tunnel Syndrome: This syndrome results from the buildup of excess fluid that results in swelling in the joints. This is very common for pregnant women and newly delivered mothers; their wrists, ankles, and knees tend to swell up, and they may experience pain, numbness, tingling, and loss of coordination in the fingers and hands. Physiotherapy techniques such as mobilization, stretching, strengthening exercises, and the use of electric modalities help reduce these symptoms.

Benefits of Physiotherapy during Pregnancy

The pregnancy period can be divided into three major trimester stages; the first trimester, second trimester, and third trimester, each covering a space of three months.

Before considering the various trimester physiotherapeutic activities, let us explore some general usefulness or benefits installed for pregnant women engaging in these treatment activities:

  • Physiotherapy can help alleviate pains experienced during pregnancy.
  • Physiotherapy helps a woman adapt to bodily changes during pregnancy.
  • This treatment prepares a woman for her delivery day, “the Big Day.”
  • Physiotherapy assists in pelvic floor rehabilitation.

Treatment options during Physiotherapy

If you decide to undergo physiotherapy during pregnancy, there are few available options for a mother. They include:

  • Pelvic floor muscle training
  • Back pain physiotherapy
  • Core stability training
  • Posture training routines
  • Electrical stimulation during pregnancy
  • Training to improve flexibility
  • Stress relief massages
  • Muscle strain massages

Physiotherapy during First Trimester 

Staying fit and healthy during pregnancy is the most reasonable care and treatment a mother can undergo for herself and her child.

Even during morning sickness episodes and other discomforts experienced during the early stage of pregnancy, getting up and exercising often helps a woman feel better.

Although rest is crucial, exercises will help a mother regulate weight gain, prepare her for putting on weight, and get her in shape for child delivery. Physiotherapy during pregnancy is also suitable for muscle tone, mood, and sleep.

During the first three months, a pregnant mother probably would not notice any bold bodily changes yet; she may just feel a little more rest and sleep.

During the first trimester, some important physiotherapy rules are to pay attention to those new limits on a mother’s energy and avoid falls. If you are expecting and still just in your first three months, inform your physiotherapist about the exercises you have decided to partake in, and talk to them about new, you would want to try.

The first trimester period is always the best time to initiate low-impact exercises that a woman can do as the pregnancy progresses.

If, before pregnancy, a woman runs for exercise three times a week, the first three months of pregnancy would be a good time to substitute one of these running sessions for water exercises.

This way, she gets a head start on water workouts when she finally gives up running during her second trimester.

How to Begin?

If you are the type that does not exercise regularly before pregnancy, this could be an excellent time to pick up a lifetime beneficial habit.

Low-level exertion and 30 minutes workout per day, for 3 to 5 times a week, is a good start. Physiotherapists are always available to help you begin physiotherapy during pregnancy.

Some physiotherapeutic routine exercises during the first three months include:

  • Pilates is one of the early exercises scheduled for pregnant women as it helps them overcome two challenges during this period; lower-back pain and loss of balance. This exercise routine involves a series of equipment and floor exercises that help build core muscles. The first session focuses on strength building, and subsequent sessions will challenge that strength and build balance. During pilate sessions, avoid poses that entail lying on the back and twisting the midsection of your body. Do not overdo the pilate exercises or other belly-focused exercises, or you can cause diastasis recti (a medical condition in which the parallel panels of the abdominal muscles temporarily separates). Pilate workouts could be done once a week.   
  • Walking: Walking some extra steps can go a long way during the early pregnancy period. A leisurely stroll to get you moving can also help you build your upper body strength and lower muscular strength. Walking exercises can be done by taking giant steps and swinging your arms; picking-up the pace gets the heart pumping.
  • Yoga is one of the best physiotherapy exercises a woman can engage in during pregnancy and after pregnancy. Yoga activities build strength and balance, keep the muscles limber, breathing rhythm and control, and reduce blood pressure. Even long after childbirth age, during menopause, yoga can help prevent other medical conditions associated with aging like osteoporosis. However, not all yoga exercises are utilized by a pregnant woman. For instance, backbends, abdomen-twist poses, headstands routine, lying on the back and Bikram (hot yoga) should be totally avoided by pregnant women. Yoga is very healthy in any quantity as long as a pregnant woman doesn’t overexert herself which may increase pain intensity. 30minutes per day to 30 minutes per week sounds great.
  • Aqua Aerobics: Some women are skeptical about water exercises, but it is healthy for you, especially during pregnancy. The water is soothing, and activities are no- to low-impact activities. Physiotherapists and also medical swimming coaches can assist you with your water-exercise routine. This can be scheduled from three to five times a week, for 30 minutes each session.
  • Running: Women that have been runners might consider picking up this exercise. Running exercises the heart rate and entire circulatory system. It helps control breathing and also strengthens the upper and lower muscles and joints. Because running drills is impossible during the second and third trimester, physiotherapists and trainers recommend it as much as possible during the first trimester. Pregnant women should, however, ensure the safe running and try not to overdo it. Treadmills with safety bars are highly recommended. 40minutes, 3 days a week sounds great for a running routine.
  • Weight training: Lightweight training will help the body build strength to prepare a woman to increase pregnancy weight and help her deliver. Free weight can be lifted, and working out on weight machines sounds good also. Caution should be taken not to strain to breathe. Exercise with a physiotherapist on a prenatal routine.  

Safety Thoughts

During the first trimester, a woman might arguably not look pregnant, so it will be good to inform exercise coaches about your expecting condition.

Safety during pregnancy is vital; warm-up exercises, including stretching before any workout, are advisable. For the first five minutes, engage in warm-up exercises to prepare the body for a workout session.

Do not overdo it; take breaks if you feel:

Always keep your body hydrated during physiotherapy sessions and also during non-exercising times such as during any physical activitiy.

Engage a quality diet and not quantity after exercising and always keep to schedules and routines.

Physiotherapy during Second Trimester 

During the second trimester, which is between 14 to 27 weeks (4 to 7 months), some drastic changes in the body begin to occur and are noticed, such as baby bump and weight gain.

The physiotherapy treatments do not really differ from that of the first trimester. Only intensity is regulated, and few activities are dropped or restricted during the second trimester.

Pregnancy workouts are required for a mother’s health and for the benefit of the developing child. Some safe exercises a to-be mother can engage in during her second trimester include:

  • Walking

 Walking is the simplest and most beneficial physical activity during pregnancy. It can be done daily, and it is recommended throughout pregnancy.

With comfortable clothing, a pair of shoes with good grip, walking can be made fun. This exercise need not be intense; a leisurely stroll in the park is enough. Timing a walk at a comfortable and consistent speed for about 30minutes ensures that your body is not sedentary and keeps the heart-healthy.

  • Slow jogging

This exercise is for women who are used to jogging. Physiotherapists recommend this only for women with a healthy pregnancy and get regular checkups.

There are, however, some protocols to be observed to make jogging safe for a mother and her child. Slow jogging should be done on flat surfaces to maintain a regular pace to avoid fatigue and affect pain relief.

This exercise is employed by pelvic floor physiotherapists to correct pelvic tilt, pelvic girdle pains and regulates circulation against pelvic muscles cramp. When feeling tired during jogging, stop! And take a break. If a treadmill is more preferable, use a slow and controlled speed.

  • Yoga

Continuation of yoga activities from the first trimester can excellently improve an expecting mother’s mental and emotional health and is mostly recommended by physical therapists.

Hormonal fluctuations and incontinence are ubiquitous during second trimesters, and they could lead to difficulty coping with stress. Yoga is greatly recommended to combat this condition in women and also help improve their flexibility.

Pro yoga students should continue with their exercises but avoid certain poses that may threaten a mother’s and her baby’s health.

For beginners, especially during pregnancy, consider picking guidance yoga classes; one may begin with pranayama (breathing yoga exercises) and gradually incorporate simple yoga poses entailed in pelvic floor muscle training.

  • Cycling

Physio-muscular strength can significantly be improved by exercising on a stationary bike. In the second trimester, a woman’s belly grows bigger, and this is the period she actually shouldn’t overstress the abdomen. Sitting on a stationary bike and cycling may be the best option yet, as long as it is not uncomfortable for her.

  • Swimming 

Just like the first trimester period, aqua exercises are beneficial for muscle relaxation and strength building.

  • Squats

Squats strengthen lower body muscles which will be appreciated as the pregnancy progresses. This can be done when the pregnancy is voided of complications, and a mother feels comfortable while undertaking the activity.

It should be noted that a breathing routine during proper squatting is essential; breath-out when you bend down and breath-in when you lift up.

Safety Thoughts

During exercises, for full bodily benefits:

  • Stay away from activities that risk you falling,
  • Stop any training if you experience abdominal pain, bleeding, or vaginal discharges.
  • Ensure to wear comfortable clothing and shoes during walking and jogging.
  • Always keep your system hydrated and follow the rules and regulations guiding any exercise.
  • Take breaks between sets and inform your exercise coach that you are expecting.
  • Eat healthy after exercising and avoid ‘overdoing it.

Physiotherapy during the Third trimester 

This is the most delicate stage of pregnancy and therapy usually consists of gentle exercise. Pregnant women who began exercises from the first trimester may enjoy many benefits such as cardiovascular fitness, mood control, weight control, and blood pressure regulation.

During the third trimester, doctors recommend low- to moderate-intensity activity. But, there are precautions pregnant women must consider to keep their baby healthy.

According to a pilates instructor and health coach, Kate Marcin, “during pregnancy, joints loosen, and balance is more difficult. Engaging in exercises will help stabilize the connections at the joints and prevent injury.”

As safety is essential, an expecting mother should seek guidance from a pelvic floor physiotherapist or any physical therapist in general before engaging in any new fitness program or continuing an on-going fitness program into the last trimester.

Physiotherapy exercises a woman should avoid during her third trimester include:

  • Bouncing
  • Jumping
  • Hopping
  • Jogging
  • Skipping

Healthy physiotherapy activities recommended for expecting mothers from 7 to 9 months include:

  • Walking

Walking is a good form of exercise for pregnant women during their last three months into pregnancy. It assists in cardiovascular challenges and helps to regulate blood flow to the lower regions. Walking activities should be done in moderation.

  • Swimming and Aqua Aerobics

A pregnant woman should take advantage of a pool and engage in aqua sports. Lap swimming is perfect for total-body exercise workouts; it also relieves aches and pains experienced during pregnancy.

Submerging in water takes the pressure off tired legs and backs and prevents overheating in the muscles. Women should always stay hydrated even during aqua physiotherapy; they should also have in mind that long swimming periods can lead to over-exertion.

Water activities such as Zumba in the water get you dancing with more resistance. Flexibility classes offer gentle ways to exercise the joints and test range of motion with water support.

Aqua jogging is also excellent for runners who feel uncomfortable with impact in later pregnancy. Aqua-Cycling might also be recommended by some physiotherapists.

  • Pilate, Yoga, Barre, and other low-impact exercises

Low impact exercises are excellent for women in their third trimester, exercises such as yoga, pilates, barre, and cycling all target major muscle groups, helping a woman feel fit and strongly prepared for delivery.

For pregnant women, the poses are modified for safety, and more comfortable as the baby adjusts position during the final week. Weakening core during increased bump, which frequently causes back pain and sciatica, can be built through Pilates exercises.

Classic Pilates on mat strengthens deep abdominal muscles, improving overall posture, and helps a woman push during a contraction.

  • Bodyweight and Toning moves

Avoid heavy weight lifting during the third trimester, for your baby’s sake. Try bodyweights workout instead to maintain strength. Bodyweight workouts include squats, modified planks, and wall pushups.

Crunches and abs work should be avoided. According to Kate Marcin, “In the third trimester, lying flat on your back for long periods can be tricky and dangerous to the body.” 

A side-lying workout is recommended to stabilize muscles and other areas such as the glutes, hips, hamstrings, and inner thighs. If weight must be lifted, lightweights not more than 5-pounds dumbbells are recommended.

Weight lifting is best suited for first and second trimester expecting women.

Safety Thoughts

A third trimester during pregnancy is occupied with all kinds of thoughts, emotions, and even physical changes and challenges. For women who are used to been fit, even just 15 minutes of exercise daily can alleviate several symptoms, give an energy boost and strengthen the body for childbirth.

For others it may require more time and consistency. Physiotherapeutic habits are wonderful to develop during pregnancy and continue into the postpartum period as well.


It is very necessary to stay fit and watch your health during pregnancy. However, it is more important to do these exercises safely and not strenuously.

Register with a good medical institution for antenatal classes and provide yourself with a safe environment under professional supervision by physiotherapists. It is advisable not to conduct these exercises alone, especially during the second and third trimesters.

Skilled physiotherapists can assists you plan an individual exercise program for your pregnancy and beyond pregnancy (postpartum) if you are crowd-conscious.