Hello and welcome to my blog! This blog is about all things osteopathy, all things movement and all things Swansea. I love osteopathy, movement, and Swansea so for me this is an absolute pleasure!
So this first blog entry is all about osteopathy and pregnancy! This is purely because I have been treating a lot of pregnant patients lately and I find most patients well informed about hormonal changes, but less so in touch with what happens to their musculo-skeletal system. So we all know that everybody gets a bump, and this can make tying your shoelaces more of a workout, but there’s a whole lot of other adaptations that your body makes in order to accommodate your bump. Knowing what is going on can be helpful in understanding aches and pains you may experience throughout and also remind you that you are pretty amazing to grow a whole other person in 9 months!
Even during the first few months, when other people can’t see that you’re pregnant, there is a lot going on! The uterus (womb) is of course growing to make space for the new baby, and although it can’t always be seen, by week 12 the uterus is the size of a grapefruit… and it’s resting on your bladder and pelvic floor- so even in the first trimester you can find that you need to visit The Ladies a bit more often.
As your grapefruit expands, the other organs need to move out of the way… at the start the uterus pushes against the small intestines and the sigmoid colon (part of your large bowel) and as it continues to expand it then pushes against the front of your tummy.
As all this is going on, your pelvis tips backwards to make enough room. This tilting movement of the pelvis stretches the hip flexors (muscles at the top of your thighs), your upper abdominal muscles (just below the ribs) and the long muscles either side of your low back.
So by the end of the first trimester you look a bit like this:
All the muscles I mentioned may be letting you know that there are changes going on, so even as early as the first trimester you may wish to take extra care of your body. I would advise listening to your body throughout pregnancy, it is making some huge adaptations and making it as easy as possible for your body to do this will be beneficial.
You will also be feeling extra tired- this is not solely because you are in fact growing an entire new person but also because the amount of blood you have increases enormously, which sounds like you would have more energy right? But the trouble is that the amounts of red blood cells (the ones that give you your oomph) don’t increase as much as the other cells in your blood. This actually means that every pregnant lady has something known as physiological anaemia…sounds scary? But it really isn’t, and the best thing to help relieve physiological anaemia…is exercise! This is because exercise asks your body to make more red blood cells, which relieves the anaemia and tiredness.
If you would like somewhere safe and friendly to exercise I would recommend taking a look at these ladies: https://www.facebook.com/thinlizzies. They are informed, encouraging, amazing and excellent to help you alleviate that anaemia!
So by the time you reach your second trimester your grapefruit is starting to feel and weigh in a bit more like a papaya. So more stuff needs to move out of the way and this time your bones and muscles get involved to help out.
As your baby grows the uterus continues to expand and meet the front wall of your tummy, it then begins to grow upwards. This has an effect on your small and large intestines, stomach and liver as they all move upwards towards your diaphragm in order to continue making space.
Side note- the diaphragm: This is a very important muscle for breathing, a balloon like structure it attaches all the way around your ribs and meets itself underneath your lungs. Contraction of your diaphragm means you can take full and deep breaths.
As your intestines, liver and stomach are not particularly squashable these organs can press on to the diaphragm. As you can imagine this can present challenges to taking those nice deep breaths I mentioned earlier. However your body is very clever and gives the diaphragm a bit of breathing space, by adapting your spinal curves, particularly around the region of your mid back.
Finally your breasts will also be stepping up their game to meet the challenge of feeding a hungry baby, and this places extra demands on your mid back known as the thoracic region. The thoracic region of your spine develops a stronger curve (known as an increased kyphosis) to support the extra weight. This extra curvature has a knock on effect for your neck which also gets a bit curvier in the opposite direction in order to keep your head upright.
Towards the end of the second trimester the pelvis usually begins to tilt forwards (sometimes it doesn’t so don’t panic if this isn’t you!) as baby and uterus get bigger. Your pelvis and spine are closely related and this means that your spinal curves do some more rearranging into what is known as a kypho-lordotic posture. This just means that the normal curves of your back are exaggerated a bit more in order to accommodate your baby. It looks a bit like this:
Again, I have highlighted some of the parts of your body that may feel a bit strained by pregnancy at this point. All of these can be helped by osteopathic treatment which works to ensure that your body has as easy a time as possible to manage going through all the changes that pregnancy requires.
Note: The next paragraph is quite confusing- refer to the diagram!
The expansion of the uterus against the front of your tummy means that your abdominal muscles and a bit of connective tissue inbetween them known as the linea alba, are under strain. By now baby can be pushing up against the bottom of your sternum and ribcage at the front of your chest and this causes a stretch through the abdominal muscles and can affect the pubic symphysis (everybody heard of symphysis pubis dysfunction?).
So by this point your abdominal contents have no more room to move upwards, instead they move backwards and sideways and your ribs and the soft tissues of your back move outwards too to accommodate this. In this classic pregnancy posture (kypholordotic posture) the weight of your uterus and baby are carried on your pubis.
If you are a bit different you may develop what is known as a sway-back posture…the weight of your baby will be carried over the pelvic floor and your pelvic ligaments. The reason this happens is that your pelvis has opted to remain tilting backwards (like it did in the second trimester) and so the spine has to make a different rearrangement of curves in order to accommodate this. So here is a picture of the sway-back pregnancy posture- note your bump will look smaller than other peoples! This is because your uterus is sitting further back, does not mean you are having a small baby and is nothing to worry about!
Other stuff going on: pelvic floor musculature must stretch whilst remaining strong, your sacrum (little bone at the back of your pelvis) needs to move and starts to do so. You also stand with a wider base in order to accommodate the extra weight, this makes you walk with a bit of a waddle!
Osteopathic treatment is particularly relevant for pregnancy as it is drug free and works through hands on treatment to the musculoskeletal system. There are few incidents in life that require such massive adaptations from the musculoskeletal system and therefore osteopathy is perfect for pregnancy as the musculoskeletal system is an osteopaths forte!