Pre- and Postnatal Physical Therapy

The female body’s unique and miraculous ability to produce and carry another human being is cause for celebration. The months leading up to childbirth provide an exciting and sacred time to prepare yourself physically, mentally and emotionally for the new life growing inside you. But while the female anatomy is uniquely designed for pregnancy and childbirth, the physical changes that occur can cause pain, discomfort and even injury.

Some discomfort during pregnancy is inevitable, but there are many proactive measures you can take to mitigate pain and discomfort, and set yourself up for a safe and rewarding childbirth experience. Prenatal physical therapy and a pregnancy exercise program will keep you feeling great, while ensuring that your body is ready and able for a healthy delivery.

Common Prenatal Complaints


The weight of the growing fetus along with hormonal shifts bring about anatomical changes to which your body must adapt. Your growing baby changes your center of gravity, making you less stable and increasing stress on your low back and pelvis. These changes can affect your posture, increasing stress along the length of your spine.

The hormone relaxin helps to loosen your ligaments to prepare your hips and pelvis for childbirth. However, increased circulating relaxin levels can also affect joints throughout your body, making them more elastic and vulnerable to injury. Lax ligaments can pull your low back and pelvis out of alignment, increasing strain in your pelvis, hips, and back. Pregnancy hormones can also cause nausea, especially in the first trimester, making it difficult to eat and stay hydrated.

Some common physical complaints of pregnant women include:
  • Low back and tailbone pain
  • Pain in the hips and pelvis
  • Rectus abdominis separation (diastasis recti)
  • Carpal tunnel syndrome
  • Joint tendonitis
  • Poor circulation
  • Pain in the feet and ankles
  • Difficulty breathing
  • Reduced balance and stability

How Physical Therapy Can Help

Many of the physical complaints of childbearing can be relieved through physical therapy and exercise. Strengthening the muscles that support your joints and assist in childbirth can help improve your posture and relieve stress on your spine, hips and pelvis.

Some prenatal physical therapy treatments include:
  1. Exercises for the core and pelvic floor muscles to help stabilize the low back and pelvis during movement
  2. Perineal massage to stretch and increase elasticity of the perineum, to reduce tearing during childbirth, and increase your tolerance for pressure as the baby’s head crowns
  3. Postural correction to reduce back pain
  4. Myofascial release therapy to reduce muscle tension and pain
  5. Massage therapy to target tight muscles and promote relaxation
  6. Targeted exercise to increase core strength, and prevent and treat diastasis recti
  7. Pelvic floor physical therapy to promote optimal pelvic floor function and relieve nerve compression
  8. Postural and breathing techniques to relax the diaphragm and reduce shortness of breath
  9. Individualized pregnancy exercise programs to promote fitness, strength and overall wellbeing

Postnatal Care and Treatment

Once your baby is born, your body needs time to heal and restore its pre-pregnancy strength and balance. The three months following childbirth are sometimes referred to as the “fourth trimester” because of the restorative healing process that continues to take place. Failure to recognize your body’s need for special care during the months following childbirth can have far-reaching repercussions for your health and wellbeing.

Physical therapy can help in the “fourth trimester” to:
  • Restore pelvic floor strength and function
  • Reduce bladder and bowel incontinence
  • Treat diastasis recti
  • Reverse uterine prolapse
  • Reduce pelvic and back pain
  • Improve sexual and reproductive function

Pre- and Postnatal Therapy at NYDNR

The pre- and postnatal specialists at NYDNR want your childbirth experience to be a positive and joyful event. We will design a personalized treatment program to minimize the discomforts of pregnancy and prepare your body for a healthy birth. After your baby is born, we will help you heal and restore your body to its best possible physical condition, so you can enjoy motherhood to its fullest.

Treatment methods may include soft tissue mobilization, myofascial release, deep tissue massage, biofeedback, muscle relaxation therapy therapeutic exercise, postural correction, training for improved gait and movement mechanics, and extra corporeal shock wave therapy (ESWT).


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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