By: Dr. Kandyce Mutter, BScKin, DC
ICPA Webster Certified
There’s no question that a woman goes through tremendous changes during the nine months of pregnancy.
The most obvious physical changes that are likely to affect the spine will begin to occur during the second trimester. As the uterus grows to accommodate the fetus, the lumbar curve of the spine will increase to account for the stomach protruding further forward.
The pelvis will also start to shift position as the normally tough pelvic ligaments soften in preparation for eventual delivery. In order to counterbalance for the abdomen protruding forward, many pregnant women end up leaning somewhat backward as they stand or walk. This can then place pressure on the pelvis, the sacroiliac joint and the ligaments, causing additional pain.
In fact, recent studies show that nearly 76% of women experience back pain during some portion of their pregnancy.
All of these changes are not isolated to the back and pelvis, but will also affect the knees, ankles and feet. These shifts in the normal position of the back can also affect posture, which may lead to sciatica and edema (water retention in the ankles and knees). This is due to the shifts in posture and the hormonal changes which occur as the weight gain continues.
Why Chiropractic care?
Chiropractic care benefits all aspects of the body’s ability to be healthy. When segments in the spine and pelvis are misaligned, imbalance is created in the surrounding muscles and ligaments which can result in tension and nerve system stress. This can affect the body’s ability to function optimally.
Doctors of Chiropractic are specially trained to work with the pregnant mother by performing chiropractic adjustments, a gentle and effective means of restoring proper pelvic balance and function.
The most obvious targets for chiropractic adjustments will be the lumbar spine and the sacroiliac joint, in order to shift the vertebrae back into alignment. This will provide more comfort in the joints as well as to help relieve low back pain. Adjustments to these joints may also relieve pressure on the sciatic nerve and help patients sleep more soundly at night.
When working with pregnant women, the chiropractor will position the patient in a supportive and comfortable manner, with pillows and props, as the gentle adjustments are being performed.
How does Chiropractic care help with labor?
Women who have undergone chiropractic adjustments during their pregnancy report that their labors are easier and less stressful on their bodies.
– A study revealed that first time mothers under chiropractic care had 24% shorter labor times versus women who were not. Without chiropractic care, the first time mom labored approximately 14 hours and with chiropractic care labor was averaged at 8-9 hours.
– Chiropractic patients who have had previous children enjoyed 39% shorter labor times. For moms having their second or more baby, they labored approximately 9-10 hours and with chiropractic care during pregnancy, this was reduced to approximately 4-5 hours of labor.
– Chiropractic adjustments during pregnancy can also reduce the likelihood of experiencing back labor. This is usually caused by position of the fetus with the baby’s back of their skull pressed against the sacrum instead of against the front of the pelvis.
Why is this?
Any baby position even slightly off during birth can slow down labor, adding more pain to the mother. Many women have also been told that their babies were too big, or labor “just slowed down” when it was really the baby’s presentation interfering with the normal process and progression.
This is why it is recommended that a woman consult with a chiropractor shortly after she discovers she is pregnant. That way, a comprehensive plan can be created to manage subluxations throughout the pregnancy which will support optimal birth outcomes.
Chiropractic care is being sought out by more and more mothers as it has been proven effective in creating a more comfortable pregnancy while optimizing overall health.
Stay Tuned!
Be sure to watch Liz Akincilar and Kandyce Mutter as they discuss the benefits of pelvic floor physical therapy and chiropractic care for people suffering from pelvic floor disorders. Tune in next week to PHRC’s Facebook page, YouTube channel and Instagram TV to see the interview!
FAQ
What are pelvic floor muscles?
The pelvic floor muscles are a group of muscles that run from the coccyx to the pubic bone. They are part of the core, helping to support our entire body as well as providing support for the bowel, bladder and uterus. These muscles help us maintain bowel and bladder control and are involved in sexual pleasure and orgasm. The technical name of the pelvic floor muscles is the Levator Ani muscle group. The pudendal nerve, the levator ani nerve, and branches from the S2 – S4 nerve roots innervate the pelvic floor muscles. They are under voluntary and autonomic control, which is a unique feature only they possess compared to other muscle groups.
What is pelvic floor physical therapy?
Pelvic floor physical therapy is a specialized area of physical therapy. Currently, physical therapists need advanced post-graduate education to be able to help people with pelvic floor dysfunction because pelvic floor disorders are not yet being taught in standard physical therapy curricula. The Pelvic Health and Rehabilitation Center provides extensive training for our staff because we recognize the limitations of physical therapy education in this unique area.
What happens at pelvic floor therapy?
During an evaluation for pelvic floor dysfunction the physical therapist will take a detailed history. Following the history the physical therapist will leave the room to allow the patient to change and drape themselves. The physical therapist will return to the room and using gloved hands will perform an external and internal manual assessment of the pelvic floor and girdle muscles. The physical therapist will once again leave the room and allow the patient to dress. Following the manual examination there may also be an examination of strength, motor control, and overall biomechanics and neuromuscular control. The physical therapist will then communicate the findings to the patient and together with their patient they establish an assessment, short term and long term goals and a treatment plan. Typically people with pelvic floor dysfunction are seen one time per week for one hour for varying amounts of time based on the severity and chronicity of the disease. A home exercise program will be established and the physical therapist will help coordinate other providers on the treatment team. Typically patients are seen for 3 months to a year.
What is pudendal neuralgia and how is it treated?
Pudendal Neuralgia is a clinical diagnosis that means pain in the sensory distribution of the pudendal nerve. The pudendal nerve is a mixed nerve that exits the S2 – S4 sacral nerve roots, we have a right and left pudendal nerve and each side has three main trunks: the dorsal branch, the perineal branch, and the inferior rectal branch. The branches supply sensation to the clitoris/penis, labia/scrotum, perineum, anus, the distal ⅓ of the urethra and rectum, and the vulva and vestibule. The nerve branches also control the pelvic floor muscles. The pudendal nerve follows a tortuous path through the pelvic floor and girdle, leaving it vulnerable to compression and tension injuries at various points along its path.
Pudendal Neuralgia occurs when the nerve is unable to slide, glide and move normally and as a result, people experience pain in some or all of the above-mentioned areas. Pelvic floor physical therapy plays a crucial role in identifying the mechanical impairments that are affecting the nerve. The physical therapy treatment plan is designed to restore normal neural function. Patients with pudendal neuralgia require pelvic floor physical therapy and may also benefit from medical management that includes pharmaceuticals and procedures such as pudendal nerve blocks or botox injections.
What is interstitial cystitis and how is it treated?
Interstitial Cystitis is a clinical diagnosis characterized by irritative bladder symptoms such as urinary urgency, frequency, and hesitancy in the absence of infection. Research has shown the majority of patients who meet the clinical definition have pelvic floor dysfunction and myalgia. Therefore, the American Urologic Association recommends pelvic floor physical therapy as first-line treatment for Interstitial Cystitis. Patients will benefit from pelvic floor physical therapy and may also benefit from pharmacologic management or medical procedures such as bladder instillations.
Who is the Pelvic Health and Rehabilitation Team?
The Pelvic Health and Rehabilitation Center was founded by Elizabeth Akincilar and Stephanie Prendergast in 2006, they have been treating people with pelvic floor disorders since 2001. They were trained and mentored by a medical doctor and quickly became experts in treating pelvic floor disorders. They began creating courses and sharing their knowledge around the world. They expanded to 11 locations in the United States and developed a residency style training program for their employees with ongoing weekly mentoring. The physical therapists who work at PHRC have undergone more training than the majority of pelvic floor physical therapists and as a result offer efficient and high quality care.
How many years of experience do we have?
Stephanie and Liz have 24 years of experience and help each and every team member become an expert in the field through their training and mentoring program.
Why PHRC versus anyone else?
PHRC is unique because of the specific focus on pelvic floor disorders and the leadership at our company. We are constantly lecturing, teaching, and staying ahead of the curve with our connections to medical experts and emerging experts. As a result, we are able to efficiently and effectively help our patients restore their pelvic health.
Do we treat men for pelvic floor therapy?
The Pelvic Health and Rehabilitation Center is unique in that the Cofounders have always treated people of all genders and therefore have trained the team members and staff the same way. Many pelvic floor physical therapists focus solely on people with vulvas, this is not the case here.
Do I need pelvic floor therapy forever?
The majority of people with pelvic floor dysfunction will undergo pelvic floor physical therapy for a set amount of time based on their goals. Every 6 -8 weeks goals will be re-established based on the physical improvements and remaining physical impairments. Most patients will achieve their goals in 3 – 6 months. If there are complicating medical or untreated comorbidities some patients will be in therapy longer.