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  • Grecia Alaniz

Pregnancy & Pelvic Health Physiotherapy

Pregnancy can be really hard. That is a reality for many mamas out there. Too often we

talk about pregnancy in such a positive way that we don’t create space for mamas to talk about the realities of pregnancy. Don’t get me wrong, pregnancy can be a beautiful thing, but it also comes with lots of physical changes and discomfort, especially in the pelvic region. But mamas may not know how they can address their aches and pains and far too often are told that it’s a normal part of pregnancy. In this blog, I’ll be sharing how pelvic floor physiotherapy can help you throughout your pregnancy and prepare you for childbirth. So, sit back, relax, and let's dive into this topic together!

Physical Changes During Pregnancy

Pregnancy is an amazing journey that transforms a mama's body. As baby grows and

develops, significant physical changes occur. These changes can have an impact on various

parts of the body, including the pelvic floor muscles. The pelvic floor muscles are vital muscles that support the bladder, uterus, and rectum, and are responsible for proper bladder and bowel function. As the uterus expands and the baby grows, the weight of baby puts pressure on the pelvic floor muscles, which can lead to discomfort and weakness.

Hormone changes also affect the pelvic floor muscles during pregnancy. The hormone

relaxin increases during pregnancy, which causes the ligaments and muscles of the body to

have more laxity and stretch. This can sometimes cause the pelvic floor muscles to increase

tension and can cause additional discomfort and weakness. There are specific conditions that I commonly see in my practice and wanted to share a little more about them with you.

Pelvic Pain in Pregnancy

Pregnancy-related pelvic girdle pain is one of the most common issues musculoskeletal

conditions I treat in pregnant mamas. It can cause discomfort and pain in the pelvic area,

including the pubic bone, sacroiliac joints, and hips. The pain can range from mild to severe and may interfere with daily activities, such as walking, sitting, or standing for long periods.

Many times, relaxin is blamed for this pain condition, but this is only part of the story. I've

already mentioned how your pelvic floor muscles will experience increased tension to

compensate for the increased laxity in your joints. But for any mamas that have had previous

low back, hip, or pelvic pain, we now know that pregnancy can increase the sensitivity of these tissues and joints. And the best way for your body to protect itself is by increasing muscle tension or guarding. But over time, this can fatigue and irritate your muscles and joints. And this is when we start to see this pain can become more constant.

While this condition is prevalent (but not normal) in pregnancy, is usually goes away

almost immediately after giving birth. There is a small percentage of mamas that may continue to experience this pain, which research has found tends to be when mamas experience increased stress and/or trauma during their pregnancy and/or childbirth. So, if you’re still experiencing pain after giving birth, please see a pelvic health physiotherapist.

Bladder Urgency & Leakage in Pregnancy

If you’ve never experienced bladder leakage until pregnancy, it can be a little

distressing. We’ve all heard the stories about mamas saying that since giving birth they’ve lost all bladder control. I’m here to tell you this is not the case!

So, what is exactly is causing your leakage? You guessed it, relaxin. Basically, the

increased laxity your tissues makes it more difficult for your pelvic floor muscles to contract

around your urethra and create enough pressure in the urethra to withstand any abdominal

pressure that comes from sneezing, laughing, and coughing. As your pregnancy progresses,

your pelvic floor muscles will have a harder time with this, as they are already working hard to

support your growing baby and pelvic organs.

In terms of urgency, most mamas will have increased urgency during their first and third

trimester. Many mamas don’t understand why they’re experiencing increased urgency in their first trimester, when baby isn’t big enough to push on the bladder. So, what is it? Hormones, again. But this time it’s due higher levels of progesterone and hCG which triggers your body to increase blood supply to the placenta. This leads to your kidneys working harder to filter through this additional blood supply, leading to more urine. This process starts to balance out as you get closer to your second trimester.

Your third trimester is a little different. Hormones are no longer driving your leakage but

muscle tense/weakness. This is why you’ll hear pelvic health physiotherapist talk about focusing on relaxing your pelvic floor in your last trimester. By this point in your pregnancy, your muscles have worked extra hard. If you haven’t been doing deep breathing, they may be in a tense position and that is why they aren’t able to withstand increased abdominal pressure from a sneeze or cough. If your pelvic floor muscles aren’t tense, it may be that you’re engaging in activities that your tissues aren’t able to handle at this stage in your pregnancy.

Vaginal Pressure in Pregnancy

Experiencing vaginal pressure during pregnancy is common and can be caused by different

factors, such as vulvar varicosities, pelvic organ prolapse, and pelvic floor muscle tension.

Vulvar varicosities refer to swollen veins in the vulva that often cause pain, itching, and

discomfort. They can also create pressure in the vaginal area, making it challenging to stand, sit, or walk for extended periods. Fortunately, pelvic floor physiotherapy can help reduce the

symptoms of vulvar varicosities by enhancing circulation and reducing swelling.

Pelvic organ prolapse takes place when pelvic organs (bladder, uterus, or rectum) fall from

their ordinary position and push against the vaginal walls. This may cause pressure and a

bulging sensation in the vaginal area. But don’t worry, there’s lots of pelvic health

physiotherapy can offer. I’ll be sharing a blog post about this soon!

Pelvic floor muscle tension can also cause vaginal pressure during pregnancy. As the uterus and baby grow, the baby's weight puts pressure on the pelvic floor muscles, causing tension and discomfort. To alleviate this tension, I teach my patients relaxation techniques and provide exercises and stretches to improve symptoms.

What next?

If you're a Toronto mama experiencing pelvic pain, bladder symptoms, or vaginal

pressure during your pregnancy, it's important to know that you don't have to suffer through it. Im here to help you through this journey. Through personalized treatment plans that include exercises, stretches, and relaxation techniques, I can help you manage your symptoms and prepare your body for childbirth. Let's work together to make your pregnancy as comfortable as possible. You can book your appointment an appointment with me here!

I hope to see you soon!

Grecia Alaniz PT, PhD(c)

Pelvic Health Physiotherapist & PhD Candidate


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