New York Times Pregnancy Pains Got You Down?

New York Times

Marianne Ryan PT was recently interviewed by Rachel Rabkin Peachman of New York Times Parenting magazine for an article entitled Pregnancy Pains Got You Down?

Pregnancy Pains

  • Women commonly experience aches and pains during each trimester of pregnancy. In most cases, they are normal and aren’t cause for alarm.
  • The most common pregnancy pains can include uterine cramping, headaches, pelvic pain, round ligament pain (sharp jabs in the lower belly or groin) and backaches.
  • Every pregnancy is different. Symptoms that occur during one pregnancy may not pop up during subsequent pregnancies, so expect the unexpected.

Pelvic pain.
 The hormones released in your body during pregnancy can loosen the joints and ligaments in your pelvic region in preparation for labor, which can cause a lot of discomfort beginning in the second trimester, said Marianne Ryan, P.T., a physical therapist in New York City and author of “Baby Bod.”

When the joints and ligaments are lax and the expanding uterus begins to weigh on them, it can destabilize the back joints of the pelvis (the sacroiliac joints) and the front cartilaginous joint of the pelvis (the pubic symphysis). This results in groin, thigh and lower back pain, which can make walking or even seemingly simple movements difficult, such as turning in bed or getting up from a chair. To compensate for the added weight and imbalance, said Ryan, moms often tighten the muscles in their buttocks unintentionally: “The muscles can stay in spasm and that can cause a whole slew of dysfunctions including painful sex and incontinence.”

How to relieve it: Explain your symptoms to your practitioner so that she can get an accurate sense of the problem. She may recommend solutions such as rest, massage, physical therapy or a pregnancy belt to offset pressure on the pelvis and to alleviate muscle strain.

Carpal tunnel syndrome. Swelling tissues can crowd the nerve that runs through the carpal tunnel (a passageway inside the wrist), causing tingling, pain and numbness in the wrist and fingers.

How to relieve it: Talk to your practitioner. She may recommend that you avoid repetitive hand movements, wear a wrist splint, apply ice to reduce swelling or try physical therapy. After you give birth and the pregnancy swelling dissipates, the carpal tunnel pain should lessen too.

Gastro-esophageal reflux. Heartburn usually starts toward the end of the second trimester, said Dr. Barfield, and can feel like a burning in the chest, often accompanied by belching and regurgitation. Pregnancy hormones can cause the gastrointestinal system to slow down and the sphincter at the top of the stomach to relax, which can force food and stomach acid up the esophagus, she said. The growing baby in the uterus can also displace the stomach so that there is less room for it to empty, which can push stomach acid up.

How to relieve it: Dr. Barfield recommended eating small, frequent meals so as not to overload your stomach and to facilitate gastric emptying. She also suggested sitting up while eating (to help the food travel down the digestive tract more easily); avoiding late-night meals (to allow your food to digest before you lie down); limiting high-fat foods (such as butter-based dishes), cold foods and spicy foods (which can aggravate the gastrointestinal system).

Back pain. The main causes, according to ACOG, are strain on the back muscles, weak abdominal muscles and pregnancy hormones that loosen and destabilize the ligaments and joints in the lower back and pelvis. The overall effect is often poor posture and weakened, sore or tight back muscles.

How to relieve it: According to Dr. Isaacs, most people can navigate back discomfort with simple solutions. ACOG recommends wearing shoes with arch support; being mindful of good body mechanics when bending or lifting (bending from your knees, for instance, rather than from your waist; and keeping your back in a neutral position when lifting items); using lumbar support when sitting; and sleeping on your side with a pillow between your legs.

You can also try a pregnancy belt to take some pressure off your lower back or ask your practitioner about core strengthening exercises. “I always remind women to stay active and exercise in pregnancy,” said Dr. Isaacs, who suggested trying prenatal yoga, massage or hydrotherapy (swimming or soaking in baths).

If you feel sharp, unbearable pain or severe aching, discuss it with your provider. “You always want to rule out [other dangerous possibilities] like a kidney infection or kidney stones,” said Dr. Ross.

Round ligament pain. Sharp jabs or achy cramps on either side of the lower abdomen are some of the most common pains during the second trimester, said Dr. Cynthia Gyamfi-Bannerman, M.D., an ob-gyn, maternal-fetal medicine specialist and co-director of the Preterm Birth Prevention Center at Columbia University Medical Center in New York City. They occur when the ligaments that support the growing uterus begin to stretch. The pain is usually intense and intermittent and often gets worse with sudden movements such as coughing or sneezing.

How to relieve it. Though it’s a natural consequence of the growing uterus, round ligament pain can be jarring. “I’ve had some women who said it was severe enough that they thought they had appendicitis,” said Dr. Clark. If you’re feeling intense pain, especially if it’s accompanied by other symptoms such as fever or bleeding, call your practitioner, who will want to rule out dangerous conditions such as appendicitis or kidney infection. If it turns out that you’re dealing with round ligament pain, you may be able to lessen the discomfort by changing positions, applying a warm compress to the painful area or avoiding sudden movements that strain the abdomen.

You can read the full article HERE

MARIANNE RYAN PT, OCS is an award-winning author, physical therapist and board-certified orthopedic clinical specialist with more than 30 years’ experience treating prenatal and postpartum women. She is the owner and Clinical Director of Marianne Ryan Physical Therapy in New York City and the creator of the groundbreaking DIY “Baby Bod” program, which is the first of its kind to bridge the gap between medical care and fitness advice. As a leading women’s health expert (and a mom), Marianne is passionate about helping women reclaim their changed bodies, whether they are pregnant, recently took part in the joy of birth or are experiencing the “joy” of menopause. Watch her TEDX video, “What Your Momma Never Told You About Childbirth” at

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