Pregnancy Induced Pathology/Problems and Tx Flashcards
Diastasis Recti
- Separation of rectus abdominus mm’s in the midline at the linea alba
- Most common above umbilicus
- Not exclusive to childbearing women but most common with them
- Less common with women with strong abdominals
- Any tear > 2cm is significant
Causes of Diastais Recti
- Basically unknown
- Hormonal effects on the connective tissue
- Biomechanical changes of pregnancy
When is Diastasis Recti most common
- Last Trimester
Does Diastasis Recti spontaneously resolve after childbirth?
- No
Diastasis Recti Symptoms
- Complaints of LBP, as a result of decreased ability of the abdominal musculature to control pelvis and lumbar spine
- Severe separations may progress to herniation of abdominal viscera through the separation in the abdominal wall
Tx 1cm vs 2cm tear
- Refer to notes
LBP commonly occurs due to?
- Postural changes
- Increased ligamentous laxity
- Decrease abdominal function
LBP Symptoms
- Increase with fatigue
- Decrease with rest and change of positions (usually disappear post-partum with proper body mechanics)
LBP Treatment
- Proper body mechanics training
- Posture instructions
- Modalities may be used post-partum if needed
SI Joint Pain causes?
- Ligamentous Laxity coupled with postural changes
SI Joint Symptoms
- Pain usually in posterior pelvis and deep buttocks distal and lateral to L5/S1
- Pain may radiate into posterior thigh and knee
- Pain with prolonged sitting, standing and walking
- Pain with stair climbing or turning in bed, unilateral standing or torsion activities
- Pain not relieved by rest
- Pain worsens with activity
- May be accompanied by pubic symphysis discomfort and/or subluxation
SI Joint Pain Treatment
- External stabilization: belts and corsets
- Exercise modified to not aggravate condition
- Avoid single leg weight bearing
- Modifications of activities
SI Joint Pain Treatment Modifications of activities
- Decrease sitting in a car
- Side-lying with pillow between LE’s
- Sexual Adaptation
- Avoid full hip abduction
Varicose Veins Causes
- Increase uterine weight
- Venous stasis in LE’s
- Increase venous distensibility
Varicose Veins Symptoms
- Occasionally mild to severe pain in LE’s
Varicose Vein Treatments
- Minimum weight bearing or LE dependent positions with ex’s
- Elastic support stockings
- Elevated LE’s
Function of pelvic floor mm’s
- Support pelvic organs
- Sphyincter- provide closure for urethra and rectum
- Sexual function
Pelvic floor mm’s Sexual function
- Increase pleasurable sensation
- Assist in maintenance of erection
Prolapse
- Pelvic organs drop due to ligamentous disruption, mm weakness
- Worsens over time and with pregnancies
- Aggreavated by chronic constipation, straining during elimination, coughing, obesity
- May require surgery
Incontinence
- May result from neurological problem and/or mm weakness
- Often occurs along with prolapse
Pain and Hypertonus
- MM Tension
- Many possible causes including delayed healing or scar tissue after perineal trauma, the childbirth process and mm spasm
Pelvic Floor Treatment
- Isometric pelvic floor ex’s to increase strength (KEGAL Ex’s)
- Elevator Ex’s
Kegal Ex’s
- Used to treat prolapse and incontinence
- Begin in supine and progress to sitting and standing
Gradually ____ and ______ pelvic floor mm’s, (_____ the elevator at each floor)
- Raise
- Lower
- Pausing
