Pregnancy Induced Pathology/Problems and Tx

Question 1

Diastasis Recti

Answer 1

• 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

Question 2

Causes of Diastais Recti

Answer 2

• Basically unknown
• Hormonal effects on the connective tissue
• Biomechanical changes of pregnancy

Question 3

When is Diastasis Recti most common

Answer 3

• Last Trimester

Question 4

Does Diastasis Recti spontaneously resolve after childbirth?

Answer 4

• No

Question 5

Diastasis Recti Symptoms

Answer 5

• 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

Question 6

Tx 1cm vs 2cm tear

Answer 6

• Refer to notes

Question 7

LBP commonly occurs due to?

Answer 7

• Postural changes
• Increased ligamentous laxity
• Decrease abdominal function

Question 8

LBP Symptoms

Answer 8

• Increase with fatigue

- Decrease with rest and change of positions (usually disappear post-partum with proper body mechanics)

Question 9

LBP Treatment

Answer 9

• Proper body mechanics training
• Posture instructions
• Modalities may be used post-partum if needed

Question 10

SI Joint Pain causes?

Answer 10

• Ligamentous Laxity coupled with postural changes

Question 11

SI Joint Symptoms

Answer 11

• 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

Question 12

SI Joint Pain Treatment

Answer 12

• External stabilization: belts and corsets
• Exercise modified to not aggravate condition
• Avoid single leg weight bearing
• Modifications of activities

Question 13

SI Joint Pain Treatment Modifications of activities

Answer 13

• Decrease sitting in a car
• Side-lying with pillow between LE’s
• Sexual Adaptation
• Avoid full hip abduction

Question 14

Varicose Veins Causes

Answer 14

• Increase uterine weight
• Venous stasis in LE’s
• Increase venous distensibility

Question 15

Varicose Veins Symptoms

Answer 15

• Occasionally mild to severe pain in LE’s

Question 16

Varicose Vein Treatments

Answer 16

• Minimum weight bearing or LE dependent positions with ex’s
• Elastic support stockings
• Elevated LE’s

Question 17

Function of pelvic floor mm’s

Answer 17

• Support pelvic organs
• Sphyincter- provide closure for urethra and rectum
• Sexual function

Question 18

Pelvic floor mm’s Sexual function

Answer 18

• Increase pleasurable sensation

- Assist in maintenance of erection

Question 19

Prolapse

Answer 19

• 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

Question 20

Incontinence

Answer 20

• May result from neurological problem and/or mm weakness

- Often occurs along with prolapse

Question 21

Pain and Hypertonus

Answer 21

• MM Tension
• Many possible causes including delayed healing or scar tissue after perineal trauma, the childbirth process and mm spasm

Question 22

Pelvic Floor Treatment

Answer 22

• Isometric pelvic floor ex’s to increase strength (KEGAL Ex’s)
• Elevator Ex’s

Question 23

Kegal Ex’s

Answer 23

• Used to treat prolapse and incontinence

- Begin in supine and progress to sitting and standing

Question 24

Gradually ____ and ______ pelvic floor mm’s, (_____ the elevator at each floor)

Answer 24

• Raise
• Lower
• Pausing