A guide to learning about your bodily changes during pregnancy – Musculoskeletal system!
Congratulations You’re Pregnant! Your body already has been and is going to continue to change so much in the next 9+ months!
We wanted to write a series of blogs to provide you with an overview of the bodily changes you will experience during pregnancy and list some helpful tips on managing your expectations in the coming months.
Here is a short breakdown of the upcoming changes to look forward to! Remember to check out the other pregnancy and pelvic health blogs.
Disclaimer: Each person and pregnancy is going to be unique! This is intended to be a brief summary to give a general picture of the physiologic changes associated with uncomplicated pregnancy. This is not meant to be an all-encompassing list or medical advice of any kind.
At any time, if you have any medical concerns or specific questions, please ask your healthcare provider.
MUSCULOSKELETAL SYSTEM: This system generally consists of muscles, ligaments, tendons, and bones. Here is a link to a short video to review the musculoskeletal system if you would like more information.
- Bone Health:
- With an increase in fetal demand, more calcium is absorbed from the intestines and mother’s bone. So, you can be at an increased risk for osteoporosis during pregnancy as the bones become brittle, especially if you are taking medications like heparin or corticosteroids, drink alcohol or smoke.
- It is STRONGLY advised to make sure you get adequate calcium intake throughout this time, and again, please consult your healthcare provider if you have any concerns about this.
- Postural Changes:
- As you gain weight in your pregnancy, your posture will change!
- As you gain weight in your pregnancy, your posture will change!
- This is due to increasing girth and stretch of body tissue to accommodate the growing baby. Please note that weight gain is healthy and between 20-30 pounds is typically recommended. Excessive weight gain can sometimes cause pain with postural changes.
- As these changes progress in your pregnancy, your body’s center of mass can shift forward causing an increased demand on your back and become a source of pain. This can be helped in many ways!
- Report any back or pelvic pain to your medical provider and he/she can refer you to a pelvic health physical therapist. Pelvic health physical therapists are specialists who can discuss exercises, need for support garments, and better ways to perform daily activities to avoid pain!
- Thoracic Outlet Syndrome (TOS):
- Sometimes, a syndrome called the thoracic outlet syndrome, can develop in pregnant women due to breast growth, upper trunk postural changes, and water/fluid retention. This involves compression and irritation of the nerve and vascular structures in your neck causing issues down the arms.
- Common symptoms include numbness/tingling down one or both arms, temporary absence of radial (wrist) pulse, pain down arms/into hands, coolness and decreased grip strength in the hands.
- If you start to develop any of these symptoms, please go to our module on TOS on our webpage and/or consult your healthcare provider for further help.
- Muscular Health:
- As the baby grows, the abdominal muscles and connective tissue around your tummy will be stretched to accommodate the growing fetus. This is normal and can sometimes cause muscle weakness and midline tissue gapping. This is commonly known as Diastasis Rectus Abdominus (DRA). Please note that the DRA most likely resolves spontaneously after delivery, but can become a problem after and may contribute to other issues.
- Common symptoms include vertical abdominal gapping, skin coning or doming during various activities, and/or pain/weakness in your abdomen or back.
- Pelvic floor muscles, those located on the bottom of your pelvis which primarily control urinary, bowel, and sexual function, are also put under additional stress during pregnancy. These muscles can begin to show pain or weakness due to the additional demands for support which can result in pelvic pain, pain with intercourse, or even urinary or fecal incontinence.
- If you have been noticing any symptoms of these core muscles, first report it to your healthcare provider, and know this can be addressed by a pelvic health physical therapist. If you have these symptoms, please go to our module on pelvic pain, incontinence or DRA on our webpage and/or consult your healthcare provider for further help.
What you may look like?
- Do not be discouraged if you are looking different than your normal self, your posture changes as your abdomen grows and your muscles lengthen to accommodate for this change. This is normal and healthy.
- With postural or muscular changes, realize that this is necessary as your pregnancy progresses, but your body does not need to stay this way forever. Most if not all of these changes can be improved and can return back to your pre-pregnancy aesthetics, but this can take time and effort after the delivery. Also, pending if your body has experienced any complications during pregnancy or delivery, your postpartum body is still your body, and it should still function well even if it doesn’t look the exact same as before.
- Especially if your abdomen looks different, with stretch marks, extra skin or weight, or diastasis rectus abdominus, remember, you can still be strong and function the same as before pregnancy. Some of these changes are not permanent, but most of the time, you will need to consider multiple factors and possibly medical intervention, such as pelvic physical therapy to address this. Many factors, such as sleep, time, and breastfeeding can all play into diastasis healing or continuation. If diastasis is your only concern, and you have no other symptoms, such as pain or urinary leakage, there are a few exercise-programs designed by healthcare professionals targeted to address this. One is linked here.
- You can lose this weight during the postpartum time period if desired, but remember what your body is going through and focus on the positives! Embrace this as your new healthy body during this pregnancy and focus on thriving and being strong during this time!
What you may feel?
- As your pregnancy progresses and the changes noted above, you may start to feel more discouraged at your body’s changing appearance. If you truly feel like you are having signs and/or symptoms of depression during this time, please tell your healthcare provider so you can get help for this.
- With symptoms of Thoracic Outlet Syndrome, like tingling, numbness, and/or coolness in your fingers, hands or wrists, please see our thoracic outlet syndrome module to try some conservative exercises to perhaps improve these symptoms. If you are truly feeling weakness in your hands with losing your grip and dropping items, this condition may be progressing to affecting your strength. Please share these symptoms with your healthcare provider to address this condition.
- Due to these changes and need for increased growth, your body requires more energy, and as a result, you may feel tired or fatigued and hungrier at times.
- This also means you will experience weight gain in your breast and pelvic region.
- You may feel some heaviness or pressure in your perineum and abdomen, and if you start to experience pain, please see your provider to see if any treatment for its cause is possible.
- Due to this weight gain, you may move a bit slower when exercising or during everyday life activities. This is also normal and the decreased intensity of exercise can help you shift your focus on exercise to being healthy during your pregnancy and prepare for labor and delivery. Here is a link to a blog on Exercise during pregnancy and post-partum to help you get started with exercise.
- With the Braxton Hicks contractions, you may feel some tightening around your abdomen or even abdominal cramps (like when on your period) randomly throughout the day or after intense activity or working out. These may be very weak or strong and rhythmic. These can give you a sense of going into labor, but most of the time, these will subside within 30 minutes after stopping an activity/working out or with positional changes (lying down to rest). This is what is known as “false labor”. If these cramps happen regularly for a while (over an hour) and you think you may be in labor, contact your healthcare provider.
Resources
In addition to the physiologic changes that happen within the body, particularly the musculoskeletal system, we would like to introduce you to the anatomy and physiology of the pelvic floor muscles. This is a group of muscles like a bowl on the underside of the pelvis, which can be most impacted by pregnancy, delivery, and in the post-partum time. These muscles are important and present for everyone, but play a particularly important role during pregnancy and especially with a vaginal delivery.
- Education Piece: Anatomy and Physiology of the Pelvic Floor Muscles
- Resources: Pelvic Sanity Pelvic Floor 101 and Female Pelvic Floor Muscles
References
- The American College of Obstetricians and Gynecologists. (2016). Your pregnancy and childbirth: Month to month. Revised 6th Edition.
- mahalie stackpole from seattle, USA, CC BY-SA 2.0 <https://creativecommons.org/licenses/by-sa/2.0>, via Wikimedia Commons
- Nicole Cozean. 2018. Pelvic Floor 101: What is the Pelvic Floor? Pelvic Sanity. Viewed Nov, 7, 2022. {https://www.pelvicsanity.com/post/2018/02/09/pelvic-floor-101-what-is-the-pelvic-floor}
- Holly Tanner. Physiologic Changes during Pregnancy. Medbridge. {www.medbridgeeducation.com}
- Beatriz morales trenas, CC BY-SA 4.0 <https://creativecommons.org/licenses/by-sa/4.0>, via Wikimedia Commons
- https://www.scientificanimations.com, CC BY-SA 4.0 <https://creativecommons.org/licenses/by-sa/4.0>, via Wikimedia Commons
- https://pxhere.com/en/photo/993215?utm_content=shareClip&utm_medium=referral&utm_source=pxhere