Pregnancy: Physiological Changes, Physiotherapy and Tips

Written by: Lindsey Peebles MSc PT, RMT
– Physiotherapist, Dry Needling Certificate, Pre and Postnatal Fitness Specialist Course, Registered Massage Therapist


The watery part of your plasma increases REALLY fast to supply enough blood to both yourself and your baby. This can cause both lightheadedness, as well as fatigue – especially in the first trimester.


Hormone levels change, which is great because that’s what helps your baby develop but also can cause headaches, and water retention.


One of those hormones is called relaxin, and it’s in charge of allowing your ligaments to soften in preparation for delivery. Because of this really necessary process, all your ligaments become more flexible and puts you at greater risk for injury during high impact activities. It may also contribute to sore feet as your arches may become more flexible.


Muscles may tighten in response to the softer ligaments in order to keep your body stable. This is one of the reasons women often begin to get hip and back pain as their pregnancy progresses.

Abdominal wall

While your baby grows, it will stretch your abdominal wall, making them weaker; this may contribute to the low back pain. Sometimes a vertical tear may develop through one of the abdominal muscles – this is called diastasis rectus. Although it is not always avoidable, there are definite strategies to help reduce it’s occurrence as well as minimise its impact both while pregnant and postpartum.

Pelvic floor

Your baby will also put pressure on your pelvic floor which may cause urinary incontinence as your pregnancy progresses. Pelvic floor health is essential to prevent leaks as well as to prepare for delivery.


Another reason for discomfort during pregnancy is that your centre of gravity shifts forward as your baby gets bigger. This can put more pressure on your low, mid back and neck.


Most pregnant women experience some type of new stressors as they prepare to go on maternity leave, give birth, care for an infant, etc. So stress very commonly contributes to muscular tension in the upper back and neck as well as headaches.


is one of the most common features of pregnancy. It is completely understandable given the energy required to grow an entirely new human from scratch.

Pregnancy & Physiotherapy

There are a lot of things outside of your control during a pregnancy, but there are also lots of things you can do with the help of a physiotherapist to ease the journey. During an uncomplicated pregnancy, physiotherapy focuses on 3 primary goals:

Maintain/build pelvic floor & abdominal muscle health

Physiotherapy during pregnancy can educate you on exercises to avoid for pelvic floor and abdominal wall health, as well as how to strengthen them using safe, low impact techniques. These can reduce the incidence of urinary incontinence, prolapse, rectus diastasis (abdominal wall separation) as well as aid in post delivery pain relief and recovery from both vaginal and cesarean deliveries.

Maintain cardiovascular health

Staying physically active is just as (if not more) important while pregnant as every other day of the year. Physiotherapists can discuss safe options for you with your current physical activity levels and preferences in mind. Both cardiovascular exercises and resistance training can be both safe and beneficial during pregnancy with the right guidance.

Reduce pain

There are numerous factors that contribute to pain during pregnancy. Physiotherapy is an incredibly effective tool at identifying the most appropriate home program to reduce your pain and keep you doing the things you enjoy throughout your pregnancy. Strengthening, stretching and mobility work are all great options for women both during and after their pregnancy, and with the right guidance, can typically be carried out throughout the duration of your pregnancy to alleviate pain.

Just some ideas:

  1. Sit before you stand to prevent falls from lightheadedness. And when you do stand, be prepared to stay still for a minute to let the dizziness settle.
  2. Stay hydrated. It will help with water retention as well as aid in keeping headaches away.
  3. Wear supportive shoes. This will hopefully help prevent your feet from aching as well as reduce injury.
  4. Exercise. It is encouraged to engage in some type of low impact form of exercise most days of the week. Listen to your body, and don’t push beyond where you’re comfortable. Some days you’ll be too tired, and that’s OK.
  5. Train your pelvic floor and deep abdominal muscles. Keagle exercises are a great way to start. Core work should be more gentle than perhaps you’re used to. Physiotherapy should assist in directing these movements.
  6. Keep your knees soft when you stand. Locking your knees puts additional pressure on your already compensating joints.
  7. Take care of yourself. Do something a few times a week that you enjoy, instead of something on your to-do list.
  8. Always know it’s OK to nap. Just do it.