There is no denying that pregnancy is one extremely daunting experience for many women (especially the first-time round, am I right?) and that is OKAY. Comparing the parenting advice from your friend Jane at lunch who has 3 kids under the age of 6, to your mother’s advice which usually revolves around “oh, I never worried about that with you” can be extremely stressful and can make you feel as though you need to pour coconut oil over your entire life to survive. However, there are many support systems in place to help you along the way for both your physical and mental health. This blog article is aimed at shedding some light onto how Osteopathy can assist you on your pregnancy journey. It is NEVER too late to see an Osteopath along your journey, whether you plan to deliver vaginally or by C-section. During pregnancy, there are many structural changes that occur, which can impact on your daily functioning. Due to biomechanical changes experienced during pregnancy, this can result on additional pressure on the spine and pelvis. This may lead to certain musculoskeletal pain and additional ailments which can impact on a woman’s wellbeing. Changes that you are likely to see
Shift in your centre of gravity
Softening of ligaments
Increase in blood volume by almost 50%
Conditions that you might experience.
Pelvic Girdle Pain
Lower Back Pain
Upper Back Pain
Swelling of the legs
Fatigue and Exhaustion (you are growing life remember!)
High or Low Blood Pressure
Who are we? I hear you say it in your mind, “Ost-E-O-path…it’s something to do with bones, isn’t it?” correct, BUT we consider all your body systems and how they impact on your wellbeing through our wholistic approach to your health.
Government registered allied health care professionals, who attend 5 years of accredited university study inclusive of clinical practice, anatomy, physiology, pathology, neuroscience and osteopathic studies.
Osteopathy is covered by most private health funds and by Medicare’s Chronic Disease Management Plans, DVA patients, State Worker’s Compensation schemes and motor accident insurers (1).
We take a thorough medical history, perform an extensive musculoskeletal examination and any other special orthopaedic or neurological testing if deemed necessary in the consultation.
Hands-on treatment approach to suit your individual wellbeing goals and alleviate pain.
We are highly skilled in supporting women throughout their pregnancies. Our role is to be supportive, aid in maternal biomechanics to help reduce pain and possible difficulties with labor.
So, how can Osteopathic treatment during pregnancy help my journey? With limited medication considered safe to take in pregnancy this leaves very few options for pain control. Osteopathic treatment in pregnancy is safe for both mothers and babies and uses non-invasive and gentle techniques that are carefully selected to minimise any risk and to assist the body to adapt to pregnancy-related changes. Pregnancy brings dramatic musculoskeletal changes that alter normal biomechanics, accompanied by ligamentous strain, increased muscle tension and decreased range of joint motion which can cause pain (2). In a recent study, the most common pregnancy related health conditions that women reported were musculoskeletal complaints including back pain at 39.5% (3). A study of 430 pregnant women found that feelings of depression, anger, anxiety and raised cortisol levels were associated with back pain and leg pain during pregnancy (6).
As Osteopaths, one of our main philosophies is that structure and function are interrelated and symbiotic. Our treatments aim to normalize the structure so that it functions as efficiently as possible. We use techniques that will assist the natural process of pregnancy and birth by aiding the body to adapt, adjust and align as the pregnancy progresses.
We use manual therapy techniques such as soft tissue massage, mobilisation of joints, myofascial stretching and joint manipulation (when deemed safe and appropriate), visceral techniques and Osteopathy in the Cranial Field. Osteopathic Manipulative Treatment (OMT) is a body-based treatment that offers a conservative, non-invasive option for relieving pregnancy-related LBP while increasing back-related function (2).
Studies suggest that Osteopathic treatment provided during the third trimester of pregnancy lessens or halts the deterioration in back-specific functioning that often characterizes the third trimester of pregnancy and thereby provides an important clinical benefit when used as a complementary therapy (4). They also indicate that providing OMT as a complement to conventional obstetrical care during the third trimester of pregnancy has beneficial outcomes (5). Benefits of Osteopathic Treatment in Pregnant Women
Decreased Duration of labor
Decreased Sacroiliac Dysfunction
Decreased Low Back Pain
Decreased Carpal Tunnel Symptoms
Decreased Use of forceps during delivery
Decreased Likelihood of having a preterm delivery
Decreased Blood Pressure
Decreased Fluid Overload
Decreased Probability of having meconium-stained amniotic fluid (8)
Download our free “Basic Pregnancy Stretches” HERE– Before commencing, remember to take this to your Osteopath, GP, Obstetrician to get clearance. How can Osteopathy help on your post-partum journey? Regardless of the type of labour and birth, women can experience a wide range of postnatal issues that can impact their function. Like pregnancy, there are limited medications deemed safe for breastfeeding. Your Osteopath may advise you to make return visits with your newborn to help prevent or manage conditions to help you meet your baby’s needs, whilst caring for your own. Conditions you may experience post-partum;
Back and neck pain due to postural challenges relating to breastfeeding.
Fatigue, anxiety or depression due to sleepless nights and the constant changes you experience as a new mum.
Incontinence and constipation due to changes in the pelvic floor and pelvic mechanics
Lifting babies, prams and capsules causing musculoskeletal strains and sprains.
Pelvic imbalance from pregnancy and labour (including C-Sections).
osteopathy.org.au, (2017). Retrieved 12/11/2017. Osteopathy: About Us. From www.osteopathy.org.au.
Hensel, K., Buchanan, S., Brown, S., Rodriguez, M., Cruser, D. (2015). Pregnancy Research on Osteopathic Manipulation Optimizing Treatment Effects-The PROMOTE study A Randomized Controlled Trial. The American Journal of Obstetrics and Gynaecology, V (212), p1-16.
Frawley, J., Sundberg, T., Steel, A., Sibbritt, D.,Broom, A., Adams, J. (2016). Prevalence and characteristics of women who consult with osteopathic practitioners during pregnancy; a report from the Australian Longitudinal Study on Women’s Health (ALSWH). The Journal of Bodywork and Movement Therapies (available via Science Direct subscription). V (20). p.168-172.
Licciardone, J., Buchanan, S., Fulda, K., Stoll, S. (2010). Osteopathic Manipulative Treatment of Back Pain and Related Symptoms During Pregnancy: A randomized Controlled Trial. American Journal of Obstetrics and Gynaecology. V (202). p.1-15.
Licciardone, J. (2017). Osteopathic Manipulative Treatment During the Third Trimester of Pregnancy. The Journal of the American Osteopathic Association. V (117). P.289-290.
Field, T., Hernandez-Reif, M., Diego, M., Schanberg, S., Kuhn, C. (2006). Stability of mood states and biochemistry across pregnancy. Infant behaviour and Development Journal. V (29). p262-267.
Saurel-Cubizolles, MJ., Romito, P., Lelong, N., Ancel, PY. (2000). Women’s health after childbirth: a longitudinal study in France and Italy. International Journal of Obstetrics & Gynaecology. V (107). P 1202-1209.
Lavelle, J. Osteopathic Manipulative Treatment in Pregnant Women. The Journal of the American Osteopathic Association. V (112). p343-346.
Keeping that New Year commitment to looking after yourself
The most beneficial thing you can do for yourself is engage in a daily movement routine. I say movement, because sometimes ‘exercise routine’ can conjure up thoughts of needing to ‘smash’ oneself by engaging in some sort of gruelling, physical activity where no pain, no gain is the mantra. This does have a place, but most people don’t need to do that to become mobile, happy and healthy.
Typically, if you are on ‘the comeback,’ or even starting from a pretty good base and looking to maintain, I always advised a regular mechanical check over to make sure all the moving parts are moving to their optimal. We look out for restricted areas that need to be released to allow you to return to activity and assess the functional capacity of the tissue to screen for injury risk and ultimately to prevent from injury in the first place.
If you have not regularly exercised in a while and you are starting back, remember slow and steady – build up! You have as much time as you need. There is no point going hard in January only to have to rest up in February and March….then struggle to get the motivation to start up again in April, which gets put off until May!
Along with appropriately warming up, cooling down, stretching and rolling, you can reduce your risk of injury, improve your recovery and performance by regularly attending a yoga class that is right for you and getting some regular massage treatment, especially in the early days…just like the professionals do.
Exercise that focuses on awareness and control of your movement, such as Clinical Pilates, is a necessary part of your regime along with adequate recovery and preparation. Clinical Pilates is one of the best movement regimes to help you understand and become aware of how you move, to re-learn movement that may be ‘out of sync’ and need improving and to strengthen your muscles and joints at angles just not achievable with ‘regular’ training.
It is important to move beyond ‘re-training’ and to work with someone like an Exercise Physiologist, to take what you have learnt about your movement through pilates and apply it to movement tasks of everyday living. It is important to start to replicate usual movement and challenge with load so that you become stronger to perform your ‘tasks of daily living’ – It’s like training for a sport. You break the game or activity into ‘drills’ and practice until your capacity to perform them improves and feels natural…….most people, with recurring or chronic pain, simply need to do something like this, but really, to do this properly, you need help and coaching from a group of experts. Preferably experts who work closely with each other and know who is the best person to be working with at any given time.
Finally through out, it is important to maintain nutrition. A great place to start is with hydration and electrolytes, where Water and Magnesium are the main ‘go to’s’. These will help to keep your energy up, reduce training soreness and maintain your muscle health and suppleness. A great deal of injury prevention and recovery can be achieved with diet and strategic supplementation.
Dr Giulian Di Venuto is principal Osteopath and Director of MOVE Osteopathy and is available for Osteopathic consultations at both Brisbane City and New Farm Clinic. Move Osteopathy also offers, Remedial Massage, Myotherapy and consultations with our Exercise Physiologists, personalised exercise programs in our own rehabilitations gyms and clinical pilates.
A serious problem in your hip joint – like damage to your cartilage. It’s not that common particularly in young people and it is usually painful.
Tight tendons or muscles ‘snapping’ ‘flicking’ and ‘clicking’ over the boney parts of your hip joint. – This is really common and is often painless. The two biggest offenders are your psoas muscle in your groin or your ITB (illiotibial band) on the outside of your hip.
So is it bad?
If you have a serious problem in your hip joint then yes the reparative ‘clicking’ could be bad and causing further damage. If it is caused by ‘tight’ muscles snapping over boney bits ….. while it’s not that bad or necessary painful, it can lead to inflammation, bursitis and other problems at the hip in some people
The people who get “snapping hip syndrome’ the most are often dancers, athletes and people doing a lot of exercise or people that are using their hip flexors a lot in some way.
To know exactly what is going on in your hip and the cause of the ‘snap’ you need your hip properly assessed and diagnosed. Once we have examined your hip then we can work out exactly what is casing it and what to do about it.
In the majority of cases that we see the ‘clicking’ or ‘snapping’ is being caused by tight muscles. Osteopathy takes a global look at your body and movement to see how and why certain muscles have become this way …. Is it a repetitive movement you’re doing? Is it to do with your posture at work or when you are exercising?. Has your psoas become overly tight due to stiffness in your lower back? And so on…
Once we figure out how and why your muscles have become this way be can work out the best way to treat it.
We might release the tension in the muscles and use techniques to improve range of motion in parts of your body that are being affected by the increased tension in these muscles.
We will often prescribe you specific stretches or techniques designed to release tension in the problematic muscles. Foam rollers and massage balls can be very helpful with this
Help you understand and improve your technique or posture with a particular exercise or activity that you are doing
Sometimes no matter what the patient does they will never get rid of it. So long as they have had it investigated and ensure that there is no damage being caused to their joints by the activity that they are doing then they continue to move and ‘clunk’ ‘snap’ and ‘click’ their way through a yoga class. Have you got a snapping hip? Or know someone who does? If you need to be moving better then come see us and we’ll get you moving again! Call one of our clinics for an appointment
WHY STRETCH? Without regular stretching muscles tend to lose flexibility, so when they are called upon to perform a certain movement it can result to damage to the muscular tissue. Certain sports, work related activities ort even activities that you may do around the house involve movements where muscles are not taken to their full range of stretch, this can lead to muscle tightness and shortening. Proper stretching even for short periods, daily can help to
Improve efficiency of the muscles
Increase extensibility of muscles
Improve co-ordination between muscle groups
Relax the muscle and help reduce pain
Decrease muscle tightening after activity
RULES FOR STRETCHING Keep the following rules in mind before attempting any stretching exercises Warm up prior to stretching – a small amount of physical activity or better still a hot bath or shower prior to stretching helps to loosen the muscles and make the stretching more effective and comfortable Stretch gently and slowly – stretch only so far that you do not feel pain. You should feel slight discomfort but no pain Hold your stretch for about 30 seconds – the tension should subside as the stretch is held. Breath slowly and deeply and concentrate on relaxing the area being stretched Avoid ballistic or bouncy stretching – try to keep movements smooth and return to you starting position slowly GETTING AND MAINTAINING A GOOD STRETCHING ROUTINE Make sure that you’re doing the stretches correctly to prevent causing an injury. Get direction from your osteopath or a trainer Your Osteopath or trainer can help you work out a routine – maybe you need to stretch daily or if your neck is sore from working at a computer you might benefit from stretching regularly throughout the day. Make sure that the set of stretches you are doing best suit your specific needs/problem Do each stretch a few times and as you become more flexible to can increase the amount of times and duration of stretch Practice regularly until you build your stretches up to being held for 30 seconds. Stretching in front of a mirror can sometimes be helpful to view your technique. Stretch both sides (where applicable) to keep things even. If the stretch is causing you pain rather than a tension stretch sensation, STOP and seek advice on modifying the stretch. Don’t force yourself into a difficult stretch and remember to keep your movements smooth and avoid jerky movements or ‘bouncing’ the stretch. Keep a regular breathing rhythm while stretching and never hold your breath while trying to perform a stretch.
Ashleigh completed her osteopathic training in 2013 at Southern Cross University in Lismore, graduating with a Bachelor of Clinical Science and a Masters of Osteopathic Medicine.
She is a committed and compassionate Osteopath who has interests in treating a wide array of complaints; from sport-related injuries, to acute and chronic conditions, to office workers.!
She was drawn to osteopathy from her interest in the relationship between the structure and function of the body. Ashleigh appreciates the challenges and diversity that patients and their injuries present.
She enjoys using a wide range of techniques, tailoring treatment to accommodate the individual patients’ needs. Ashleigh will be working with us from early 2014 at the Alex Hills and Brisbane Elizabeth street clinics on the following days
MONDAY: MOVE Osteopathy at Alex Hills
TUESDAY: MOVE Osteopathy at Elizabeth Street – Brisbane City
WEDNESDAY: MOVE Osteopathy at Alex Hills
THURSDAY: MOVE Osteopathy at Elizabeth Street – Brisbane City