Antenatal physiotherapy

antenatal physiotherapy

1. Antenatal physiotherapy By Dr.Akshita (PT) -D.C.PT -Yoga instructor -Nutritionist

2. Women in good health should be encouraged to engage in regular moderate intensity physical exercise during a normal, uncomplicated pregnancy A thorough medical evaluation should be conducted prior to prescription of a specific exercise program

3. Aims To improve the physical and mental health of mother and children. To ensure that the mother and her baby are in the best possible health. To detect early and treat properly complications Offering education for parenthood To prepare the woman for labor, lactation and care of her infant

4. To develop awareness and control of posture during after pregnancy. To develop strength for demands of infant care , as well as inc. weight bearing and circulatory compromises. To prepare for labour , delivery and post partum activities.

5. CONTRAINDICATIONS FOR EXERCISE Chest pain Abdominal and pelvic pain Dizziness Vaginal bleeding Headache Sudden swelling on ankle ,face ,hands

6. Guidelines for exercises Avoid any kind of jerky movements. Warm up before exercises , followed by cool down post exercises ( shavasana can be used). Do not exercise in supine position for more than 5 minutes continuously. Encourgement for bladder emptying prior the session.

7. Avoid exercise on single leg standing. STOP WHEN- - persistant pain -leakage of amniotic fluid -vaginal bleeding - sob - dizziness or fainting

8. Sequence Warm up Selective stretching Aerobics Postural exercises Strengthening exercises Pelvic floor exercises Cool down Relaxation techniques

9. Warm up Atms Heel slides Static quads Static hams Finger movements

10. Stretching Neck muscles Scapular muscles n shoulder muscle. Lowe limb muscles.- adductors , TA.

11. AEROBIC EXERCISES Walking Low impact aerobics classes Stationary cycle Swimming Low impact dancing Jogging

12. POSTURAL EXERCISES/STRENGTHENING EXERCISES CORRECTION OF DIASTASIS RECTI-  muscles in your abdomen separate during pregnancy, leaving a gap that allows your belly to pooch out. 

13. PELVIC TILTS - quadriped position/standing.

14. WALL SLIDES-

15. CAT AND CAMEL

16. clamshell

17. Trunk curl ups-if no diastasis recti present Diagonal curl ups. Modified cycle -alternate heel slide

18. B/L U/L Strengthening Active exercises Use of dumbells Use of resistance bands

19. PELVIC FLOOR EXERCISES Pelvic clock Kegals exercise Static gluteals

20. Cool down exercises Slow the pace of walking , cycling etc. Shavansana Deep breathing exercises -segmental breathing -thoracic expansion -diaphragmatic breathing

21. RELAXATION TECHNIQUES POSITION :lying with towel roll under the waist at right with pillow under the knees. Diaphragmatic breathing (avoid breath holding) Meditation can be practised . Light music may also help.

22. BODY MECHANICS AND POSTURE TRAINING LYING SUPINE- place a towel roll under the waist and a p illow under the knees. SIDE LYING- place a pillow underthe top thigh and knee to avoid pelvic rotations.

23. SITTING – sit with hip and knee with at right angle, back should be support, a pillow can be placed , - a low stool can be used for foot support , if require. STANDING / WALKING – walking is more preferred than standing still. - while standing try to distribute weight equally.

24. Avoid stooping. Avoid repetitive trunk rotation. Avoid forward bending instead perform knee bending to lift up object from ground whenever required.

25. SLEEP POSITIONS

26. POSITIONS FOR LABOR Walking Sitting on a chair fully upright Sitting backwards on the chair with legs apart.  

27. Tailor sitting Squatting- it speeds up pushing phase of labour Hands and knees – Great position to help the back take a break from the intensity of contractions

28. Breast feeding postures

29. Busting the myths about Pregnancy

30. Myth:  Morning sickness means my baby is probably not getting enough nutrition: Fact: Morning sickness is just one of the most common symptoms of pregnancy which arises due to hormonal changes in your body . Unless you notice warning signs like dehydration, severe weight loss or severe morning sickness, there is no need to panic .

31. Myth: Slightest of touch over the tummy can harm the baby Your baby is well protected in your uterus and is cushioned from minor bumps, stumbles, and falls by the amniotic fluid in which s/he floats . Moreover the abdominal layers protect the baby from any minor accidents. If you experience cramps or vaginal bleeding, contact your doctor immediately.

32. Myth: Exercising will harm my baby Being fit increases your stamina and prepares you for the strenuous process of childbirth . In fact, women who were not used to doing any exercise are advised to start doing some during their pregnancy . Brisk walk is the safest, swimming, breathing exercises and yoga and meditation are recommended as they are great relaxants But should only be practiced after consulting with doctor.

33. Myth: Eating hot and spicy foods can cause abortion. If eaten in moderation, it causes no harm to the baby . However , one should avoid very spicy food as during pregnancy. Many pregnant women have the symptoms of heartburn and very spicy food may increase it.

34. Myth: Pregnant mothers must eat for two . The requirements of the pregnant mothers increase, she is supposed to eat a little extra, about 350 kcals per day more. Pregnant mother actually needs is a well-balanced nutritious diet that consists of all the food groups, so that it fulfils the needs of all the nutrients adequately. Pregnancy is not about eating for two but eating a balanced diet.

35. Myth: Drinking coffee adversely affects pregnancy False. Coffee in small amounts does not affect the baby, but avoid drinking more than three cups a day. Very large amount of caffeine may result in a baby with a low birth-weight.

36. Myth: Not to take bath False Bathing helps in keeping body clean and germ free . It is essential for maintaining proper hygiene and everyone should take bath . Pregnant women are no exception for this vital daily activity – unless there is bleeding or the water breaks . Too hot water should be avoided

37. Myth: Pregnant women with low belly have a boy, pregnancy acne means a girl . False How a woman carries her baby depends on her body type and whether she has been pregnant before. In a second pregnancy, the pregnancy may appear to be lower since abdominal muscles may be looser . Pregnancy acne also has nothing to do with gender; it is just a result of natural hormonal changes.

38. Myth: You cannot avoid backache Scientifically speaking backaches can be minimized by having correct postures and by doing gentle back exercises . Try to keep your spine straight. You should bend your knees to lift anything and carry it close to your body.

39. Common Discomforts of Pregnancy 1.Nausea and Vomiting- most cases of nausea and vomiting in pregnancy will resolve spontaneously within 16 to 20weeks. non-pharmacological :ginger 2.Heartburn- Eat small, more frequent meals. Use antacids. Avoid overeating and spicy foods Don’t lie flat

40. 3.Backache Wear shoes with low heels. Back support while sitting Use firmer mattress. Perform pelvic rocking or tilting Don’t bend 4. Fatigue Rest frequency. Go to bed earlier.

41. Dependent Edema Avoid standing for long periods. Elevate legs when laying or sitting. Avoid tight stockings.

42. Nasal Stuffiness and Epistaxis Avoid decongestants. Use humidifiers, and normal saline drops .

43. Ptyalism (excessive salivation) Perform frequent mouth care. Chew gum. Decrease fluid intake at night. Maintain fluid intake during day.

44. Sleep Difficulties Rest frequently Decrease fluid intake at night Relaxation techniques Pillow between knees Propped up

45. When a new life enters this world “ the pain of the child birth is not remembered. It’s the child that is remembered”

46. THANK YOU