Management of Common Pregnancy Symptoms

Muscle aches, cramps and swelling are common during pregnancy. Here are some simple ways to help you manage the discomfort.

To relieve swollen legs

Pregnancy causes your body to retain fluid — increasing pressure from the growing womb slows down the blood returning to the heart, resulting in pooling of blood especially in the legs. This commonly occurs in the late second to third trimester.

The following measures may help:

Avoid prolonged standing
Elevate legs
Wear graduated compression stockings
Wear comfortable supportive shoes
Keep active

You can try this exercise at home or even at your workplace:

Ankle pumps

Begin with elevating your legs — a good way is to lie on the sofa with your legs on the arm rests.

In a long sitting position (to sit straight with your legs stretched out in front of you), bend an ankle upwards, as if you're pulling your toes towards you. Relax that foot and repeat with the other foot. Repeat this exercise 10 times on each foot.

To stop leg cramps

The cause of leg cramps is unknown. It could be due to the increased work from carrying extra body weight during your daily activities.

The following measures may help:

Avoid prolonged standing or walking
Wear comfortable and supportive footwear
Avoid high heels
Stretch your leg muscles regularly

Try these exercises:

Calf stretch in sitting

You begin by sitting on a mat or a firm surface, keeping one leg bent with the foot flat on the floor and pointing forward. Loop a towel around the foot of the straight leg and slowly pull the foot to point towards you. Hold the position for 20 seconds and slowly release the towel. Repeat this exercise 10 times on each leg.

Calf stretch in standing

You begin by standing on a firm surface, and taking a step forward with one foot. Your front leg's knee should be bent, and both feet are pointing to your front. You may lean a hand on a heavy chair or do this exercise next to a wall for support.

Hold this position for 20 seconds, and switch sides by bringing the front foot back to the side of the other foot, then extending the other foot out to the front.

Carpal tunnel syndrome

The fluid your body retains in pregnancy places increased pressure on the median nerve in the wrist. Common symptoms can include numbness, and pins and needles in the fingers.

The following measures may help:

Use a wrist splint, if pain is present or worse at night
Avoid sleeping on your hands
Elevate your hands
Keep active
Check work ergonomics, avoid prolonged periods in the same position

Try these exercises:

Hand squeeze

You'll begin by raising your arms straight out and at a level above your heart. Open and close your palms — you can choose to squeeze a stress ball in each palm as a variation to this exercise. Repeat this 10 times for both hands.

Wrist extension stretch

Extend your elbow to hold your arm straight in front of you. Stretch your wrist backwards and press the fingers and palm towards you with your other hand. Hold the stretch for 20 seconds and change to the other arm. Do 10 repetitions of this exercise on both arms.

Backache

Back pain is common in pregnancy; some 50–70 percent of pregnant women will suffer from lower back pain at some point during pregnancy.

Back pain may occur because of:

Hormonal changes

During pregnancy, the ligaments relax to allow the pelvis to stretch and accommodate the growth of the baby. Other joints also become more flexible and require more support from muscles — which may tire or strain easily.

Biomechanical changes

Backache can be a result of your abdomen growing and stretching in front, supported by your back muscles.

Try these exercises:

Pelvic tilt in four point kneeling

You need to get down on your hands and knees on a mat for this pose. To ensure good posture, check that your shoulders are above your hands and that your hips are above your knees.

Relax your abdomen and take a breath in. While breathing out, suck your belly in, imagining pulling your belly button up towards the spine. Tilt your pelvis backwards to flatten your back further and hold this position for 5 seconds. Repeat the steps 10 times.

Make sure your lower back is not arched throughout the exercise and do not hold your breathe. A great way to check your posture is to practice with a mirror on your side.

Pelvic tilt in standing

Stand upright with your feet shoulder-width apart, ensuring not to lock your knees in extension. Tilt your pelvis backwards to flatten your back, you should feel your abdominal and buttock muscles tighten when you do so. Hold this position for 5 seconds and revert to standing normally.

Do not hold your breath when doing this exercise, and repeat steps 10 times.

Pelvic rocking

Begin by standing with your feet shoulder-width apart, and rock your pelvis to your left and to your right. Repeat this 10 times.

Make sure that as you rock your pelvis, your upper body is upright and not swaying.

Pelvic tilt/rocking combined

A combination of the previous two exercises.

Stand upright with your feet shoulder-width apart, making sure not to lock your knees. Rock and tilt your pelvis clockwise (i.e. rock your pelvis left, tilt forward, rock right then tilt back if you start from the left). Do this rocking sequence 10 times.

There are other pain coping strategies that may help alleviate your back pain. Placing a heat pack over the lower back along with a massage can help to relieve muscle tension in the area. A maternity belt may help to support the weight of the growing abdomen.

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By Catherine CHUA Bee Hong Senior Principal Physiotherapist, Elizabeth CHAN Jiahui Principal Physiotherapist, KK Women's and Children's Hospital

Sources:
The New Art and Science of Pregnancy and Childbirth 2008, World Scientific
Healthy Start for your Baby 2012, Health Promotion Board Singapore

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