Quick Guide To The Most Common Injuries During Pregnancy

Pregnancy is a transformative time filled with anticipation and excitement. However, the physical changes that come with this new chapter can also bring about some common injuries during pregnancy. Understanding these common injuries during pregnancy can help expectant mothers manage and alleviate their symptoms, ensuring a healthier and more comfortable pregnancy

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What Are The Most Common Injuries During Pregnancy?

1. Lower Back Pain

Lower back pain is perhaps the most common of all injuries during pregnancy. As the baby grows, the weight of the uterus shifts the center of gravity, putting extra strain on the lower back. Additionally, hormonal changes lead to the relaxation of ligaments, contributing to back discomfort. Studies estimate that low back pain is affecting 50% of all pregnant women. It is caused by the extra weight and pressure on the spine, as well as the changes in spinal biomechanics that occur during pregnancy. Symptoms may include pain in the lower back, buttocks, and legs, difficulty standing or walking, and a feeling of stiffness or tightness in the back.

Sciatica: Sciatica is a condition that causes pain, tingling, and numbness in the back and legs. It is caused by compression or irritation of the sciatic nerve, which runs down the back of the leg. Sciatica most often occurs during the third trimester of pregnancy, when the baby’s weight is putting extra pressure on the nerve. This can be particularly uncomfortable and limit mobility.

2. Pelvic Pain

Pelvic pain often arises from the loosening of the pelvic ligaments in preparation for childbirth. Therefore, discomfort can develop in the pelvic region, including the symphysis pubis and sacroiliac joints.

Pelvic Girdle Pain (PGP): PGP is a very common injury during pregnancy and can affect up to half of all pregnant women. It is caused by the pelvic bones moving asymmetrically. Hence, causing decreased movement on one side of the pelvis and increased movement on the other side, the risk is higher as the baby grows. This can lead to pain in the hips, lower back, and buttocks.  

Symptoms can vary from woman to woman, but may include pain when standing or walking, difficulty climbing stairs or carrying objects, and a feeling of instability in the pelvic area. PGP during pregnancy is the highest predictor for pelvic pain post partum. So it is important to address PGP early in order to mitigate issues later on.

Pelvic Floor Dysfunction/Stress Incontinence

Pregnancy and childbirth stretches and weakens the pelvic floor muscles. This can result in urinary incontinence particularly during activities which increase internal abdominal pressure such as:

• coughing
• sneezing
• lifting 
• bending forwards 
• exercising (i.e. walking, running, aerobics)

This is very common post pregnancy and can be extremely embarrassing and distressing. The good news is like all muscles in the body the pelvic floor can also be strengthened. It is good practice to commence regular pelvic floor exercises during and after pregnancy. 

These exercises are provided during most ante/postnatal classes but it is best to see a physiotherapist who specialises in women’s health to ensure the correct muscles are being activated when exercising. 

3. Round Ligament Pain

Round ligament pain is one of the most common injuries during pregnancy. As the uterus expands, the round ligaments that support it can stretch and cause sharp, stabbing pain in the lower abdomen. This discomfort often occurs with sudden movements or changes in position.

This pain in the lower abdomen usually crops up in the second trimester and is felt in the lower abdomen/groin area. Many women report that it’s most uncomfortable in transitional movements such as getting up from a chair or in/out of a car. Thankfully it is usually short lasting and tends to disappear within a couple of weeks.

4. Carpal Tunnel Syndrome

Carpal tunnel syndrome can develop due to fluid retention and swelling, which compresses the median nerve in the wrist. Eventually, this can cause numbness, tingling, and pain in the hands and fingers.

The carpel tunnel is located on the palm side of the wrist and comprises of 9 tendons and 1 nerve (median nerve). Problems arise when the nerve becomes compressed due to swelling within the carpel tunnel. Consequently, symptoms typically arise including pain or numbness or tingling into the thumb, 1st and 2nd fingers, hand weakness, cramping, pain with repeated gripping and night pain. Carpel tunnel syndrome is often observed during pregnancy from fluid retention and after pregnancy due to overuse of the hands for instance holding their newborn. Activity modification such as using supportive pillows during breast feeding and wearing wrist splints can help to alleviate symptoms.

5. Hip Pain

The hips can experience increased strain due to changes in posture and weight distribution, leading to pain and discomfort. However, this issue is often exacerbated by long periods of standing or walking. This injury is most prevalent in the third trimester due to the extra weight around the middle of a woman’s body. This weight puts significantly more mechanical stress on the hips.

6. Knee Pain

Knee pain is a common injury during pregnancy due to altered posture and weight distribution. The added weight places extra stress on the knees, leading to discomfort. During pregnancy, there is an increase in the hormone Relaxin – this causes the ligaments supporting the joints in the body to relax, allowing the baby to pass through the pelvis during birth. It’s important to note that it is not just the ligaments in the pelvis that relax, it’s all ligaments in the body. There are ligaments supporting every joint, this includes the spine, shoulders, elbows, wrist, knees and ankles. As a result these joints are more mobile and will be affected differently by the loads placed on them.

7. Shoulder and Upper Back Pain

Postural changes and the added weight of pregnancy can lead to shoulder and upper back pain. This discomfort often results from carrying the extra weight and adjusting to new body mechanics. Other reasons can include stress and hormonal changes. The larger breast mass and increased lordosis can increase muscular work, therefore causing a strain to the upper back and shoulders.

8. Plantar Fasciopathy / Fasciitis 

The plantar fascia is a tough band of fibrous tissue located over the sole of the foot. Its role is to provide support for the foot by maintaining its natural arch. Irritation of the plantar fascia can occur due to prolonged standing and weight bearing. Symptoms include pain on the underside of the heel or in the arch of the foot, pain and stiffness in the morning that improves with movement and an increase in pain during and after activity. This is a common injury during pregnancy due to weight gain and especially in those who have flat feet.

9. Sacroiliac joint Pain (SIJ)

The sacroiliac joints are the joints where the lower part of the spine (sacrum) connects to the pelvis. There are two sacroiliac joints, one on each side, with ligaments in each joint that hold the bones together.

Sacroiliac joint pain can be difficult to diagnose as other conditions can cause similar symptoms. Sacroiliac joint pain is most commonly felt in the low back and buttock but can also be referred into the thigh and leg. This is often described as “a pain in my butt”.  SIJ pain can be aggravated with prolonged sitting or standing, standing on one leg, stair climbing, going from sit to stand, and with running. 20% of SIJ pain cases are pregnancy-related. Female hormones are released during pregnancy, relaxing the sacroiliac ligaments. This stretching in ligaments results in changes to the sacroiliac joints, making them hypermobile

A physiotherapist can help you find positions and movements that are more comfortable for you. This might include using pillows to support your top leg when sleeping (which can help to reduce night pain) or modify everyday exercises and activities around the house to make them less painful.

Like with pubic symphysis pain, hands-on treatment and support belts can help. Most women with SIJ pain benefit from strength training, so seeing your physiotherapist for an individualised program is ideal.

Conclusion

Pregnancy is a time of profound change, and it’s not uncommon for expectant mothers to experience various musculoskeletal injuries or discomforts. Understanding these common injuries during pregnancy and implementing strategies for relief can significantly improve your comfort and overall well-being. Always consult with your healthcare provider before starting any new exercise or treatment plan to ensure it is safe and appropriate for your individual needs. With the right care and support, you can navigate these common injuries during pregnancy with greater ease and enjoy this special time in your life.