Pregnancy brings incredible changes to your body, but it often brings a host of new physical challenges as well. If you are experiencing new aches, a sense of heaviness in your pelvis, or breathlessness that seems to appear out of nowhere, you are certainly not alone. For decades, many women have been told that these discomforts are just a normal part of the journey and something they simply have to endure.
At Fortius Allied Health, we want to immediately reframe that narrative. A lot of the physical toll of pregnancy is highly treatable. You do not have to just put up with the pain. By working with a pregnancy physio, you can actively manage your symptoms, build strength, and prepare your body for labour and beyond.
First Trimester: Building a Strong Foundation Early
The first trimester is often dominated by fatigue and nausea, making exercise feel like an impossible task. However, this is actually the most critical time to establish a strong physical foundation. While your baby bump might not be showing yet, hormonal shifts are already prompting posture changes beginning around week 6 to 8.
This is also the ideal time to begin early pelvic floor education. Many women wait until after they give birth to think about their pelvic floor, but learning how to correctly engage and relax these muscles starting in week 8 is far more effective. Building awareness early means your muscles will be better equipped to handle the increasing downward pressure as your baby grows.
During this stage, your pregnancy physio will also guide you through gentle exercise for fatigue management. Moving your body, even in small amounts, can boost your energy levels and help mitigate the early aches associated with your shifting centre of gravity.
Second Trimester: Managing Pelvic Girdle Pain and Posture
As you enter the second trimester, your bump becomes more prominent and your body produces higher levels of a hormone called relaxin. Relaxin is designed to loosen your ligaments in preparation for birth, but it can also lead to joint instability. This is the primary driver behind pelvic girdle pain (PGP), a common condition that causes sharp or aching pain in the front or back of the pelvis.
If you are experiencing PGP, a pregnancy physio will conduct specific clinical assessments to pinpoint the issue. We often use the Active Straight Leg Raise and posterior pelvic pain provocation tests to determine exactly where the instability lies. Once diagnosed, pelvic girdle pain can be highly responsive to treatment. We use a combination of gentle manual therapy, sacroiliac joint support (such as fitting you for a pregnancy support belt), and modified exercise to stabilise the pelvis.
The second trimester is also when many women experience round ligament pain, which feels like a sharp pulling sensation on either side of the lower abdomen. Your physio can teach you strategies to move safely and reduce this discomfort.
For those working in office environments, the second trimester brings unique challenges. We provide practical advice for desk workers, ensuring your workstation is ergonomically adjusted to support your changing posture and prevent lower back pain.
Third Trimester: Birth Preparation and Symptom Relief
The third trimester is the home stretch. Your body is carrying significantly more weight, and the focus shifts towards birth preparation and managing late-stage symptoms. As your baby grows and takes up more space, you might experience rib pain, sciatica-like symptoms, or even carpal tunnel in pregnancy due to fluid retention compressing nerves in your wrists.
A major focus during these final weeks is perineal massage. Starting around 34 to 35 weeks, perineal massage helps to stretch and relax the tissues at the back of the vagina, reducing the risk of tearing during a vaginal birth. Your physio can teach you or your partner the correct techniques to perform this safely at home.
We also focus heavily on birth preparation and optimal foetal positioning. By using specific movements and stretches, we can help create space in your pelvis, encouraging your baby to move into the best possible position for labour. Furthermore, we will guide you on how to modify exercise as the bump grows, ensuring you stay active without placing undue stress on your body.
Pelvic Floor Physio: What You Really Need to Know
When it comes to pregnancy, seeing a pelvic floor physio is one of the best investments you can make for your long-term health. The pelvic floor is a hammock of muscles that supports your bladder, uterus, and bowel. During pregnancy, these muscles endure immense strain.
A thorough assessment involves evaluating the strength, endurance, and coordination of your pelvic floor muscles. It is vital to understand the difference between a weak pelvic floor and a hypertonic (too tight) pelvic floor. Many women assume they just need to do hundreds of pelvic floor exercises, but if your muscles are hypertonic, doing more Kegels can actually make things worse and potentially hinder the birth process. You need to know how to relax these muscles just as much as you need to know how to contract them.
Depending on your comfort level, your physio may offer an internal or external assessment. An internal assessment provides the most accurate picture of your muscle function, but it is never mandatory. We can still gather valuable information and provide excellent care using external methods.
Understanding your pelvic floor function is not only crucial for labour but also sets the stage for effective postnatal physio recovery. For more detailed clinical guidelines on women’s health and pelvic floor care, we align our practices with the standards set by the Australian Physiotherapy Association Women’s Health section, ensuring you receive the highest standard of evidence-based care.
Safe Exercise During Pregnancy: What to Do and What to Avoid
Staying active during pregnancy offers incredible benefits, including improved sleep, better mood, and a lower risk of gestational diabetes. However, knowing what is safe can be confusing.
Generally, low-impact activities like swimming and walking are fantastic choices. Resistance training with appropriate adaptations is also highly encouraged to maintain muscle strength. At Fortius Allied Health, we offer specialised clinical exercise programming during pregnancy to ensure your workouts are both safe and effective.
There are a few key things to avoid as your pregnancy progresses. After 20 weeks, you should avoid exercising in a supine position (lying flat on your back) as the weight of the baby can compress a major blood vessel and reduce blood flow. You should also avoid high-impact sports, contact sports, and the Valsalva manoeuvre (holding your breath while straining or lifting heavy weights).
If you are unsure whether you need hands-on treatment or an exercise program, you can learn more about exercise physiology vs physiotherapy on our website. For those looking for a safe, supervised group setting, we highly recommend clinical Pilates for pregnancy, which focuses heavily on core stability, breathing, and pelvic floor integration.
What to Expect at Your First Pregnancy Physio Appointment
If you have never seen a physio during pregnancy, you might be wondering what the first appointment involves. We start with a comprehensive chat about your medical history, your pregnancy journey so far, and your specific goals. Whether you want to run safely into your second trimester or simply want to walk around the supermarket without pelvic pain, we tailor our approach to you.
Next, we conduct a physical assessment. This includes looking at your posture, how you move, and testing the stability of your pelvis and spine. Based on these findings, we will provide hands-on treatment to relieve immediate pain and create a customised exercise and management plan for you to take home.
Frequently Asked Questions
When should I see a physio during pregnancy?
Ideally, we recommend booking your first appointment during the first trimester to establish a baseline and start early education. However, you can see a pregnancy physio at any stage of your pregnancy, and it is never too late to seek help for pain or birth preparation.
Is physio safe in all trimesters?
Yes. Physiotherapy is completely safe in all trimesters. Our highly trained physiotherapists use appropriate modifications to ensure all treatments and exercises are safe for both you and your baby at every stage of development.
What is pelvic girdle pain and can physio fix it?
Pelvic girdle pain is discomfort caused by stiffness or uneven movement in the pelvic joints, often exacerbated by pregnancy hormones. While we may not “cure” it completely while you are still pregnant, physiotherapy can significantly reduce the pain and improve your mobility through manual therapy, support garments, and targeted exercises.
Do I need a GP referral?
No, you do not need a GP referral to see a physiotherapist at Fortius Allied Health. You can self-refer and book an appointment directly. However, if you have a complex medical history, your GP might provide a Medicare Chronic Disease Management (CDM) plan, which can help subsidise the cost of up to five sessions.
Will I need an internal pelvic floor examination?
An internal pelvic floor examination is often offered because it provides the most accurate assessment of your muscle function. However, it is never mandatory. The process will be fully explained beforehand, and we will only proceed if you are completely comfortable. We can effectively assess and treat you externally if you prefer.
Can physio help after I’ve already given birth?
Absolutely. Once your baby is born, your care seamlessly transitions into postnatal physio. We help you safely rehabilitate your pelvic floor, manage abdominal separation (diastasis recti), and rebuild your overall strength so you can return to the activities you love.
Start Your Pregnancy Journey with Fortius Allied Health
Pregnancy should be an exciting and rewarding journey, not one defined by pain and physical limitations. At Fortius Allied Health, our dedicated team is here to provide seamless, patient-centred care that empowers you to feel strong and comfortable from your first trimester right through to your postnatal recovery.
We are proud to serve the Sunshine Coast community across multiple locations. Whether you need a physio in Noosa, are looking for support at our Caloundra clinic, require expert care from our Gympie team, or wish to visit us in Birtinya, we are here to help.
Take control of your pregnancy health today. Book an appointment online or call your nearest Fortius Allied Health clinic to get started.
