Date of Award

2016

Document Type

Scholarly Project

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

First Advisor

Schawnn Decker

Keywords

Joint Instability -- therapy; Low Back Pain -- therapy; Muscle Weakness -- therapy; Pelvic Girdle Pain -- therapy; Postpartum Period; Case Reports

Abstract

Background and Purpose

Due to the increase in relaxin hormone during pregnancy women often experience increases in joint and ligament laxity. The result of this increase in laxity during or after pregnancy can lead to problems with postural and/or gait abnormalities, diastasis recti (separation between left and right side of rectus abdominus muscle) and pain, specifically, low back and pelvic girdle pain. Activities of daily living are often impacted because of these problems. The purpose of this case study is to highlight some of the principal issues and therapeutic options for postpartum women as presented through the case of one new mother.

Case Description

The patient isa 35 year old Caucasian female presenting at an outpatient orthopedic clinic ten months postpartum. Her chief complaints include periodic sharp pain down back and left groin, muscle spasms/hitching in left abdomen, locked-in low back, left hip grinding, decreased hip and lumbar range of motion and hip instability. She is limited by pain in many of her ADLs including lifting and carrying her 20lb son.

Intervention

Therapeutic exercise, manual therapy and therapeutic interventions were employed over the course of 14 weeks and 28 sessions to treat this patient's LE ROM limitations, joint tightness and core muscle weakness.

Outcomes

Following PT intervention the patient improved in overall lower extremity ROM, core strength and joint motion. Functionally, she was able to return to her normal ADLs with minimal pain symptoms.

Discussion

The functional gains made by this patient throughout the course of her therapy sessions demonstrate the importance of physical therapy as a useful tool in post-partum recovery. Given the extreme changes to the musculoskeletal system during and after pregnancy it is important for physical therapy to assume a greater role in working with this population.

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