This document outlines the principles and benefits of ante-natal and post-natal physiotherapy. It discusses how exercises can help reduce stress and pains during pregnancy, as well as improve circulation, posture, weight control, and recovery after birth. Guidelines are provided for safe exercises during pregnancy, including proper warm-up, cool-down, duration and positions. Specific exercises are described targeting areas like the ankles, arms, abdomen, back, and pelvis. Post-natal physiotherapy focuses on pelvic floor exercises and other aerobic activities like walking, swimming and aqua classes to continue providing benefits after giving birth.

1. ANTE-NATAL AND
POST-NATAL
PHYSIOTHERAPY

2. • The general principle of ante-natal and post-natal physiotherapy is to reduce
stress and relax a pregnant women. The general benefits of regular exercises
include – psychological and social benefits.
• Reduction in aches and pains of pregnancy.
• Increased circulation minimizes veins and swelling.
• Improved posture and body awareness.
• Controlled weight gain.

3. • Reduction in aliments of pregnancy such as stiffness, tension, constipation and
insomnia.
• Post natal recovery.
• Improve core stability and pelvic floor muscle strength.
• Weight-bearing exercises reduce the length of labor and prepare woman for
physical demand of labor.

4. • Contraindication for exercise – chest pain
• Abdominal and pelvic pain
• Dizziness
• Vaginal bleeding
• Headache
• Sudden swelling on ankles, face and hands.

5. • Guidelines for exercise – avoid any kind of jerky movements.
• Warm-up before exercises followed by cool down post exercise.
• Do not exercise in spine position for more than 5 min.
• Encouragement for bladder emptying prior to the session.
• Avoid exercise on single leg standing.

6. • Ante –natal exercise – 1. warming up exercise – stand up right position, feet
slightly apart and weight evenly distributed on each foot.
• Bend forward from the waist downwards as if trying to touch the toes and then
slowly bring the body back up to the upright position.
• Repeat 5 times.
• Remain in the standing position. Place hands on the hips and rotate the head,
neck and spine from the waist to the left and back again and then to right and
back again. Repeat 5 times.

8. • 2. stretching – it start with squatting position with a forward hand hold. Keeping
the back straight as possible and gently spread knees outwards with your hand.
Repeat it 5 times.
• Sitting on a firm surface with knees far apart. Relax the upper body, resting
hands on front of thighs and then gently glide forward, sliding hands along the
floor until you feel the stretch in buttocks and groin.
• Slowly release the stretch by following the same pattern backward until
achieving starting position.

9. • 3. ankle and foot exercises – sit on the floor with long sitting with hands palm
down behind for support. Point toes down towards the floor hold for a few
seconds and then extend upwards.
• Relax the foot completely and repeat. This exercise is particularly helpful for
those who are suffering with calf-cramping. Repeat 5 times.
• Remain in the same position placing a firm pillow or roller under the calf of leg
so that ankle hangs loosely and do ankle movement middle, out and than rolled.
Do it 5 times.

10. • 4. arm and shoulder exercises – stand – up straight weight evenly distributed
and feel slightly apart. Lift both shoulder, bringing it as close to the ear possible
but without drooping head forward.
• Roll the shoulder girdle alternatively or together in a complete circle one way 5
times and repeat in opposite direction.
• Remain in same position with arms firmly by the sides. Raise one arm straight
up above the head and gently swing it down and around attempting to complete
a circle motion. Repeating in opposite direction. Repeat 5 times in each direction.

11. • 5. abdominal exercise - lie on a firm surface with the head and neck bent and
slightly apart and arms relaxed by the sides. Contract stomach muscle while
breathing and hold for a count 5 then relax completely while breathing in,
keeping the neck and shoulder totally relaxed. Repeat 5 times.
• Remaining in same position , flex the hip knees alternately keeping neck and
shoulders on the floor and totally relaxed. Repeat 5 times.

12. • 6. back exercise – prone kneel with knees slightly apart. Drop head down and
hunch the back towards while breathing out, hold for a count of 4 then gently
release, dropping the spine downwards while breathing in and raising the head
upwards at the same time. Repeat 5 times.
• Remain kneeling and bring on knee inwards towards the dropped head. Gently
kick it out towards the rear, raising the head. Repeat 5 times with each leg.
•

13. • 7. pelvic exercise – obtaining the correct pelvic tilt during pregnancy will go a
long way in helping the body to adapt to its changing shape, improve over-all
circulation, hopefully relieve some of the pregnancy discomfort and strengthen
abdominal and pelvic floor muscles in preparation for labor.
• 8. Pelvic tilt – sit on the edge of hard chair with knees apart. Gently hallow the
back, noticing how the pelvis tilts downwards, now round the lower back
tightening the abdominal muscles. This exercise may also be done in standing
position.

15. • Post-natal physiotherapy – 1. pelvic floor – supine lying with head and neck
supported by a pillow, hip knee flexed and arms relaxed at sides. Tense the
muscles around the vagina, urethra and rectum. Hold for count 3 and relax.
• Reasons for toning the pelvic floor muscles – minimizing the effects of stress
incontinence in the later stages of pregnancy. Giving added support to enlarging
uterus and growing baby, offering more in the way of comfort during pregnancy
well-toned pelvic floor muscles also aid in preventing a prolapsed uterus
following the birth.

17. • Walking and Swimming – the place adopted should be sufficient cause aerobic
changes. If pelvic pain is a problem avoid kicking movement motion of legs.
• Back care classes – core – stability exercise may be taught sometimes using a
Swiss ball.
• Gym work – the pregnant women may have access to a static bicycle, treadmill
or cross trainer all of which encourage aerobic activity.
• Aqua natal classes – water based exercise groups designed specifically for
pregnant and post natal women.

18. • Women in aqua-natal classes may notice that they get relief from aches and pains
feel they have more energy after the class and sleep better.
• Exercise in water helps to tone the respiratory muscles, leg movements of
swimming and exercise in water aid venous return and diuretic effect of
immersion is helpful to a pregnant women troubled by fluid retention.
• Breathing exercise - this help for relief during labor.
• 1. abdominal breathing – suitable for mild pain. Breathe through the nose and
feel abdomen expand. Then breathe out through the mouth.

19. • 2. lower costal breathing – suitable for medium pain. Put your hands on the
lower rib cage. Breathe in through the nose and feel your chest expand. Then
breathe out lightly through the mouth.
• 3. apical breathing – suitable for severe pain. Cross your hands below the
clavicles with your mouth slightly open. Breathe in through the nose and mouth.
• Breathe out lightly as if trying to flicker the flame of a candle without blowing in
out and feel. Upper and lungs moving slightly up and down.