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Understanding changes to an expectant woman’s body

Extensive physical and physiological changes take place in an expectant woman through the actions of the hormones, oestrogen, progesterone and relaxin. These changes create challenges, which should never be undermined, and hence it is important to understand the effects on the woman’s body during pregnancy to learn to cope with the challenges.

Respiratory system

The demand of oxygen is increased because the basal metabolic rate and the mass of the expectant woman increase as well. It is estimated that a woman will require about 20% more oxygen than normal at term. She also exhales more carbon dioxide which triggers the already sensitive respiratory system to increase the respiratory rate slightly. Hence, it is this lowering of the carbon dioxide that leads to pregnant women to become breathless on activity. Also, many expectant women will experience the ascending uterus which progressively obstructs the descent of the diaphragm, which is needed for deep breathing. It can force the diaphragm upwards by at least 4cm towards the end of pregnancy. Hence this rising pressure pushes the rib cage out sideways and forwards, resulting in pain in the front of the lower ribs, also known as ribflare. Furthermore, rib-flaring make expectant women breathe with the top part of her chest, thereby causing breathlessness even during mild exertion during pregnany but especially so, towards the end of term.

The cardiovascular system

During pregnancy, a woman’s blood volume increases by at least 40%. However, the plasma volume increases more than the red cells, hence possibly resulted in dilution anaemia, leading to tiredness in the early weeks of pregnancy. She may also feel faint when lying on her back. This is due to enlarging fetus compressing the aorta and inferior vena cava against the lumbar spine, thereby restricting blood flow. This condition is known as pregnancy supine hypotensive syndrome and can be relieved by turning onto her side. Such a condition tend to happen more in the 3rd trimester, though it can occur any time after the 4th month of pregnancy.

Varicose veins of the legs may occur during pregnancy or worsen during this period. This is due to reduction in vascular tone and changes in collagen structure in the body (due to progesterone and relaxin) .

For the same reason, “water retention” or swelling in ankles, feet and hands in late pregnancy may lead to joint stiffness and nerve compression syndromes, such as carpal tunnel syndrome.

The musculoskeletal system

The hormone, relaxin, is produced about 2 weeks into pregnancy. Relaxin alters the composition of collagen, which exist in joints, ligaments and connective tissues. As a result, the modified collagen is more elastic and flexible, leading to more movement in joints, and thus less stability of the system. The weight bearing joints, such as the pelvis, bear the brunt of the increased stress and loading during pregnancy, and with the instability that relaxin cause, the pelvis is susceptible to injury and pain, one of the conditions known as symphysis pubis diastasis. Also, ligaments of feet become lax and with the additional weight of pregnancy, causes discomfort. This results in aching and flat feet. Hence, comfortable yet supportive foot wear is strongly recommended during this period.

Posture-wise, her centre of gravity will move forward, leading to increased lower back curvature, compensatory curving of the upper back, rounding of shoulders and forward chin position. This incorrect posture exerts excessive strain and fatigue on her body, particularly in the spine, pelvis and other weight bearing joints (i.e. knees), resulting in aches and pains, such as lower back, with the pain spreading to the buttocks, thighs and down the legs.

Other muscular changes, such as the separation of the abdominal muscle, known as rectii diastasis, is associated with low back strain, as the abdominals are no longer able to support core and the spine as efficiently as before.

Therefore, with all the extensive changes in the expectant woman’s body, it is obvious that the healtier and fitter she is both before and during pregnancy, the more easily she can cope with pregnancy. If possible, she should prepare to be fit physically and emotionally before each pregnancy and maintain the fitness during the pregnancy, thereby enhancing recovery after delivery. In the next article in this series, we will look at the common physical problems affecting women during pregnancy and it’s solutions.

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Very professional and caring Therapists. My left foot has been hurting for a month. After 3 sessions, 80% of the pain is gone. I just need one more session and I think I should be fine. Thank you very much.
Theressa Lim
Theressa Lim
I had an excellent sports massage by Wan Ling, which was very different from the usual massage I've tried elsewhere. Wan Ling skillfully and systematically loosened every muscle in my upper back and neck over the course of an hour. If anyone is seeking relief from tense muscles, I would highly recommend making an appointment with Wan Ling.
Rebecca Lim
Rebecca Lim
Came to see Xue Ting with a broken shoulder for the last 6 weeks and was impressed with her attentiveness and ability to make me feel me feel comforted in my condition . Very dedicated and good therapist indeed .
Janet Koh
Janet Koh
They adopt a scientific and personal approach. The therapists put in a lot of effort to diagnose the issue before attending to it. Overall, I would strongly recommend their professionalism and methods.
Varun Sharma
Varun Sharma
Really good sports massage! Booking process was efficient too :)
Charmaine Miranda
Charmaine Miranda
Friendly and really professional service! I immediately felt welcomed the moment I stepped into the clinic! The physio offered me great advice beyond what I had asked, which allowed me to have a deeper understanding as to why I had my issue in the first place. With this kind of service, I would honestly recommend this physio if you are serious about getting better.
Jimmy Allen Poh
Jimmy Allen Poh
Thoughtful and sincere service. Highly recommended!
Benedict Koh
Benedict Koh
My mum received her first Apos treatment. We intend to continue until her hip muscles become strong. We believe in the treatment as we saw how amazing it was. The idea was simple. Really love that she can be herself again, for long term. The hip and knee cap operations offers 15yrs. Hence we reject the cost and short-life. My wish is that the treatment cost can be lowered and more are aware of this treatment. God bless and thank you team.
Victoria Soh
Victoria Soh
Look for Soo, he is a great physiotherapist . Always communicating and always asking for my feedback. I’m on the right path to recovery all thanks to Soo. Two thumbs up.
Daniel Wang
Daniel Wang
Xue Ting has been working on my troublesome QL, hip girdle - basically the whole left lower kinetic chain! She has been patient, strong and cerebral in her approach to my 48 year old compensatory mechanisms. Her strong massage will finish with an assessment of muscle imbalance and poor activation with finally a retraining back to healthy movement.I’m impressed! Thanks Core Concepts!
Brett McLaren
Brett McLaren
I went from barely understanding physical therapy for injuries, to highly recommending Core Concepts to friends and family for their aches and pains. Ken was knowledgeable, patient and explained symptoms and consequences in a simple, relatable manner. I hope more people will come to understand how physio is a much better alternative to short-term painkillers.
Manda Misso
Manda Misso
Ken is really amazing!
Terry Tan
Terry Tan
The physiotherapist here explained the problem very well and provided me with exercises that helped improved my condition.
Ferdinand Mar
Ferdinand Mar
I have been experiencing great pain on my shoulder coupled with occasional numbness on my arm. Thanks to Ken Liew, I felt so much relieved after my first session. He was very patient and knowledgeable and had definitely made my 1st visit to a physiotherapy clinic a very memorable one. Thank you so much Ken
Bee Choo Gian
Bee Choo Gian
I have been experiencing knee pains lately especially walking up and down the stairs. The pain was so bad that I was very concern. I chanced upon CoreConcept on FB and book an appointment with them at Camden Medical Centre. My therapist was Ken Liew, he is very professional and knowledgeable. He did a thorough job to assess my condition. To my surprise I felt immediate relieved on my knee after the first session with him! Amazing! Looking forward to my next session. 😊
Sandy Toh CH
Sandy Toh CH
Hi I am Sally and I am in my late sixties. I have endured a year of thigh(joint) pains and thought that it must be due to old age. Visited Core Concepts at Novena and after only 2 sessions, my condition improved so much that I was able to climb stairs easily again. THANKS to my Physiotherapist Samuel Ong who is extremely polite, professional and knowledgeable.
Shino Tutu
Shino Tutu
I have had several sports related injuries and Core Concepts has saved me and put me "back to new" each times! The therapists are excellent - knowledgeable and professional, and the receptionists (Carol, Adiqah and Rin) are always friendly and helpful. They even give me oreo cookies for my children! :)
Paola Venturini Hubert
Paola Venturini Hubert
Highly recommended for sports massage
Simon Ray
Simon Ray
Extremely friendly staff and therapists! Folks Novena Square are just simply smiley and happy. Coming here towards the end of the work day always brings up my mood. Therapist and coach are fabulous. My condition improve so much that I can even start to train up some of my predominately unrealized problems. Highly recommended!
Von Ling Wei Hao
Von Ling Wei Hao
I go to Novena and Cheryl is my therapist. She was upfront from the get go about my neck condition. I liked her honesty and said we'll give it a try. I was better after 4 weekly sessions and continued to go to her every 2 weeks. With her help I am in a better condition, had to put in effort on the exercises she taught me as well.
Tania Chevrez
Tania Chevrez
Li Hoong is a very dedicated sports massage therapist and functional trainer. Her ultimate goal is the client's holistic well-being. Highly recommend.
Pei Yee Wong
Pei Yee Wong
i have tried different physiotherapy sessions with almost 10 physiotherapists in india and in Singapore, my back pain was treated well by CHERYLL, with God's grace , i was pain free only after Cheryll attended to me. Thank you Cheryll and core concepts for the great experience.
Madiha Sadiq
Madiha Sadiq
I am working with Yiren on my knee after my ACL/MCL reconstruction and recovery has been good! He does a thorough job to assess my progress each session and challenges me to push myself to get to various milestones. He's extremely friendly and helpful despite my many questions. Thanks!
Yingling Huang
Yingling Huang
After many different physio and massage sessions in different places, my experience with the core concepts team has been the best. I started seeing them for sports massage, and now for my knee rehab. The level of care and attention makes me want to do more for myself. Isn't this most important when one tend to slack off with the prescribed exercises?
YitKoon Gan
YitKoon Gan
Very friendly and professional physiotherapist as well as receptionists within the clinic. Dr. Issac Wong is easy to approach and came up with alternative ways for me to strengthen my weak thigh muscles and it really helped in reducing my knee pain! Thanks :)
Sam Costanza
Sam Costanza
The best physiotherapist ever. Cheryl is really good. Doesn't shortchange me of time and make sure I feel better before she lets me go. The front desk staff are great too. Very accomodating and friendly. Thank you Carol and Farrah. Only thing if they can give instructions to how to go to their place will be great. Usually only unit number but do give some details like mrt exits and directions to lift and such will be excellent. Coz I almost got lost in 2 different places. Overall still love core concept because of Cheryl! Thank you Cheryl!!
Jeanette Goh
Jeanette Goh
Found out about Core Concepts last year through social media and made an appointment as i was experiencing some neck and shoulder discomfort after a traffic accident. My therapist was evidently experienced and was able to pinpoint the cause of my aches. The one thing i loved about my experience at Core Concepts is that they are not like typical physiotherapists who simply prescribe take home exercises, instead my therapist was extremely hands on, helping me to massage my neck at the right spots to relief the stiffness - best massage ever! Would highly recommend Core Concepts!!
Claire Chia
Claire Chia
Easily the best physio clinic I've been to.
Natarajan Baradwaj
Natarajan Baradwaj
The only physio clinic i trust! A unique approach to treating pains, you simply have to try it out for yourself. Have recommended many friends and family and core concepts has not disappointed. Thumbs up!!!
Claire Chia
Claire Chia
From the reception to the therapist, they are friendly and nice. I was taught on a 2 steps stretching to strengthen my leg muscles that I can do it myself daily and It did help :) Will recommend to anyone who wish to have therapy sessions.
Jaz
Jaz
Knowledgeable and brilliant!
Brenda Chong
Brenda Chong
-emails with advertisement and birthday wishes came, but they didn't think that their customer (with 4/10 sessions remaining in his package) would have expected a reminder of ANY kind if his package was already expiring. I asked the clerk from my last visit how many sessions I had remaining, and she told me 4, with no update on the expiry at all. -assumed I wanted a physiotherapy (PT) appointment when my past SMS have always been for sports massage (SM); whenever I asked for "available slots", they would give me the slots for SM. yet they suddenly gave me the list of available slots for PT ytd. I'm also to blame for not verifying and reading their long SMS carefully.-their masseuse is very good though, skilful and respectful. They ask important questions to understand their client before starting on the SM. I'd still return even though the administrative process is lacking.
Beale Liu JieXiong
Beale Liu JieXiong
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