Physio during pregnancy

[Anjenica]

I have a client in her 2nd trimester. She was involved in an MVA and presents with whiplash and coccygodynia/SIJ dysfunction. She is considered high risk (34 yo, twins, fertility drugs, etc.). She is also seeing a RMT. No modalities allowed as per OB. What can I do??

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[Physiobase]

The are a few links to come exercise considerations and I think the Canadian Guidelines etc in the following topic p214.ezboard.com/fphysiobasecommunityforum91289frm9.showMessage?top icID=43.topic

[alophysio]

Hi.

I would be comfortable assesing the SIJ and L/S. Techniques are gentle and shouldn't be a problem.

With the whiplash, you should be able to do mobilisations or muscle energy in supine or sitting.

Yes I know that supine is considered risky in pregnancy but the risk is because of the IVC and risk of compression. If you keep your assessment and treatment quick ~few mins and rotate what you are working on, she should be just fine. Alternatively, have her lie on her right side slightly - pillow under left L/S and the spine should protect the IVC from being squashed.

I treat lots of pregnant women - if you are going to squash the IVC, they will tell you it is uncomfortable. I haven't had any probs yet (thank God!) and I have treated 41 week gestation mothers in prone and supine. Just get them comfy!

Hope that helps!