PMC Musculoskeletal Changes in Pregnancy 3 — Questions and Answers
Question 1: Symphysis pubis dysfunction (SPD) during pregnancy is characterized by pain at which anatomical location?
- Posterior superior iliac spine
- Anterior midline pubic joint (Correct answer)
- Ischial tuberosity
- Coccyx
Correct answer: Anterior midline pubic joint
SPD involves pain and instability at the symphysis pubis, the cartilaginous joint at the anterior midline where the two pubic bones meet.
Question 2: A prenatal massage therapist notices a client's shoulders are rounding forward significantly in the second trimester. Which postural change most likely drives this compensatory pattern?
- Decreased thoracic mobility
- Breast enlargement increasing anterior chest weight (Correct answer)
- Shortened pectoralis minor from birth
- Thoracic vertebral rotation
Correct answer: Breast enlargement increasing anterior chest weight
Breast enlargement increases anterior chest weight, pulling the shoulders forward and contributing to increased thoracic kyphosis during pregnancy.
Question 3: During pregnancy, the foot often flattens and lengthens due to which combination of factors?
- Increased arch muscle tone and weight gain
- Ligament laxity and increased body weight (Correct answer)
- Reduced plantar fascia tension and estrogen
- Metatarsal stress fractures and edema
Correct answer: Ligament laxity and increased body weight
Relaxin-induced ligament laxity combined with increased body weight causes the plantar arch to flatten and the foot to lengthen during pregnancy.
Question 4: Which position is safest for addressing low back pain via massage in a client who is 32 weeks pregnant?
- Prone with a pregnancy bolster
- Supine with legs flat
- Side-lying with supportive pillows (Correct answer)
- Semi-reclined at 90 degrees
Correct answer: Side-lying with supportive pillows
Side-lying (lateral recumbent) position with supportive pillows is the safest and most comfortable position for massage in the third trimester.
Question 5: Anterior pelvic tilt in pregnancy causes which muscle to become adaptively shortened?
- Hamstrings
- Gluteus maximus
- Iliopsoas (Correct answer)
- Tibialis anterior
Correct answer: Iliopsoas
Anterior pelvic tilt shortens and tightens the iliopsoas (hip flexors) while the opposing gluteal and abdominal muscles lengthen and weaken.
Question 6: Why does the pregnant client's gait often become wider-based (wider stance) during the second and third trimesters?
- Increased quadriceps strength
- Pelvic joint laxity requiring broader base of support (Correct answer)
- Fetal position affecting hip rotation
- Reduced ankle dorsiflexion
Correct answer: Pelvic joint laxity requiring broader base of support
Relaxin-induced laxity in pelvic ligaments reduces joint stability, so the body adopts a wider base of support to maintain balance.
Question 7: Which nerve root level is most commonly implicated in sciatica symptoms that develop during pregnancy?
- L1-L2
- L3-L4
- L4-L5 and L5-S1 (Correct answer)
- S2-S4
Correct answer: L4-L5 and L5-S1
Pregnancy-related sciatica most commonly involves L4-L5 and L5-S1 nerve roots, which can be compressed by the enlarged uterus or piriformis muscle.
PMC Musculoskeletal Changes in Pregnancy 3
Symphysis pubis dysfunction (SPD) during pregnancy is characterized by pain at which anatomical location?