Your body is changing every week. Your treatment should too.
Pregnancy is not the time for a generic program handed off to an aide. Every prenatal and postpartum session at Physica Medica is conducted personally by Dr. Birikov — no assistants, no shared gym floor, no guesswork. If you're dealing with pelvic pain, back pain, or trying to recover after delivery, this is where you get care that actually accounts for where you are right now.
Physical Therapy During and After Pregnancy
Pregnancy puts real mechanical stress on your body. Your center of gravity shifts, your ligaments loosen, your pelvis widens, and your core — the system that stabilizes your spine — gets progressively challenged. Pain is common. It is not inevitable, and it does not have to wait until after delivery to be addressed.
I work with patients at every stage: first trimester discomfort, second and third trimester pelvic girdle pain and back pain, labor preparation, and postpartum recovery. These are different problems at different times — and they often belong to the same person. The goal throughout is the same: keep you moving, reduce pain, and protect your body for what comes next.
Postpartum is its own phase entirely. Diastasis recti, pelvic floor dysfunction, and back pain that started during pregnancy don't always resolve on their own after delivery. Many women wait months assuming things will normalize. Physical therapy shortens that window significantly when the right work is done early.
Common Pregnancy-Related Pain Conditions We Treat
Pelvic girdle pain is one of the most common — and most undertreated — complaints during pregnancy. It can make walking, rolling over in bed, or climbing stairs genuinely difficult. Round ligament pain, which causes sharp pulling sensations in the lower abdomen, is another condition that responds well to manual therapy and targeted movement work. I also treat low back pain, SI joint dysfunction, sciatica, and the postpartum conditions that follow delivery: diastasis recti, pelvic floor weakness, and back pain that lingers well after the baby arrives.
If you've been told to just rest and wait it out, that's not always the right answer. Pain that goes unaddressed during pregnancy often compounds. Treating it directly — with hands-on care that accounts for your stage of pregnancy — tends to produce faster, more lasting relief than waiting.
What to Expect in a Prenatal PT Session
Every step is performed by Dr. Birikov, personally
Assessment
Before anything else, I assess your specific stage of pregnancy, your symptoms, and how your body is moving. What's appropriate at 14 weeks is different from what's appropriate at 34 weeks. I don't apply a standard protocol — I find what's actually driving your pain and work from there.
Hands-on treatment
Manual therapy, soft tissue work, and carefully selected techniques based on what your body needs that day. All positions and methods are adapted for pregnancy. Nothing is applied without knowing exactly where you are in your pregnancy and what your body can handle.
Movement correction
I address the movement patterns and muscle imbalances that are contributing to your pain. For prenatal patients, this often means work on pelvic stability, hip mechanics, and the way your body is compensating for the changes happening week to week.
Plan adjustment
Your body at 28 weeks is not your body at 36 weeks. Before you leave each session, I update your plan based on what I found that day. Because I see you every session, I track those changes directly — nothing gets missed because it was handed off to someone else.
Why One-on-One Care Matters More During Pregnancy
At a standard PT clinic, you might see a different therapist each visit. You might spend half the session with an aide running you through exercises. For most conditions, that's frustrating. During pregnancy, it's a real problem. Your body is changing week to week. A therapist who last saw you three weeks ago — or who is seeing you for the first time — does not have the context to make safe, accurate decisions about your care.
- I see you every session, so I track your changes directly. What shifted since last week, what's improving, what needs a different approach — I know because I was there.
- Treatment is adjusted in real time based on your current stage of pregnancy and how you responded to the last session, not based on a generic prenatal protocol.
- You get the full session with an experienced clinician who is specifically assessing your body — not a shared floor and a printed exercise sheet.
Pregnancy is not the time for cookie-cutter PT. The one-on-one model isn't a premium add-on here. It's the baseline requirement for care that's actually safe and actually responsive.
Postpartum Recovery & Rehabilitation
Delivery changes your body in ways that don't always announce themselves immediately. Diastasis recti — where the two sides of your abdominal muscles separate during pregnancy — often goes undiagnosed and untreated, leading to ongoing core instability and back pain. Pelvic floor dysfunction after delivery can cause pain, weakness, and dysfunction that affects daily life. These are not things to wait out. They respond to direct, targeted treatment. I assess postpartum patients the same way I assess any patient: find the root cause, treat it specifically, and rebuild the function that was lost.
One-on-One Prenatal PT vs. a Standard Clinic
| Physica Medica | Traditional PT Clinic | |
|---|---|---|
| Who treats you | Dr. Birikov, every session | Whoever is available that day |
| Hands-on time | The full session | ~10–15 minutes, often with an aide |
| The floor | Private treatment space | Shared gym floor, 3–4 patients at once |
| Your plan | Built and adjusted for your body | Standardized protocol sheet |
| Continuity | Same doctor tracks your progress | New therapist re-reads your chart |
About the cost — upfront
Physica Medica is a cash-pay practice. I don't bill insurance. That means I'm not constrained by session limits, approved treatment lists, or billing codes that have nothing to do with what your body actually needs. Pricing is discussed directly on your first call — no surprises, no hidden fees.
See payment and insurance details →
What one-on-one care feels like
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Questions I hear before the first session
Is physical therapy safe during pregnancy? Yes — when it's performed by a qualified clinician who assesses your specific stage of pregnancy before applying any technique. Every session here is conducted personally by Dr. Birikov. No aides, no handoffs. Positions, pressure, and methods are all adapted to where you are in your pregnancy. If something isn't appropriate for your current stage, we don't do it.
When should I start prenatal physical therapy — first, second, or third trimester? As soon as you have pain worth addressing. There is no trimester that is too early. Earlier treatment generally means faster relief and less compensation patterning to undo later. Third trimester patients can also benefit significantly from labor preparation work focused on pelvic mobility and positioning. Postpartum patients are welcome as well — ideally within the first few weeks after delivery, though it's never too late to start.
Can physical therapy help with postpartum recovery and pelvic pain? Yes. Diastasis recti, pelvic floor dysfunction, and back pain that persists after delivery are all conditions I treat directly. Many women assume these issues will resolve on their own. Some do. Many don't — or take far longer than necessary without targeted treatment. If you're still dealing with pain, weakness, or dysfunction weeks or months after delivery, that's a reason to schedule, not to wait longer.