Pregnancy is full of a LOT of challenges: morning sickness, fatigue, hormonal fluctuations, weight gain, etc. Another challenge that can occur in pregnancy is musculoskeletal pain. This can include the following: low back pain, upper back pain, pelvis pain, and much more. Research shows that 50-70% of pregnant women experience postural back pain and 68% of women with this pain will continue to experience it into postpartum life.
There are a few reasons why these musculoskeletal injuries rear their ugly heads during pregnancy. The first reason being that the hormones of pregnancy increase ligamentous laxity and soften cartilage in the entire body. The hormones do not just target the pelvis, but the entire body. Therefore, all joints in the body are at risk of joint instability. This joint hypermobility leads to increase risk of injury to back, pelvis, hips, and beyond. Secondly, there are many changes in posture with pregnancy because the body’s center of gravity shifts upward and forward which creates exaggerated spinal curvatures.
The good news is that a lot of this pain in pregnancy can be eliminated, if not at least minimized. We are here to help you at Rebound! Today what we want to share with you is a few basic postural changes you can make in your day to greatly help reduce pain & discomfort or your chance of injury during pregnancy.
The first important posture we want to talk about is one that we all do VERY often. How many of you expectant mamas have back pain just after standing and doing dishes for 10 minutes? I am at 34 weeks pregnant and I experience this same pain when I am not focused on my standing posture. With pregnancy there are drastic changes in our center of gravity resulting in exaggerated spinal curvatures. These exaggerated curvatures are when our butts stick out further back and our baby bellies are protruding further forward. It is important for us not to let the weight of the baby pull us into further exaggerated positions. These exaggerated curvatures can then lead to both lower and upper back pain. Instead, we want to stand in an upright position where we focus on our rib cage being stacked over our pelvis. A lot of pregnant moms will notice that their symptoms can worsen as the day progresses so it’s important to pay attention to standing posture as the body fatigues.
(see pictures below)
The second important activity we want to talk about is holding either your toddler and/or another object, like a laundry basket. A lot of times the bending/lifting mechanics are altered because of the large baby bump and because of the changes in center of gravity like we mentioned earlier. The key is standing tall with pelvis and ribs aligned and with the child/object close to us. It is very tempting to want to stick one hip out to the side when holding a heavier item for a while but it is not good for our pelvis symmetry over time. Most of us will have a habit of choosing one side over another but it is important to not just always stick on one side.
The last activity we are going to address today is getting in and out of bed. It is very important to pay attention to how you get both in and out of bed. As all pregnant mamas learn quickly, finding a comfortable position and maneuvering yourself in the bed can be very tricky as baby grows. It’s important to not sit up straight out of bed doing a “sit-up” motion. This can cause abdominal coning and further exaggerate diastasis rectus and it also puts a high amount of stress on your back. The best way to get out of bed is to “log-roll” which is to roll to your side and then slowly get up using your arms to assist. Then when standing up out of bed try not to pivot and stand on one leg because that can aggravate pelvis pain. Instead, put both legs together to stand up. In order to get back into bed you’ll want to reverse this sequence. Sit down on bed with both feet together, then lay down on your side on the bed with your hands to assist and then roll over with your spine in a straight line the whole time.
If you have more questions about pain or discomfort that you are experiencing in pregnancy then please reach out to a physical therapist who specializes in women’s health, specifically prenatal. Physical Therapy can help with posture assessment and correction, manual release, and address any symptoms or pain you might be experiencing. PTs not only can help pregnant women stay pain-free, but they can also help with an easier labor & delivery and lessen the potential pain during the postpartum stage. At Rebound we want to make your pregnancy as comfortable and enjoyable as possible so please let us help you!
VIDEO/PICTURES:
Standing Posture:
DO: Stack rib cage over pelvis.
Shoulders held down & back.
DO NOT: Let abdomen and butt stick out.
Hunch shoulders.
Holding/Lifting a Toddler:
DO: Stand tall with pelvis and rib cage aligned.
Use your legs when lifting and bring/hold the item close to your body.
DO NOT: Push one hip out to the side.
Bend at your back.
Getting Out of Bed:
DO: Bend knees when laying on your back.
Scoot to side of bed before rolling onto your side.
Drop your legs off the bed and cross your arms (bottom arm bent at elbow) and push up with top arm. (Reverse to get back into bed.)
Use 2 leg stance to stand and rotate.
DO NOT: Sit straight up.
Pivot or do single leg stance to aggravate pelvis pain.
Video Demonstration on Getting Out of Bed
*IMPORTANT NOTE
Although this isn’t a blog written for the postnatal stage, in order to decrease chance of back pain post pregnancy and to increase the chance of diastasis rectus healing it is important to pay attention to these postures and positionings after birth as well!
Anna Towne, PT, DPT, CSCS