There are many changes that occur in a woman’s body to make room for that very special bundle of joy. Although these changes are quite amazing, they can leave many women experiencing pain both throughout pregnancy and during the postpartum period. Two common problems include low back pain (LBP) and pelvic girdle pain (PGP). Research has reported the prevalence of LBP and PGP as high as 65-70%. In addition, 77% of women experienced back pain AFTER pregnancy which impacted their ability to perform their daily tasks. WOW, that’s a lot! So, if you are a mommy-to-be or have a little one at home and are experiencing some pain, rest assured you are not alone. The good news is there are ways to help reduce strain in certain areas as you continue through your pregnancy and if these tips don’t help resolve the pain, a Physical Therapist can determine the treatment plan that can. To better understand how to help reduce strain it is important to understand some key points.
Key Anatomical Changes During Pregnancy
Hormones create more mobility: Ligaments are what provide extra support to our joints where the bones come together. Many of the pelvic ligaments loosen in order to progressively make room for the growing baby. As ligaments become more stretched, strain is put upon areas such as the sacro-iliac joint (back of pelvis) and the pubic symphysis joint (where the pubic bones come together).
Abdominal muscles stretch and spread: The abdominal muscles are progressively stretching as pregnancy progresses. Sometimes, the abdominal muscles that run vertically down our abdomen can separate in response to that beautiful growing belly. In the third trimester, this can be present in about 66% of women. Separation can impair the body’s ability to transfer loads and thus put more stress onto areas such as the pelvis and low back.
Posture changes: At first a woman’s baby “bump” starts off barely noticeable and ever so slight, but as the belly keeps getting bigger and bigger, the center of mass is shifted forward. In order to prevent from tipping over, a woman will typically adapt by increasing the arch in the low back. This creates a change in forces on the spine and the work of the back muscles.
Feet flatten: During weeks 12-34 of pregnancy, the feet can gradually flatten. As one area in a body changes, you can bet that there will be a domino effect up the chain, and many other parts and regions will follow and respond. As feet flatten, the hips and knees rotate inward placing new strain upon the inside of the knees and again into the backside of the hips and pelvic region.
Rib cage widens: Did you know the rib cage also expands to create space? This new mobility and position can create irritation of the joints where the ribs insert into the spine.
BDI Highlight: Helpful Tips
Tips for Reducing Strain
Avoid asymmetrical postures: Do you like to cross your legs or shift your weight onto one leg while standing? It’s best to try to stay symmetrical with weight placed evenly on both feet to minimize extra strain to the joint surfaces. Remember, when pregnant, the ligaments are not offering as much support as they typically do.
Postures to avoid or minimize:
Standing with all bodyweight onto one leg
Carrying infant on one hip
Sleeping with one knee up
Crossing legs or ankles
Due to changes in a pregnant woman’s feet, over-the-counter arch supports or even prescribed orthotics can be beneficial to help control the motion and forces coming from the ground into the knee, hip, and low back.
The body has both local muscles and global muscles. Local muscles are deep, respond to changes in posture, and help support and control small motions at the level of our joints. Global muscles are superficial and help generate torque for larger dynamic movements. We need BOTH of these systems to work efficiently at all times in order to function best. Here are some exercises that can challenge work at the hip and trunk muscles in a coordinated way to activate both of these important muscular systems. These exercises will offer stability to the lumbar and pelvic girdle regions that are progressively getting loaded as that little sprout keeps on growing! With your healthcare provider’s approval, feel free to learn these movements and give them a try by clicking HERE!
If you have questions on low back or pelvic girdle pain during pregnancy, you can contact Jenna Calo at jcalo@bodydynamicsinc.com