Low Back Pain
Low back pain is the most common complaint I hear from my patients who are pregnant or recently post-partum. Why? During pregnancy, women produce a hormone called relaxin. This hormone causes an increase in laxity to allow the joints to expand to accommodate the growing fetus and eventually allow you to push that baby out. As pregnancy progresses, women also gain weight, especially in the lower abdominal region due to the growing fetus and uterus. This weight gain shifts our center of gravity further in front of us which in turn causes a shift in our natural spinal curve. The low back becomes more lordotic or arched putting more strain on the low back musculature and joints. All the while, the abdominal muscles are weakening due to the excessive stretch being placed on them by the expanding belly. Post-partum the center of gravity shifts rapidly but the muscles have not yet recovered to take on the responsibility of stabilizing and responding to this change.
All these factors combined cause decreased stability in the Lumbar or low back region and increased muscle tension leading to pain. Pregnancy and post-partum can also be a stressful time, which we know only increases our pain perception (see the previous post on the effect of stress on pain to learn more). Back pain can range in intensity from mild to severe and in limitation from annoyance to unable to move. Luckily, physical therapy can help!
Here are 3 of my favorite exercises to increase Lumbar stability, reduce muscle tension, and reduce pain:
- CAT-COW
Begin on your hands and knees with shoulders stacked over your wrists and hips over your knees. Slowly breath in as you arch your low back, lift your head to the ceiling, and pull your shoulder blades down your back. Slowly breath out as you round your low back and tuck your chin to your chest. Remember to engage your deep core muscles by thinking about pulling your belly button toward your spine and move slowly as we are working on controlled mobility to improve your overall stability in the low back.
- BIRD DOG
Begin on your hands and knees with shoulders stacked over your wrists and hips over your knees. Engage the core muscles by thinking about pulling your belly button toward your spine. Keep your spine neutral and your head in line with your spine by looking 6 inches in front of your hands. Slowly lift one arm and the opposite leg and try to lengthen each toward the far walls. Slowly return the arm/leg to the starting position, then repeat with the opposite arm leg. Remember to move slowly and with control. Your hips and back should stay level throughout this exercise. Think about a glass of water sitting on your pelvis that you don’t want to spill. Don’t forget to breathe.
- CLAMSHELL
Begin laying on one side with your knees bent, hips stacked, and feet stacked. You want your feet in line with your hips. Engage your core muscles by thinking about pulling your belly button toward your spine. Slowly lift your top knee while keeping the feet together and the hips in line. Hold at the top for a count of three then slowly lower your knee to the starting position. Do this motion 15-20 times on this side then repeat on the other side. Don’t forget to breathe.
Remember its important to modify activities during pregnancy so if you are having any symptoms or notice any separation in your abdominal muscles with these exercises, please contact me for modifications.
With the appropriate physical therapy treatment, you can increase your strength and stability safely while pregnant and improve your post-partum recovery. Physical therapists can also analyze your movement patterns and help you to modify these patterns to accommodate your current body and help you maintain function without being limited by back pain. Doctors of physical therapy are trained in identifying red flags that may indicate a need to be further assessed by your OBGYN so you can be confident that you are getting the treatment you need. Just because back pain is “normal” does not mean it can’t be improved. If you feel like back pain is limiting you, give us a call today to see what Life Changes Physical Therapy can do for you!
