Things could not be any better. You have been trying for months now but at last you are carrying a child. The excitement at the thought of becoming a mother is uncontainable: you are already dreaming about the baby shower, the crib, the tiny clothes and the insane amount of diapers that you will have to stock. Your whole life is changing and so has your body over the past months. The experience has been exciting; again things could not be any better. Then comes the back pain, killing the good vibe of the pregnancy.
Now why are you having back pain? The many anatomical and physiological changes occurring to your body collectively contribute to your back pain. Women gain about 25-35 lbs during pregnancy. Including the wonderful life that you are harboring, your placenta, uterus, breast, blood, fluid and fat all increase in size. Your body compensates for the added weight by increasing the curve on your back and neck, leading to what we call: pregnancy posture. The increase belly size stretches your abdominal muscles to a point where they cannot fire efficiently. If the abs get stretched, the thoracolumbar fascia is also stretched because it is connected to the abdominal wall. Think of the two structures as the elastic band of a pair of short. The more you wear it, the wider it gets, and the wider it gets, the less it anchors around your waste. So once those structures are lengthened, their job of stabilizing your trunk becomes very difficult. The increase weight during pregnancy also stretches your pelvic muscles, which also compromise their job at stabilizing the spine. In addition, your joint becomes very loose because of all the hormonal changes happening to your body. The scenario we end up having here is an increased flexible spine under pregnancy weight and groups of muscles too weak to stabilize it. It’s no wonder you are having back pain. To make things worse the stretching of the abdominal muscle, specifically the rectus abdominus, can be so severe that this muscle could split right at midline. Activity such as sitting up from your bed can become very difficult. You could also be at risk for a hernia depending on the severity of the split, and it is the last thing your pregnancy swagger needs.
Yes, you have thought about the cribs, the baby shower and the diapers but have you ever thought about preparing your body for the massive change you will experience with pregnancy? There are things you can do now to strengthen your body and reduce your back pain; you can start by working on your lower body. Here’s the game plan: you strengthen your lower extremity muscles to take up more of your pregnancy weight, reducing some of that pressure on your back. Clam and bridges are great exercises to strengthen you hip muscles.
Straight leg raises and leg lift exercises can also be added to the routine for strengthening of both the hip and knee, and you can do some ankle pump to strengthen your calf muscle.
Notice there were no standing exercises performed. Your core muscles are not as strong during pregnancy, therefore it is very important to begin exercises in the positions as demonstrated in the videos to minimize injury.
Remember the main reason you are having low back pain is because the muscles that provide stability for your back are weak. So you are going to need to strengthen them as well. Exercise such as Bent leg fall out is great for providing stability at the abdominals while you lay on your back.
After two to three sets, get on your hands and knees and do the bird dog at a very slow pace. Make sure you keep a neutral spine during this exercise and make sure you keep your pelvis from turning otherwise this exercise is pointless. This exercise is very easy to do with the wrong form, so pay attention to what your body is doing.
Doing these exercises not only reduce your back pain during pregnancy but they also help speed up recovery after your delivery. So the sooner you start, the more prepared your body will be. It is also important to mention that as pregnancy progresses, the abdominals will stretch more and more, so exercise must be adapted to meet your need, and proper assessment must be done before you engage in any of those exercises. So consult with your OBGYN and your Physical Therapist.