Low Back Pain and Pregnancy; prevention and advice

Low back pain and pelvic pain in pregnancy is often thought of as inevitable, but that’s not always the case, especially if you have the chance to prepare your body for pregnancy. A quote from an Indian Kundalini yoga teacher was passed onto us recently and it got us thinking...

“Life does not start in your womb on the first day of conception.  Look at the natural law.  We build a house first, fix it up, then enter it.  Nobody digs the ground for a foundation and then moves the furniture in ”

It has been estimated that 50% to 80% of women experience back pain during pregnancy and it can occur at any stage. It goes without saying that during pregnancy your body goes through lots of dramatic changes!

Centre of gravity and postural changes

As the foetus grows and the abdomen expands to the front, it causes the centre of gravity to shift forwards, which in turn means that the curve at the base of the spine increases, putting more stress on structures supporting the spine.

Muscles

The abdominal and pelvic floor muscles become stretched and therefore weakened. Did you know that the ‘six pack’ muscle separates lengthways to accommodate the expanding abdomen!

Hormones

The hormone Relaxin is naturally released during pregnancy to soften ligaments around the pelvis in preparation for birth. However it can also result in excessive movement in the joints in your lower back and pelvis- creating something we call ‘overload’ which can lead to pain, especially in combination with postural changes and muscle weakness.

So, what to do?

Strengthen your ‘core’ – the deep muscles from your lower ribcage to your bum.

If your core is strong, your back and pelvis are better supported and therefore more likely to withstand the softening of ligaments and changes in the centre of gravity. Having a strong core can also help prevent over-separation of abdominal muscles and that post pregnancy bulge that many women find undesirable. It is important that you do the correct type of core exercises as the wrong exercises such as sit-ups can make it worse.

Taking up Pilates pre-pregnancy and then switching to a class specifically designed for pregnancy is a great way to go. A word of caution though, Pilates relies on precision and form to be safe and effective; therefore joining a class of 10+ people can be counter-productive. There is no way with a class size this big that you will get the kind of coaching needed to get the moves right. We recommend investing in a few private lessons first to get the basics sound and if you are already a keen Pilates convert and have never done this, it’s worth checking your technique at any time. If you already have back problems then seek out a physio that is also trained in Pilates to get it properly sorted.

There are also some very skilled personal trainers and yoga teachers that specialise in working with women both pre and post partum. We would be happy to make recommendations to fit your personal circumstances.

Strengthen your pelvic floor muscles

These muscles work with your core muscles to provide stability to the lower back and pelvis. They also support your organs such as the bladder, bowels and womb so if they are weak, can cause problems such as incontinence and prolapse and  contribute to back pain. Check out our blog on the pelvic floor if you’re worried that you already may have issues with this- it’s one of our pet hates that we are led to believe ‘accidents’ are a normal consequence of pregnancy or indeed something that you need to accept at any time!

Focus on your posture

Ensuring good posture in standing and sitting both before and during pregnancy will help to reduce the stress and forces through your spine and will encourage your body to use the correct muscles to support your back. In-fact, good posture is core training in itself and conversely, poor posture leads to de-training of these muscles. Pregnancy aside, nearly every back issue we see is rooted in poor postural habits, both sitting and standing. As a really basic guide to correcting standing posture, stand sideways on to a mirror and follow this check list;

  1. Make sure that 2/3 of your weight is through your heels and only 1/3 through the balls of your feet.
  2. Your knees should be ‘soft’; neither bent nor locked backwards.
  3. Your bum muscles should feel a little active when you press them, not soft and relaxed. If they are soft, tuck your bottom and pelvis underneath you a little to get them to engage.
  4. There should be a small hollow in the small of your back (your lumbar spine area)
  5. Your upper back should not be hunched. Elongate this part of your spine as if stretching up towards the ceiling.
  6. Your head should sit over your neck and upper back- often people stand with their chins poking forwards. To correct this, gently tuck the chin in and down taking care not to tense the muscles in the front of the neck.
  7. Gently roll the shoulders back and down without pulling them back ‘military’ style.

Preparing good foundations and building strong walls ready for your baby to move in is a great way of making your pregnancy comfortable and more enjoyable. However, don’t stress if you haven’t worked on preparing your body before becoming pregnant, these are things that can be worked on right the way through pregnancy and will also help your body recover more quickly once your baby has arrived.