Your posture and the pressure your postural muscles are under change greatly during the course of your pregnancy and can lead to lower back pain. The obvious reason for this change and the resulting back pain is the extra little body that you are increasingly carrying on the front! But it is not the only reason, and the changes during pregnancy to the musculoskeletal system can often cause spinal or pelvic pain as well as lengthening of the abdominal and pelvic floor muscles.
The incidence of some degree of back pain during pregnancy is relatively high. Researchers worldwide have suggested that between 30 - 70% of pregnant women are affected. This is a large majority of mum's so it appears there needs to be more done to prevent lower back occuring during pregnancy.
The main causes of back pain during pregnancy remains debatable as often there are several issues involved. An increase in body weight, hormonal changes, postural changes, a past history of back pain, repetitive bending and lifting, are all thought to contribute. The most common sites of pregnancy related back pain are the lower back and the posterior pelvis (back of the pelvis), although other sites may also exist.
Changes in your postural alignment is a natural occurrence as pregnancy develops. The ideal posture ensures the most efficient use of our back muscles so that the least energy is required of these postural muscles. Pregnancy results in an increase in overall body mass and a change in the centre of gravity. As the pregnancy progresses the posture adapts to the changing weight and subsequent forces imposed on the body.
The picture here shows an ideal posture during pregnancy: we want you to be standing 'tall' with your tummy muscles pulled in and your bottom tucked under.
The exact postural changes that occur in response to pregnancy can vary however the general change is that there is an exaggeration of the curve in the lumbar spine (lower back). This exaggerated curve in the lower back is what causes the back muscles to be placed under stress and can lead to back pain. It was thought that following the birth, a woman's posture returns to the way that it was pre-pregnancy. However some studies have shown that the posture after pregnancy is not significantly different to the posture developed during the later stage of pregnancy.
Hormonal changes that occur during pregnancy cause a softening of ligaments and the joints, particularly of the pelvis, to enable the foetus to pass through the birth canal more easily. This results in increased joint looseness and decreased stability. This, in conjunction with lengthening of the abdominal muscles, compromises the stability of the spine and results in excess mobility of the joints. This may be the cause of pain in the lower back and posterior pelvis.
Various forms of corsets and supportive braces are available which may provide an increase in joint stability and alleviate low back and posterior pelvic pain. Good core and lower back muscle strengthening can act as a natural 'girdle' and both pregnant and new mum's should be doing a variety of core exercises to help reduce the risk of lower back pain. See our article on core muscle training, but be aware if you are at a pre or post natal stage of pregnancy you will need specialised exercises and back care!
If you have experienced back pain in the past you are obviously more likely to report back pain during pregnancy. Also, if you have experienced pregnancy related back pain with a child you are more likely to experience back pain in subsequent pregnancies. If you fall into either of these categories you should seek specialised back care from a health professional or personal trainer to take steps to reduce the risk of lower back problems. Stretching and strengthening exercises like the ones below should be undertaken to avoid the incidence of back pain.
Despite these natural occurring changes, undertaking physical activity and maintaining a good level of physical fitness and strength is likely to reduce the risk of developing back pain during pregnancy. Moving around, keeping active, and doing the correct type of training will certainly help your core muscles stay strong and this will reduce the chance of lower back pain problems.
Once you have had your baby it is equally important to take care of your back! A good core training program will help to progressively train your stomach muscles and get your strength back after childbirth. You should start with pelvic floor training and move onto gradually more intensive core muscle exercises. We have a full core training program for Mum's so contact us for more information!
You should be careful with your posture and lifting after pregnancy. Your baby will start out very light but over the months will grow to become a heavy little thing! Follow these tips for good posture and back care with your baby after birth (see pictures below):
* standing 'tall' with your tummy muscles pulled in and your bottom tucked under
* sitting in a comfortable chair with good back support particularly when feeding your baby
* lifting correctly by bending your knees, keeping your back straight, tightening your stomach and pelvic floor muscles and holding the object firmly and close to your body
* avoiding sudden and repetitive bending and twisting movements
* making sure that your working surfaces are at the waist / hip height
* alternating sitting and standing jobs.
  
To find out more about back pain during pregnancy, prenatal back pain, back care, post natal back pain, or exercising before or after pregnancy please contact us!
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Postural changes during pregnancy
