Low Back Pain during Pregnancy

Typically at the beginning of the year I write about New Year's Resolutions and how to keep them, how to chose the right club or trainer, or how to prepare foods that help you lose those extra Holiday pounds. This year I decided to go a different route. My education favors clearly the work with special populations and the rehabilitation of a variety of orthopedic, neurological and internal medicine conditions. So besides attacking main stream fitness issues I will dedicate a portion of my 2012 Blog to tips on rehab. My first blog is a tribute to all women who have gone or are currently going through the most incredible transformation: Pregnancy and the sometimes not so incredible side effects.

Low Back Pain is very common during pregnancy (50-70% of pregnant women) especially as changes in weight and center of gravity put added strain on your spine. As a Physio Therapist I want to know whether exercises can make a difference and if so which exercises to choose.

Weight gains during pregnancy (typically 25-35 lbs) have to be supported by mom's spine in addition the growing weight of the baby and uterus might place additional pressure on vessels and nerves in the pelvis and lumbar region. The growth of uterus and baby has also the effect that the body's center of gravity moves anterior drawing the lumbar spine often into hyper extension causing pressure and irritation to nerves exiting the spine in the lumbar region and pacing additional strain on muscles and tendons supporting body posture. Hormonal changes during pregnancy include an increase in relaxin, a hormone that relaxes muscles and tendons preparing the birth canal for the process of giving birth. This hormone unfortunately works also on muscles and tendons supporting mom's spine possibly leading to further exacerbation of already existing back pain. Last but not least, some pregnant women do experience muscle separation of the rectis abdominis (Straight abdominal muscle or six pack :-) along the center seam leading to a decrease in spinal postural stability.

Looking at research, there are four major studies out, that have evaluated this situation with different conclusions. Two of the studies did see increased value in adding lumbar stabilization exercises in order to treat low back pain in pregnant women, two studies found no significant difference between pregnant women who did engage in such exercises and those who did not. I concluded based on those four studies that pelvic lumbar stabilization exercises appear to be helpful certainly are not likely to cause additional pain and therefore to be recommended.

Simple low back stability exercises include, but are not limited to:

• Posterior Pelvic Tilt
• Hip Abduction
• Bridging
• Side Plank
• Hip/Leg Extension from Quadruped Position

any of these exercises can be modified to accomodate mom's prior experience with core stability training and her level of fitness.

I hope this little bit of info is helpful to all becoming moms and helps make your pregnancy a little easier.
Best wishes,

Hartmut Broring - M.S. Physio Therapy
Founder and President
Back In Form, Inc.