Babies are trouble… Nine joyous months of weight gain, morning sickness, aches and pains, mood swings so strong you could leave even the most macho of men trembling in fear, and then when they do arrive, you must cater to their every need or feel the wrath of their selfish little scream…
Convinced yet? No of course you’re not, because the truth is, the end result makes all those trivial by-products worth every second (says he). But despite this, there is no denying it, bearing and raising a child is demanding; emotionally, mentally and physically. So let’s see if we can make this bumpy ride a little more comfortable.
A few facts and stats and backs and babies
Pregnancy is a wonderful chapter in a woman’s life, it’s the primary bonding time with your new child. But for up to 80% of you, this special time will be hampered with niggling back pain that can make life somewhat cumbersome when you’re busy making a baby. This will typically occur in early stages of pregnancy (often around 10-14th week period) and unfortunately, can continue to intensify until birth, and sometimes beyond. The reasons why are quite simple:
Hormones – You’re fresh faced, glowing and radiant, you are oozing with baby making prowess and everyone around can see it… but let’s face it girls, deep down you’re a hormonal mess! Your body is pumping out millions of mood altering chemicals quicker than you can say “I fancy another slice of chocolate and bacon on toast” and no one should dare stand in your way. But why is this?
Well, hormones play essential roles in the function of our beings, and just as they are able to alter our psychological state, they can influence physically. During the early stages of pregnancy – and then again at delivery – there is a substantial spike in the production of a hormone called Relaxin. This hormone causes joints and ligaments (particularly in the lower back, hips and pelvis) to become supple and loose; aiming to prepare us for the structural and systemic changes that occur during both pregnancy and child birth.
There’s a downside; excessive mobility isn’t always a good thing. If you’re not taking correct precautions, a combination of postural changes, weight gain and weakened, supple joints leaves you susceptible to injury.
Weakened core (abdominal muscles) – So we often see gym enthusiasts strengthening their core in the gym, because the truth is, we all want a flat stomach with sculptured abs on show, but the core serves a more important underlying function. The core, in essence acts to vacuum pack and brace the lumbar region of your body, it keeps us in an upright position and provides stability and protection to our spine. The fast growing bambino inside cause’s abdominal distention, separating the muscular structures meaning that they soon become flattened and weak. As a consequence, this loss of core efficiency means that the back muscles, discs and spine have to compensate and work overtime… The result? A tired, achy and fatigued lower back that feels soooo much better when you sit and rest (take note all men)
Postural changes – Many practitioners place a huge emphasis on ‘posture related back pain’, but this isn’t the whole story. Yes, there are some more ‘ideal’ postures i.e. where the spine and hips are evenly balanced, but it doesn’t have to be the same for everyone. Our bodies are amazing at adapting to the ordeals we put them through; they can simply take a little while to adjust. The problem with ‘pregnancy posture’ is that these changes are fairly extreme and happen over a relatively short period of time. The diagram below demonstrates this brilliantly.
credit image to: http://resources.ama.uk.com/glowm_www/graphics/figures/v2/0080/001f.gif
As your bump becomes heavier and larger, our centre of gravity shifts; you suddenly have a force pulling you forward, which you naturally try to counteract by adopting an opposing ‘sway back posture’ i.e. increasing the curvature in your lower back. This completely throws out your normal spinal alignment so that certain muscles and structures rapidly become overloaded, overused and tired, causing – you guessed it – aches, pains and fatigue!
Weight gain – Yes is sounds pretty obvious… and with the average pregnant woman gaining some 23-30lbs (a combination of baby, amniotic fluid, placenta, increase blood volume and adipose tissue), there’s not a great deal you can do to avoid it, but there some simple steps which you can take to counteract and improve your adaptability for these physical changes.
Baby steps to a better back
There are three very important words I use frequently in my practice – and I’ve used over and over again in the past few paragraphs; ‘change’, ‘compensate’ and ‘adapt’. These three terms are key principles to both understanding and managing your low back pain during pregnancy.
Change is inevitable, nothing can be done about this; a tiny person is growing inside of you and things are going to be a little different for a while. Certain muscles, joints and ligaments will become overworked, overloaded and overwhelmed in an attempt to compensate for these postural and physical modifications. The need to adapt in this relatively short period of time means certain areas of your body become fatigued, exhausted and downright painful.
So…’knowledge is power’ and ‘the best form of defence is attack’. Now we understand why these areas become painful let’s look at some ways to counteract it.
You wouldn’t go straight into a marathon without training first, so why should this be any different… there’s a long road ahead!
We discussed earlier that one of the main sources of back pain is due to postural fatigue of the lumbar spine and surrounding musculature. This occurs because abdominal distention causes the core structures to become weakened and less efficient, and more often enough, the lower back just isn’t strong enough to cope with these demands. Therefore, it makes perfect sense to try and enter pregnancy with a strengthened and pre-conditioned baby-holding apparatus.
My advice, take up Pilates or find yourself a Personal trainer who you feel comfortable with (they’re not all big burly brutes who scream and shout). A good PT is worth their weight in gold; they can provide you with huge variety of safe and effective exercises aimed to strengthen glutes, legs, abdominals, and of course, the lower back.
Cardio – if you’re in the process of trying to get pregnant, it may not be the best time to sign up to any marathons as extensive exercise can sometimes interfere with your menstrual cycle, however, it’s perfectly safe to get that blood pumping with light to moderate activity. Whether you decide to do it through swimming, cycling, jogging or any other means of exercise, improving cardio-vascular health will substantially improve your tissues ability to cope with the upcoming demands of pregnancy.
Weight loss – If you’re prone to lower back pain and you’re carrying a few extra pounds around the midriff, losing some weight will certainly be advantageous. Once again, many PT’s have great nutritional knowledge which when combined with their exercise plan, should see the weight drop off. Be aware – dramatic weight loss can interfere with your ability to conceive, so it’s always advisable to discuss weight control with your GP before taking on any new diets.
If you’re not in a position where you are able to use a PT or gymnasium facilities, watch our video with some great strengthening exercises which can be performed in the comfort of your own home.
Firstly, let’s be cautious, all of what I propose will only be beneficial for a normal pregnancy (if there is such a thing as a ‘normal pregnancy’), but as I’m not speaking with you one to one, I’d urge anyone with any queries or concerns to firstly consult their health care professional prior to undertaking any of the following suggestions.
Is Osteopathy safe whilst I’m pregnant?
In a nutshell, yes. Osteopathy has one of the best safety records of any medically related profession and is commonly used as a ‘drug-free’ alternative to help alleviate pregnancy related pains.
Osteopaths use gentle, carefully selected and specialised techniques to minimise any risk to you and your baby. Our treatment aims to normalise the structure, aiding the body to adapt and align so that it functions as efficiently as possible, and, ultimately, helps you to feel relaxed, comfortable and relieved from those aches and pains.
After spending time treating in specialised ‘Expected Mothers’ clinics in London, I have first-hand experience in the treatment and management of pregnancy related pains. Some other common presentations are:
- Sacro-illiac joint pain
- Carpal tunnel syndrome
- Upper back, neck and shoulder pain
- Plantar fasciitis
- Heartburn/acid reflux
With the help of Hayley Deane, a local Pilates instructor, who has demonstrated each exercise, The Osteo Practice has put together a series of video’s which are aimed to help you combat some of those annoying aches and pains associated with pregnancy .
Our first video demonstrates 6 simple, safe and effective exercises to strengthen the necessary muscle groups.
Keeping mobile and stretching out those tired overworked areas not only feels great, but is also a quick and relaxing way to ease the stress and strains on joints. Check out our 7 simple stretches for back pain relief during pregnancy.
A few other suggestions are:
- Prenatal Pilates and Yoga
- Aqua natal exercise classes
A few little tips to keep those grumbles at bay
Shoes – Sorry ladies, it’s time to put those Louboutin’s back in the cupboard for a while. High heels increase the curvature of your back and create pressure that drives the weight of your pregnancy directly into your lower spine and hips. They also create a further shift in your centre of gravity which can make you unbalanced and vulnerable to falling.
Try wearing some comfortable low-heeled shoes, with built-in arch support to take the strain from your feet.
Sleep & pillows – Try sleeping on your slide with both knees bent and pillow between. As your pregnancy advances you may also wish to place a pillow under the bump to help provide support and to reduce strain on hips, lower back and pelvis.
Posture and lifting – Be aware of your postural changes and try to maintain an upright positon: keep your shoulders back, chest high, spine straight and your pelvis tucked in.
Lifting can be a tricky one, as I mentioned earlier, the hormone relaxin can make joints and structures vulnerable to injury, it’s therefore really important that bend with your knees and lift from a crouched position.
Rest up – it’s very important to stay active (as mentioned throughout the article), however, it’s equally important to take regular breaks and not to push yourself too hard. Try to split your activities and don’t over-exert yourself – you’ve got a tough enough job as it is! Many of the aches and pain you’re experiencing are due to tired, fatigued structures in the body, so it makes sense to give them some chill-out time. Sit back with a lumbar support, keep your feet up, knees bent and relax.
Maternity belt – This is supportive garment which straps around the lower back and underneath your bump. It can help to reduce strains on the pelvic girdle and lower back, and can act as a substitute for the abdominal core muscles.
Alternative therapies – Of course I’m going to be biased towards Osteopathy, but if you find that you’re more suited to other forms of therapy such as acupuncture, physiotherapy, massage etc, you should consider enquiring to whether practitioners believe they can be of help. My advice is to always have a talk with your primary health care provider and discuss the options!
Call a doctor? – Some accompanying symptoms may be a cause for concern. If you’ve noticing bleeding, uterine tightening, sporadic episodes of pain or cramping, fever, burning on urination or areas of numbness/shooting pain or pin and needles into your legs, you should contact your doctor.
Our advice is to always consult with your general practitioner or primary health care professional first, even before undertaking any of our suggested pain management techniques. Whilst back pain is a very common occurrence during pregnancy, every individual and case is different and it can’t hurt to put your mind at rest!
Good luck and congratulations!
The Osteo Practice