Pregnancy is an incredible journey, but it brings significant changes to your body. These changes, while normal, can lead to discomfort and low back pain for many mommas.
Common Musculoskeletal Changes During Pregnancy
1. Changes in Posture
• As your belly grows, your upper back (thoracic spine) tends to curve forward more (increased kyphosis), and your lower back (lumbar spine) curves inward more (increased lordosis).
• This puts extra strain on the joints, ligaments, discs, and muscles in your lower back, leading to pain.
2. Rib Cage Changes
• Your rib cage flares upward and outward, widening the angle underneath your sternum.
• This can make your mid-back (thoracic spine) and diaphragm stiffer, forcing your lower back to pick up the slack in mobility. This extra movement in your lumbar spine can lead to pain and soft tissue strain.
3. Walking Changes
• Pregnancy alters how you walk to improve balance and stability. These changes include:
• Slower walking speed
• Shorter, less frequent steps
• Weight shifting from your rear foot to your forefoot for dynamic stability. This shift increases strain on your lumbar paraspinals, glutes, and hamstrings to balance your body and can lead to muscular aches and pains in your lower back.
Why It’s Important to Address Low Back Pain During Pregnancy
Low back pain isn’t just a physical issue—it can also take an emotional toll. Research highlights that pregnancy-related low back pain can lead to:
• Feelings of physical limitations
• Frustration and mood changes
• Concerns about future pregnancies
And here’s the kicker: if left untreated, low back pain can persist postpartum.
Studies show:
• 25-50% of women still experience low back pain at 3 months postpartum.
• For some, it can last up to 12+ years postpartum
Low back pain in pregnancy is often linked to:
• Increased hip external rotation and abduction (leading to a wider stance and out-toeing)
• Pain and limitation with low back flexion and compensations with hip flexion bending over
• Tenderness in the low back muscles (paraspinals) and common trigger points in the piriformis, glutes, and adductors
• Diastasis recti (abdominal separation)
So addressing low back pain sooner rather than later is key—not just for your comfort during pregnancy but also for your recovery postpartum.
How to Manage Low Back Pain During Pregnancy
The best way to manage pregnancy-related low back pain is through a combination of mobility exercises, stretches, postural stability, and strengthening exercises. Here are some practical tips to get you started.
1. Improve Lumbar Mobility and Hip Internal Rotation
Pregnancy can reduce mobility in your lower back and hips. These exercises can help you stay flexible and fight off stiffness:
Cat-Cow Stretch
• Start on all fours.
• Arch your back (cow) by lifting your tailbone and chest while letting your belly drop.
• Round your back (cat) by tucking your tailbone and chin while pulling your belly button upward.
• Move slowly and focus on your breathing.
Hip 90/90 Stretch
• Sit on the floor with one leg bent in front of you at a 90-degree angle and the other leg bent behind you at 90 degrees.
• Slowly lean forward over your front leg for a stretch, then rotate toward your back leg for hip mobility.
2. Stretch Common Areas of Tension
Tightness in the piriformis, glutes, adductors, and low back muscles is common during pregnancy. Stretching these areas can often relieve pain in the moment and improve mobility.
Seated Cross-Body Piriformis Stretch
• Sit on a chair. Cross one ankle over the opposite knee.
• Gently press your knee downward and lean slightly forward to feel a stretch in your glutes and piriformis.
Figure-4 Stretch with Foam Roll
• Sitting on a foam roll, cross one ankle over the opposite knee to form a “figure 4.”
• With a foam roller under your hips, gently roll back and forth, throughout your glutes
Quadruped Adductor Rock Backs
• Start on all fours with one leg extended out to the side.
• Rock your hips backward until you feel a stretch in your inner thighs, hold that stretch for 30-60 seconds, then return to the starting position.
Child’s Pose
• Kneel on the floor with your big toes touching and knees wide apart.
• Sit back onto your heels and stretch your arms forward to stretch your lower back muscles
3. Strengthen Your Deep Core for Stability and Posture
A strong core helps manage intra-abdominal pressure and supports your posture, reducing strain on your lower back.
Abdominal Draw-Ins with Paloff Press
• Standing with a resistance band anchored to the side.
• Engage your deep core muscles by imagining a zipper zipping up your lower core from your pubic bone to your belly button and exhale to press the band straight out in front of you, resisting rotation.
Quadruped Transverse Abdominis Draw-Ins with Bird Dog
• Start on all fours. Gently draw your belly button toward your spine. Use the same cue to engage your deep core muscles.
• Keeping your deep core drawn in, exhale to extend one arm and the opposite leg away from one another.
Farmer Carry Draw-Ins with Marching
• Hold a weight in one hand while standing tall keeping your shoulder, hip joint, and ankle lined up from the side. Engage your core imagining the zipper zipping up your pubic bone to your belly button. Keep this engaged as you lift one knee to march, then alternate sides. Make sure to breath throughout.
Why Working on this Early Matters
Working on your low back pain during pregnancy isn’t just about feeling better in the moment—it’s about preventing it from worsening and reducing the risk of long-term issues. Here’s a quick recap of what you can do:
• Start Early: Address low back pain as soon as you notice it to prevent it from becoming more severe.
• Stretch and Mobilize: Use exercises like cat-cows, hip stretches, and foam rolling to relieve tension in the moment and improve mobility.
• Strengthen Your Core: Build deep core strength and stability to support your growing belly and improve posture.
Pregnancy is a time of incredible change, and your body is doing amazing work to grow and support your baby. You deserve to feel strong and comfortable as you navigate this journey, momma. By incorporating these strategies into your routine, you can keep low back pain at bay and focus on what matters most—preparing to meet your little one.
You’ve got this! If you have any questions or want more personalized guidance, let me know. I’m here to support you every step of the way.
References:
Bergström, Cecilia, Margareta Persson, and Ingrid Mogren. "Pregnancy-related low back pain and pelvic girdle pain approximately 14 months after pregnancy–pain status, self-rated health and family situation." BMC pregnancy and childbirth 14 (2014): 1-12.
Munro, Allana, et al. "Prevalence and predictors of chronic pain in pregnancy and postpartum." Journal of obstetrics and gynaecology Canada 39.9 (2017): 734-741.
Wuytack F, Curtis E, Begley C. Experiences of First-Time Mothers With Persistent Pelvic Girdle Pain After Childbirth: Descriptive Qualitative Study. Phys Ther. 2015 Oct;95(10):1354-64. doi: 10.2522/ptj.20150088. Epub 2015 Apr 30. PMID: 25929535.
