By: Heather Kidder, PT, DPT
Six million pregnancies occur in the United States per year. Of these pregnancies, 80 percent of women will report experiencing low back pain during the pregnancy, of which one-third will rate their pain as severe to completely debilitating. In fact, approximately 700,000 pregnant women are placed on bed rest each year due to pain. Physical therapy is an excellent natural alternative to bed rest; it can help women manage their low back pain while pregnant, allowing them to focus on the arrival of the new addition to their family.
During pregnancy, the female body experiences quite a bit of change over the span of 40 weeks. As one example, it releases a hormone called relaxin, which is responsible for relaxing the ligaments surrounding the sacroiliac joint (SIJ) to allow the birth of the baby. Due to the increased laxity of the joints within the low back, joints may become misaligned, creating pain. In addition to this hormone, the growing fetus causes the expectant mother’s belly to grow in size, creating an increased curve in the low back and shifting her center of gravity forward. Furthermore, it is typical for a woman to gain 30 to 50 pounds during her pregnancy, which will create increased compression forces within joints, create muscle imbalances, and cause the arches to fall. All of these bodily changes can further lead to poor force placement within the low back, leading to lower back pain.
Physical therapy is a safe, natural, and cost-effective alternative for the management of low back pain during pregnancy. It has even been shown to decrease sick leave for pregnant women when done with a program consisting of exercise and education. It is safe for women without a high-risk pregnancy to be active and exercise throughout the nine months leading up to their baby’s birth. Some proven exercises that can be performed during physical therapy are pelvic tilts, sit-to-stands, bridging, and rowing. In addition to these exercises, a physical therapist can assist with postural re-education and appropriate hip and pelvic joint alignments through muscle energy techniques (MET). A trained physical therapist will also take into consideration the postures and positions in which exercises are performed.
On average, labor can last 12-18 hours for a first-time pregnancy. Exercises should be performed for endurance, not in short bursts, to help a woman prepare for the marathon of labor. Additionally, labor and delivery can occur in multiple postures/positions – from lying on your back, to sidelying, to maintaining a quadruped position.
Pregnancy is a natural process for the female human body. Many changes occur quickly over a 40-week period, which can lead to poor force application with functional daily tasks. This in turn causes the low back pain that one-third of the pregnant population rates as severe to completely debilitating, and at times leads to early sick leave or bed rest. Physical therapy is a safe, natural, and cost-effective alternative for management of low back pain during pregnancy. It can help prepare the mother-to-be for the physical demands of labor – and the wonderful delivery of her newborn.
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