30 Nov Pre and Post-Partum Back Health
Pregnancy and the post-partum period can wreak havoc on the spine. The most likely reason for this is the added strain of the extra frontal weight during pregnancy and the subsequent decrease in this weight after delivery. Add to this the relative weakness of the abdominals since they are stretched out for 9 months and it’s a recipe for back pain. In this way the displacement of belly weight acts like a fulcrum to the spine, putting enormous amounts of pressure on its structure. A Cesarean section can further complicate this situation. Muscles do not work well when they are stretched out, no matter how strong they are!
The spine itself has some natural curves so it can attempt to naturally correct for this, but it is not always able to do so effectively. A deepening of the curve in the back generally accompanies pregnancy and thus back pain is a result.
There are many ways this can be minimized to reduce pressure on the spine and decrease or prevent pain.
The most important of these is always posture….but likely not in the way you think! Posture plays a huge role in keeping us out of back pain and is likely a leading cause of back pain even in non-pregnant people. During pregnancy and after, it is important to NOT allow for the deepening of the lower spinal curve. This means the abdominals must stay ‘engaged’ (ie. slightly taut) during any activity as well as with sitting, including walking, standing and sitting. This is referred to as a pelvic tilt. It is both a postural position and an exercise.
The position requires you to pull your navel into your spine by using your deep abdominals to ‘brace’ your spine.
The exercise involves holding this position for longer and longer periods, and eventually holding this position during all active back movements, including static sitting, as sitting also requires the lower back muscles.
Try this exercise: Laying on your back with your knees bent, ‘tilt’ your pelvis by pulling your navel into your spine and holding it for 5-10 seconds for 3 sets of 15-20. Work up to being able to hold this position whether standing, performing a squat, walking or even cycling or running. This core muscle should always be engaged during active movement to counteract the forward pressure of the belly on the spine. Try to begin by doing the exercise laying on your back (safe to do throughout pregnancy as long as you don’t hold your breath…it is a very sight muscle contraction). Even post-pregnancy and for most doctors, post C-section, the pelvic tilt is recommended. Be sure to ask your doctor if you can begin pelvic tilts as it may be advised to wait a week or so post-birth or until the sutures or stitches are removed.
Once a pelvic tilt can be achieved on your back, lay in the same position on your back with your knees bent, tilt and hold the pelvis as before, and then lift your butt up slowly as high as you can go comfortably, hold 3 seconds, and then slowly lower. Be sure to hold the tilt the entire time of the exercise, until your butt is back on the ground.
Next work into using this position holding the belly button in towards the spine when you are standing and sitting.
Then lastly incorporate it into any exercise you may be doing including walking or other aerobic exercise. A good ‘advanced’ version is doing a pelvic tilt and then 10 squats against a wall and then free standing, again holding the tilt the entire time.
Remember the idea is to be able to always keep your deep abdominals slightly engaged to protect the spine from the added pressure. Think of it like wearing a natural back brace. Active muscle contraction is much preferred and works much better than adding any physical brace!