It is common for women to complain of neck, lower back, and/or pelvic pain during their pregnancy. However, that does not mean that it is normal. There are things you can do now to prevent or decrease these pains. Paying attention to posture and moving the right way will help ease your discomfort and allow you to better enjoy this exciting time.
Quick tips to improve function during pregnancy
It is important to maintain optimal alignment while sleeping to decrease stress on joints and improve your ability to rest at night. Lying on your left side will allow the best circulation to occur between you and your growing baby. While lying on your side, make sure that your neck is well supported on a pillow and is in alignment with your upper back. To decrease pain in the pelvis and hip area, be sure to use enough pillows in between your knees. Your top hip, knee and ankle should be in a straight line and pillows should support all. Place a pillow horizontally across your bottom hip and belly to decrease hip pain and back pain. For extra back support, roll a pillow the long way, and wedge it under your back, starting from your shoulders to your buttocks. There are pregnancy pillows that you can purchase to perform some of these functions. However, make sure these principles are still being followed for optimal relief.
While sitting or standing, excess strain on your muscles does occur due to physiological changes with pregnancy. As your belly grows, your center of mass shifts forward and you have a higher tendency to lower your chest, round your shoulders, and position your neck and head forward. Although this naturally happens, you should resist this position. Over a prolonged period, this position will weaken your muscles and lead to discomfort. To combat this posture, lift your chest by pulling your shoulder blades back and down. This is similar to the posture Superman would take when showing off his emblem, but you are Super-mom, which is way more impressive! Make sure you tuck your chin close to your neck and try to keep your ears located in line with the middle of your shoulders. If you are sitting for several hours in the day at work or at home, make sure you stand up and walk around at least every thirty minutes, more often if you can work that into your schedule. The longer you sit in one position, the more discomfort you will feel when you must stand up and move afterwards.
When you lift objects in your environment, you should have the same technique whether you are lifting a light object or a heavy object. Use this technique even when you lift your child or baby carrier. To start, get as close as possible to the object. While inhaling, widen your stance, keep your back straight and bend your knees to grasp the object. Then as you exhale, keep the object close to your body and straighten your knees to lift. To release the object, keep the object close to your body, keep your back straight and bend your knees to bring the object to its resting place.
To get into bed while minimizing discomfort, start by sitting on the edge of the bed. At the same time, lie directly onto your side and lift the legs onto the bed. It is important to roll to the other side without twisting the spine. Keep your knees bent while on the bed, move your legs and upper body at the same time to roll onto your back. To move back to your side, reach across your body and drop your bent knees to the side, simultaneously. To get out of the bed, lie on your side, then drop your legs off of the side of the bed and push up with your arms at the same time. This method allows you to use momentum and minimize strain on your pelvis and back.
Getting in and out of the car is a common practice that we do every day. What we don’t know is that we can excessively stress our pelvic joints while doing this activity. During pregnancy, a hormone called Relaxin relaxes the joints, ligaments and connective tissue in your body. This hormonal change makes it easier to shift your pelvic joints, which may lead to discomfort over your pubic bone in the front or very low on your backside. In order to minimize this stress, you should pay attention to everyday activities, which may increase this risk. To get into a sedan or low car, you should start by sitting in the seat with your legs outside of the vehicle. While keeping your knees in line with your hips, bring both legs into the car. To get out of the car, reverse this sequence. To get into an SUV, truck or higher vehicle, place both feet as close to the door as possible. Reach up for the handle above the window to pull yourself up, and place the innermost foot just inside the door (leaving enough room for your other foot to fit). Bring up the second foot to meet the first and sit down. Now, you can scoot your feet and bottom to sit comfortably in the seat. To get out of this vehicle, you will swing both legs to outside the video, scoot forward using the handles, and slide out of the vehicle (similar to getting out of a low car). Prior to getting in the vehicle, place all belongings in a seat where you can easily reach them, if it is necessary. Do not reach in the back seat while driving. In addition, be sure to place the horizontal seatbelt across your hips, and never over your belly.
During pregnancy, our body starts to adapt as our baby and belly grow which shifts our center of gravity forward. Very commonly as our baby and belly grow, the width between our feet increases to improve our stability, but can be excessive. We decrease the speed of walking and may become stiff throughout our movements, leading to the “pregnancy waddle”. To correct, bring your feet under your hips, move your pelvis to a neutral position, adjust your shoulders back and down, then tuck the chin in slightly. As you walk, maintain these positions to limit muscular imbalances, which can occur over time and lead to pain if not modified. Your body will do what is easiest to adapt, but that does not mean that you cannot improve the way you move.
Movement is medicine. If you were very active prior to your pregnancy, do not decrease your activity until you feel it is too challenging, physically unsafe or unless your Medical Doctor advises you. If you were not active prior to your pregnancy, you may start a walking program or exercise in the swimming pool to prevent increased pain and discomfort, but do not start a strenuous activity routine during this time. These types of light activities can be very beneficial to mothers who have Diabetes, Gestational Diabetes, or who are overweight. Always follow instructions from your Certified Nurse Midwife or Obstetric Physician to determine if physical activity is safe for you and your baby. If you have neck, hip or back pain that is worsening, consult with your medical doctor and ask if Physical Therapy is an option for you to improve your ability to function.
Arantzazu Garate Cioce, PT, DPT
Lovelace Women’s Hospital
Arantzazu Garate is a Florida-native, graduate of the University of South Florida Morsani College of Medicine with her Doctorate in Physical Therapy. “Zazu”, as her friends and patients call her, is a Physical Therapist who specializes in Pregnancy and Postpartum Physical Therapy. She works at the Lovelace Women’s Hospital Outpatient clinic and can be reached via email Arantzazu.Garate@lovelace.com or office telephone at 505-727-4610.