As I observe my wife progress through the stages of her pregnancy, the numerous physical changes and postural changes that occur during this process are evident. The female’s body is suddenly required to accommodate to increasing weight in the abdominal region pulling the pelvis into an anterior pelvic tilt, increasing breast tissue biasing the shoulders to a rounded position and the head to a forward head position, and the body’s increased levels of the hormone relaxin cause subsequent instability through the body. Consequently, many pregnant women struggle with low back pain, neck pain, mid back pain, and/or pelvic pain. The goal of this blog is to provide you with 5 simple exercises which will aid in maintaining proper posture and avoiding muscular imbalances during the course of pregnancy in order to avoid pain, promote posture, and avoid post-partum muscular imbalances and musculoskeletal issues.
1 & 2) Hip flexor stretch and bridge
An anterior pelvic tilt is a very common posture adopted during pregnancy. As a consequence, the hip flexors and low back extensors become shortened and taut, while the abdominals and gluteals become lengthened and weakened. This faulty posture is a common contributor to low back pain.
To assist in reversing this posture, I recommend a hip flexor stretch and a bridge. These two exercises will help to reverse the above described postural abnormality by engaging the gluteals and lower abdominals, and stretching the hip flexor and low back extensors.
Hip flexor stretch: In a kneeling position, you want to contract your gluteals and lower abdomen in order to cause the front of your pelvis to rotate up. While maintaining this contraction, shift your weight forward and you should feel a stretch in the front of the hip.
Bridge: Lying on your back, bend your knees so both feet are flat on the floor. Perform the above described gluteal and lower abdominal contraction to tilt your pelvis (it should feel like your low back flattens into the ground). From this position, push through your heels and use your gluteals to raise your body off of the floor.
The squat is a great exercise to maintain hip mobility as well as maintain hip and thigh strength during pregnancy. The squat may be one of the more debated exercises in the healthcare world, but my general recommendations are that you allow your hips to drop below 90 degrees, your torso matches the angle of your lower leg, and your knees are angled so that they pass over the 4th and 5th toes (and yes! your knees can go past your toes)
4) Bilateral shoulder external rotation
In order to combat rounding of the shoulders and a forward head posture, use this simple exercise to strengthen the muscles in the mid back and shoulder blades. Hold a theraband in both hands, with your palms up and your elbows at your sides. Keep your head in a neutral position with your ears over your shoulders, and pull the theraband apart, thinking that you are squeezing your shoulder blades together. Hold the end position for 5 seconds, relax, and repeat.
5) Bird dogs
Bird dogs are a great exercise for promoting hip and core strength and stability. For this exercise, begin in a hands and knees positions. You want to maintain a neutral spine throughout this exercise. You will extend one leg, while raising the opposite arm into a table top position.
At Chandler Physical Therapy, we see many women during various stages of their pregnancy for low back pain and neck pain. If you think that you would benefit from physical therapy, please contact Chandler Physical Therapy and one of our therapists would be glad to follow up with you.