hey everybody it’s doctor Jo, and today I have a special guest with me Doctor Jen, and we’re gonna talk about low back and pelvic pain during pregnancy. so let’s get started. so Doctor Jen specializes in the pelvic floor. so this is awesome, that’s why she’s special. she’s actually just a cool special person anyways, but she’s also pregnant. like it’s not really fair for me to tell you what to do, but she’s gonna tell you what to do. so tell me a little bit about what you do in general. so I am a pelvic floor physical therapist. and what that means is I specialize in treating bowel, bladder, and sexual dysfunction in men, women, and little kids, and that includes the pre and post partum population. so I see a lot of women who are dealing with pain, urinary or bowel issues during and after pregnancy. so a lot of stuff. lots of lots of stuff. yeah. so today we’re going to talk about low back pain, pelvic pain during pregnancy cuz I think you kind of know about that.
So let’s get started tell me some things that you experienced in general being pregnant and those ailments and what can you do to fix them. perfect I think I speak for most women in their third trimester when I say that there are a lot of changes that happen in your body. so some of the first things that change are your hormones. so your hormones are shifting all over the place and during the first and third trimester is when those hormones are the most variable. so you may see a woman who has barely gained any weight but is complaining of significant low back or pelvic pain because she has a special hormone called relaxin moving her pelvis to get ready for baby. and then that happens a whole lot more in the third trimester, so those hormonal changes will cause some pain in general, but the next biggest problem during your third trimester is postural changes.
So the weight of the baby as well as the weakness that occurs in your belly and your bottom changes the way that you stand and then the way that you transition. so all of a sudden you’re experiencing pain as you get out of bed, bend over to pick up a child, tie your shoe. name it it all hurts because our posture has changed. all that weight shifts forward. yeah.
Yes exactly, exactly so what we want to do today is talk about how you can bring that back to it what we would call a neutral posture to help calm down your pain. awesome. yeah all right so you’re gonna show us some stuff. I’m gonna show you guys my top five exercises for low back and pelvic pain during pregnancy. I just want to mention that these exercises are a balance of both mobility and stability. so we do want your pelvic girdle to move, but we want it to move safely and we want it to move pain-free. and then the next category of exercises that we do are stability or what we call control exercises. to where you can get your body moving in a pain free range and stable in a pain free range. cool. so the first thing that I want to do is I want to lie down.
Now all of that to say if you are a bigger lady who’s having a harder time lying on your back there are lots of modifications. you can grab a seat on the edge of the chair you can prop yourself up on a ton of pillows, but in general it is safe to lie on your back for short periods of time in the third trimester. so that’s where I want to start today. so I’m going to go ahead and lie down on my back, and show you both a mobility and a stability exercise. all right we’re gonna switch roo. right oh oh oh. see it’s real here, it’s not just me with a basketball underneath my shirt. it’s part of it okay. so in a relatively relaxed position with your hips and knees bent and feet flat what, I want you guys to do is connect to your pelvis and your low back.
So the first direction that we really emphasize movement is that what we call a forward and a backward direction. you can see how she’s coming kind of up and down with her belly there. pretty cool. yeah. this should be pain-free and initially your movements may be very very small. so for example a woman who’s having excessive pain at 39 weeks may only be able to move this much, but any movement is better than nothing at all. it really is lubrication for those joints. a woman who’s earlier in her pregnancy may be able to excessively arch and then round and tuck that bottom under. okay. but I really want the movement to come from the low back and the pelvic girdle, okay. so I usually have patients do about five to ten in each direction and trying to maintain normal breathing during the movement. so dr. Jen while are you’re doing this, if you have a little bit of increased tightness maybe slight pain in the beginning but it then decreases is that okay? that is a great question. absolutely. it may be slightly uncomfortable at first, yes absolutely. because you’re tight it in there.
Mm-hmm, easy-peasy. so we call this an anterior or posterior pelvic tilt. once you return to the middle. just pointing to where the pelvic tilt is. good. once you return to the middle, as silly as this exercise may seem, I want you to move your pelvis in a side to side direction. so imagine for a second that you’re going to draw one side of your pelvic girdle up towards your armpit, and then bring it back to that neutral spine. draw the other side up towards your armpit and then come back towards the middle.
Again moving through your range comfortably. and by the end you really should feel as if you’ve gained a little bit of mobility. this is sometimes something that you can do on a Swiss ball as well. would you do it while you’re pregnant because a lot of times with low back pain, I’ll have people get on a Swiss ball or a therapy ball. absolutely. so if you don’t have a stability ball which is a wonderful option for this exercise, you can always sit on the edge of your chair with your back unsupported. so if lying down is problematic.
If you have difficulty catching your breath then get on the edge of the chair and you can do this exact same exercise in your pain free range of motion. this is what I call the Shakira. yes, yes, it’s true it’s true. so let’s pair this with a little bit of stability shall? we alright the core is made up of four muscles: diaphragm, pelvic floor, transversus abdominus, and our deep multifidus or low back muscles. and they should function beautifully together to stabilize the spine and pelvis prior to movement. and so what I want to do is, I want to have you ladies connect with your core. and so I don’t know what cues you give your patients, but you can just imagine that you’re gently drawing your baby back towards your spine, you see subtle flattening of my low back.
I’m able to hold and maintain normal breathing which is key. if you have to hold your breath you’re not doing it right. so I have patients take a big deep breath nothing happens, setting up the exercise and as you exhale gently draw that baby back towards your spine. goes down. hold, hold, and relax. it’s a pretty dramatic difference when you’re in your third trimester, you can really see your abs activating. if that cue doesn’t work for you, you can imagine that you’re gonna tighten your inner corset, zip up a tight pair of pants, but regardless minimal movement of the spine and pelvis should occur, and relax. and I tell people this is all happening here, so you’re not pushing with your legs, right? it should all be in that core in that pelvic area.
So if you feel like you’re pushing down with your legs or your feet are sliding, you’re probably not doing it quite right. absolutely. let’s say ladies that you’re experiencing a little bit of urinary leakage when you cough, or sneeze, or lift or laugh, during pregnancy. this is a great way to start incorporating your pelvic floor into your routine. so the ABS should fire and are best friends with your pelvic floor. so now imagine for example that you’re inhaling and nothing’s happening, as you exhale you pull that baby back towards your spine, you won’t be able to see this, but gently lift from the bottom of your core as if you’re holding back gas or urine, and let go. and trying to connect with those muscles is key. this is the basis for returning to exercise after pregnancy. it starts here and then we translate to jumping, bending, jump roping, lunging squatting, you name it, but you have to master it in a pain free position here. so again I inhale nothing happens there, exhale pull belly button to the spine, lift as if you’re holding back gas, continuing to breathe and relax.
Always making sure that after a contraction there’s relaxation. nice. can we progress? yeah let’s do it. okay awesome. so Dr. Jo, mm-hmm. there’s a huge muscle group in the back of the pelvic girdle that stabilizes your SI joints, but also helps to lift your hips and that is? the glutes. so these muscles are key in preventing low back pain because they stabilize from the back side. so we are gonna add on to our basic core contraction which was abs in, pelvic floor lift, and now that movement is gonna occur, I’m gonna squeeze my tushie as I lift up continuing to breathe and come back down. this is awesome at the end of the day when you’re feeling excessive pressure in your belly like everything is being pulled down. you can do a gentle inversion. so inhale belly gets big, exhale pull that baby and lift the pelvic floor activate those glutes continuing to breathe and come on down. easy, easy exercise. if it’s painful, you do not have to go nearly as high.
You can really just get those glutes firing and come up in your safe range. if you’re feeling good go ahead and activate, lift the pelvic floor, and come up a smidge higher. I really want you to feel those muscles firing in the back because they do play such a huge role in stabilizing the pelvis. I usually have patients do “to tired” just enough to where you feel like your bottom muscles are really firing and getting a little tired, and then that’s it. sweet. cool. squeeze and booty muscle. do it. alright. alright let’s change positions and I want to show you two more things. okay. for my last two exercises, I want to change positions a little bit. so I want you to know that that basic core exercise you can do in any position, seated on the edge of the chair, why don’t you try it while you bend over to pick up your baby carrier. all of those really basic exercises can become very functional and then like I said you can get back to running and maintaining normal core activation because you’ve mastered it and trained your brain to use it appropriately.
So at the end of the day when the back is really feeling strained or those sacroiliac or SI joints are really feeling irritated, a great position to get in is quadruped, or all fours. so I’m sure you’ve seen this with dr. Jo before, but what I’m gonna do is I’m gonna prop onto my hands and my knees and I’m gonna mobilize my spine and pelvis just like I did lying down. the beauty of this is that gravity is really gonna help and you’ll get a little resistance to help through that range, okay. so I’ll go ahead and demonstrate. I’m gonna place my wrist directly under my shoulders. you guys have heard that before. my knees under my hips and what happens first and foremost is gravity kind of pulls and my belly drops and this actually is quite relieving to get the weight away from my spine.
So I can just hang out here and breathe, rest, and get a little bit of relief from low back pain. but I do challenge you to find that neutral spine where I’ve activated my core just subtly. okay. and what I want you to do is really work through that range because we want the pelvis to be mobile and pain-free. remember that it should move but it should be pain-free, and you should be in control. so as I just inhale I’m gonna just let gently let my my tail go up towards the ceiling, my belly drop down towards the floor, getting that excessive arch, and then with my exhale I’m gonna round up pushing my belly button up towards my spine, trying the best I can to get some length in the low back and gluteals in general.
As pregnant women this is where we live from postural changes, the weight of the baby, laxity of the ligaments, like we already talked about. so we really have to challenge ourselves to be here and then this is the opposite direction which provides that stretch in that leg in the low backing gluteals. okay. so again I’m just gonna start pairing that with my breath slowly in my range. it can be as exaggerated as I’m doing now, or it can be as subtle as something like this. again about five to ten times in each direction, moving my pelvic girdle, and then I’m going to come back to neutral.
So remember that lateral pelvic tilt I taught you when you were sitting down? where you draw one side of your pelvis up into your armpit? we’re going to do that same thing here, and it looks absurd. so I call this wagging your tail or Shakira, but imagine for a second you’re drawing one side of the pelvis up. I’m getting length on the left side of my low back and I’m tightening the right side, coming back to neutral. drawing the left side up, getting length on the right side of my pelvis, and then coming back to the middle again. it can be a subtle tail wag. you get a shy dog, or it can be a really happy tail wag. that would be Bear. it would be Bear. and then come back to neutral.
So for the last pose that I was talking about, the restorative pose, I want Jo to demonstrate because early in your pregnancy you may be experiencing low back pain and that is not uncommon, and you’ll be able to do this exercise a little bit easier than somebody who’s in their third trimester. so the point of Child’s Pose is one relaxation, but also to get some length in the back of the spine and the glutes. so Jo has sat her bottom back onto her heels, and now all you’re gonna do is reach her upper body forward, feeling a good pull in the upper lower and gluteal region. okay. so you can stay here and spend about two to five minutes breathing. okay. this is a wonderful position to just get some length in the low back for a prolonged period of time. okay. and then go ahead and come on out of that. I’m going to show you a modification if you’re experiencing a large abdominal girth in the way. so I’m going to scoot over just a little bit and grab a pillow you can fold it up.
With the dog hairs on it. separate the knees wide because we do have to make room for the belly. bottoms still back on the heels, and then I’m slowly working myself forward turning my head to the side, but still trying to get the length in the low back. breathing and sitting back into that stretch as I can. again it should feel really really great beginning, middle, or end of your pregnancy. like we talked about, you may not be able to get in this position. getting down on the floor might be a little bit of a challenge for you. so seated on the edge of your chair with your knees wide, you can just gently lean forward trying to get what we call flexion in the low back in the gluteus. so there’s some good modifications as we go. the other great thing about Child’s Pose is you can start to connect to your pelvic floor. as you prepare for delivery, we want your pelvic floor to start to relax and open, so while you’re in Child’s Pose focusing on your breathing, you can do that small subtle squeeze, feel the pelvic floor come back down and live there, so that your body can get to know where it needs to be during delivery.
Mm-hmm. so a little trick of the trade there. one thing that I do want to mention that dr. Jo pointed out was breathing. breathing is everything. if you are holding your breath you’re doing the exercise incorrectly, and it’s not functional anymore. so I generally will tell my patients that as you inhale nothing’s happening, you’re really just setting up the exercise, but all of the power from your core and the movement is coming with your exhalation. so when we were on our back we inhale, belly got big, we pulled those abs in. with our exhale we lifted the hips and that should translate from squatting, bending over to pick something up, dead lifting, you name it. nice. cool. cool. those are the five all right.
So I I had asked you earlier is there anything that you shouldn’t be doing while you’re pregnant, certain exercises, certain movements. that’s a really great question. so in general if it hurts you want to find a way to modify it. so whether you’re experiencing pain in the front of the pelvic girdle, the back. really excessive movements of the leg and the pelvis can be a little bit too much. so think about getting in and out of your car and really swinging that leg around. you’re gonna want to modify and limit that because you do have that laxity, but in general, if you were an active exercise or performing even recreational exercise prior to getting pregnant, you should and can continue that all during your pregnancy. cool. however if you get pregnant and that is your motivation to start an exercise program, don’t do it. find a physical therapist whether they specialize in the pelvic floor or general orthopedics, and have someone take you through safe exercises because when you get pregnant is not the time to start a new exercise routine.
Lastly if you’re having any difficult, difficulty breathing, primarily on your back, get off your back. ok. so use common sense, right. be smart but stay active and moving this is a great time to connect to your body and get your core a little bit stronger. awesome. oh no contact sports, no scuba diving. right yeah cuz you just float back up. I think those are, I think those are the only two big things that you need to avoid. yeah and it’s very important to go see your physical therapist even if it’s just for an evaluation because someone like dr. Jen is gonna give you all that information and make sure you’re doing it correctly, even if you just go one time, then at least you know you’re doing it the right way instead of just doing it.
absolutely. yeah. absolutely so there you have it. those were some exercises for low back pain and pelvic pain during pregnancy. so if you’d like to help support my channel click on the link above, and don’t forget to subscribe by clicking right down there. and remember be safe, have fun, yeah, and I hope you feel better soon!.
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