Back pain doesn't have to be an unavoidable part of pregnancy. There are things you can do -- such as a few simple exercises -- to keep the pain in check. Here, a physical therapist has some advice just for expectant mamas.
Kim Grundy

Pregnancy back painDuring pregnancy, your ever-expanding body releases hormones that cause the joints and ligaments of your pelvis to loosen in preparation for childbirth. Then your growing bump changes your center of balance, resulting in an increased lumbar lordosis, or arch, in your back. This also means that the muscles that support your back have a much larger load to carry, and fatigue more quickly.

All together, during the second half of pregnancy, you will probably develop muscle imbalances, with some areas shortening and becoming tight, while others lengthening and becoming weaker.

It is for all these reasons that exercise -- including light strengthening, stretching and yoga -- are so important.

However, like so many things during pregnancy, be sure to talk with your doctor or midwife about the back pain you are having, and make sure you are given the green light to exercise.

If you're given the go-ahead, try the following four exercises daily:

Sitting pelvic tilt
Studies have shown that the pelvic tilt can significantly lower your pain, especially in the third trimester. The exercise is easy and requires no fancy equipment -- only a chair! Sitting upright with your feet shoulder width apart on the floor, tighten your stomach muscles, flattening your back into the back of the chair. Hold 5 seconds and perform 20-30 times. This exercise can also be done standing, flattening your back against the wall.

Lower back and pelvic stretch
This stretch will help loosen those tight muscles. Sitting in your chair, cross your right leg with your ankle resting on your leg. Use your hand to help lift your leg up, if needed. Slowly lean forward, only as far as your stomach will comfortably allow, until you feel a stretch in your right buttock/sacrum. Hold 15 seconds and perform 10 times. Do the stretch on the opposite leg, stopping if painful.

The quad/hip flexor stretch
This one is important because it loosens the muscles at the front of your hips and legs, which get tight due to your changed posture. To perform this stretch, hold onto a steady surface (such as a chair or the back of sofa) while standing. Grab your ankle, bending your leg back behind you and gently pulling until you feel a stretch in front. Hold 15 seconds, and repeat 10 times. Then switch sides.

Angry cat stretch
The last stretch, the angry cat, takes the pressure of your uterus off of your back. This stretch also helps to stretch and open up the spaces between your vertebrae. Getting on all fours, arch your back up letting your head drop down feeling the stretch in your low back. Hold for 10 seconds, and then flatten your back down with your head in a neutral or straight position. Repeat 10 times. This exercise is also helpful if your baby is doing some painful rib jabbing, because it will encourage him to change position.

Love to swim? Water aerobics has also been shown to be effective in decreasing back pain, and the women who participated had significantly fewer sick days from work (and they made that sound like a good thing)! Just make sure the class you attend is a designated prenatal class and taught by a knowledgeable instructor. Other alternative treatments that have shown to be effective include both massage and acupuncture.

Along with the exercises listed above, it is important to add some cardiovascular training to your routine. Try to incorporate walking 15-30 minutes at an easy pace, stopping if you are unable to carry on a conversation or if your back pain intensifies. You can also break up your walk in three 10-minute sessions, which has been shown to be just as effective.

A maternity support belt can also help take the pressure off of your lower back and sacrum. Studies have shown a decrease in pain with daily activities -- including household chores, exercise and sleep -- when wearing the support. (You can keep the belt hidden if you want your spouse to continue with the vacuuming!) Talk to your caregiver or try going to a medical supply store and check out various supports to find the one that is most comfortable for you.

And there's one more thing you can do. It is also important to keep your weight in check, as a higher weight gain has been tied to increased back pain.

Feeling good for the long term
So why do some women suffer from terrible back pain, while others sail through without a single twinge of discomfort? Studies have shown that those who have a history of back pain prior to pregnancy (or who already experienced it while carrying another child) have a higher chance of facing it again -- and may even experience the pain earlier in their term.

Back pain or not, studies have shown there is no correlation between the health of the baby and low back discomfort. So enjoy your pregnancy, and know that all your aches and pains will soon be over and you will have a beautiful baby to hold in your

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