Managing Low Back Pain in Pregnancy: The Role of Pelvic Floor Physical Therapy
Low back pain during pregnancy is common but not something you have to live with. Pelvic Floor Physical Therapy can help alleviate discomfort by targeting muscle function, core stability, and alignment to support you during all phases of labor, delivery and postpartum recovery.
Pelvic floor physical therapy can be highly beneficial for someone who is pregnant and experiencing low back pain. Pregnancy often places significant strain on our bodies, especially the pelvic floor and surrounding muscles. We also want to take into consideration which pregnancy this is for you, along with how far along you are when you start experiencing pain.
If this is not your first pregnancy, you are likely still in the “open-birth position.” This will significantly impact your low back pain, along with other symptoms, like leakage, hip pain, pelvic pain, and more.
If this is your first pregnancy, we need to dive a little deeper, but in general, pelvic floor physical therapy focuses on improving muscle function, alignment, and mobility in these areas, which can help alleviate discomfort.
Here's how Pelvic Floor Physical Therapy can help women experiencing low back pain during pregnancy:
1. Strengthen Pelvic Floor Muscles:
During pregnancy, the pelvic floor muscles support the growing uterus, bladder, and bowel. Strengthening these muscles can help reduce the load on the low back and pelvis, improving posture and reducing strain.
Treatment considerations will include how far along you are in your pregnancy, as we want to focus a lot of energy on pelvic floor muscle awareness, as well as implementation of relaxation techniques as we get closer to your estimated due date (EDD).
Direct strengthening of your pelvic floor is also accompanied by breath work to ensure coordination of the pelvic floor. Here is a helpful demonstration of proper diaphragmatic breathing techniques.
2. Improve Core Stability:
The pelvic floor is part of the core muscle group, along with the abdominals, diaphragm, and back muscles. Strengthening the entire core can help stabilize the spine and pelvis, which can alleviate low back pain and reduce the risk of injury.
This process looks different for everyone, and specific exercises for each person need to be individualized.
Here is a demonstration of one standard exercise, the Quadruped TRA Contraction.
Once you have mastered the above exercise, it is important to progress your strength in your core to address low back pain during your pregnancy and prepare for postpartum recovery.
3. Correct Posture and Alignment:
As the body changes during pregnancy, it can lead to poor posture and misalignment, especially in the spine and pelvis. A physical therapist can help realign the body and teach techniques for maintaining better posture, which can relieve back pain.
Once you have been closed out of the open-birth position, and you are back in alignment, it is so important to teach you what “good posture” is and how to strengthen and maintain.
Everything done in your PT appointment is only a small fraction of what you need to be working on at home.
“Perfect posture” is making sure you are “in a line” from the side as follows → Ankle bone, hip, shoulder, and ear.
Another consideration is your FOOTWEAR! Check out our three-part series for foot mechanics and shoe recommendations to help with your low back pain during your pregnancy.
4. Stretch Tight Muscles:
Pelvic floor physical therapists often focus on stretching and relaxing muscles that have become tight during pregnancy, such as the hip flexors, hamstrings, and muscles in the lower back, which can contribute to pain.
Stretching each of these muscles daily will help significantly with low back pain.
5. Address Muscle Imbalances:
Pregnancy can also create imbalances between muscle groups. Pelvic floor physical therapy can help identify and address these imbalances, strengthening weaker muscles and releasing tension in overworked muscles, improving overall balance and pain relief.
This is very specific and individualized to the client. We would love to discuss your specific concerns in person or online.
6. Manual Therapy for Pain Relief:
Therapists often use manual techniques such as soft tissue mobilization, myofascial release, and joint mobilization to relieve tension, reduce pain, and improve mobility in the lower back and pelvic area.
A lot of times, your low back pain is also connected to your pelvic floor pain and tension. There are times when a possible internal evaluation is needed to decide what your pelvic tension is causing directly and indirectly. It is important to seek a highly trained individual who can identify and treat your specific needs.
7. Pelvic Girdle Support:
Pelvic floor physical therapy can help address issues related to pelvic girdle pain, which often contributes to lower back discomfort during pregnancy. This includes exercises and supportive techniques to stabilize the pelvic area.
Pelvic floor physical therapists have a lot of recourses, including braces, supportive garments, and other interventions that can significantly alter pain.
8. Education on Body Mechanics:
A key component of pelvic floor therapy is educating pregnant women on proper body mechanics for daily activities (like lifting, bending, and sleeping positions) to avoid aggravating low back pain.
Again, we only spend one hour with you, vs all of the other hours in your day/week/month. The key to success is teaching you how to improve your functional mobility and move in an efficient manner.
9. Breathing Techniques:
Proper diaphragmatic breathing, taught during therapy, can support the pelvic floor, alleviate tension, and assist with relaxation during pregnancy, which helps manage pain.
Learning diaphragmatic breathing techniques during your pregnancy, not only will help your low back pain but will also help you prepare for labor and delivery and have more pelvic floor muscle awareness for postpartum recovery.
Again, you can view a diaphragmatic breathing demonstration here.
10. Prepare for Labor and Delivery:
Pelvic floor therapy also helps pregnant women prepare for childbirth by improving the flexibility and control of the pelvic muscles, which can help reduce strain during delivery and minimize complications postpartum.
By addressing both the muscular and postural issues that contribute to low back pain, pelvic floor physical therapy can significantly improve comfort and quality of life during pregnancy.
Please reach out to us with any questions you may have!
