It's a tough call, but no one would dispute that back pain ranks in the Top 10 list of a pregnant woman's gripes. According to the North American Spine Society, at least half of all women experience back pain at some point in pregnancy.
An aching back is usually caused by your shifting center of gravity. The weight of your baby puts strain on your lower back, but it also may simply be the result of pregnancy-related weight gain. The good news is that the aches usually go away after the baby is born.
By stretching your back daily, and doing a series of muscle-strengthening exercises and stretches you can keep your back on track -- during pregnancy and beyond. These exercises are safe to do throughout pregnancy and afterward, but if you ever feel discomfort, stop immediately.
You should always check with your physician before beginning a new exercise program, but if you have a pre-existing back problem, it's especially important to get your doctor's approval for new exercises.
Regular exercise gives you energy and keeps you healthy during pregnancy. It also helps you feel better during a time when your body is undergoing tremendous change. But it's no time to overdo it, unless you're in the best of shape. Here is a summary of the current exercise guidelines from the American Congress of Obstetricians and Gynecologists (ACOG):
- Continue mild to moderate exercise routines for at least 30 minutes on most, or even all, days.
- After the first trimester, avoid doing exercises on your back since it can decrease blood flow to the uterus.
- Never exercise to exhaustion.
- Don't exercise in hot, humid weather or when you are sick with a fever.
- Drink extra water on the days you exercise.
- Avoid activities that may cause you to lose your balance, especially during your third trimester.
- Stop exercising immediately and call your physician if you experience any of the following symptoms: pain, vaginal bleeding, dizziness or lightheadedness, increased shortness of breath, uterine contractions and chest pain, fluid leaking from the vagina.
- It's probably not necessary to say it, but if you're pregnant, you should avoid downhill skiing, scuba diving and contact sports like soccer, basketball and ice hockey, according to ACOG.
- You can certainly exercise on your own, but you may also consider enrolling in an exercise class for pregnant women -- or even a water exercise class, especially as it becomes more difficult to move around. The classes are often conducted by certified instructors who can make sure you move in a safe and effective manner.
Before doing the following exercises, warm up by walking in place for five minutes. You can do the first six moves every day, but give your muscles 48 hours of rest in between the last three strength-training moves listed below:
- Cat back stretch (to stretch your entire back). Get down on all fours and flatten your back so your spine is aligned from your neck to your tailbone. Now arch your back slowly, starting at the tailbone and stretching up through your shoulders. Hold for five seconds. Relax to the neutral position. Repeat five times.
- Heel sits (to stretch your lower back and buttocks). Get down on your knees and bend over, stretching your hands out before you, palms flat on the floor. Slowly rock back onto your heels (As your baby grows, move your knees wider apart to accommodate.) While sitting back, walk your fingers forward, increasing the stretch. Stretch one arm at a time for increased flexibility. Hold for 20 to 30 seconds; repeat two to three times.
- Forward bend (to stretch and strengthen your back). Sit in a chair with a hard seat and back. Keep your arms relaxed. Bend forward slowly, allowing your arms to hang down in front of you. Hold with position for a count of five, and sit up slowly without arching your back. Repeat five times.
- Trunk twist (to stretch your back and upper torso). Sit on the floor with your legs crossed, with your left hand holding your left foot and your right hand on the floor at your side for support. Slowly twist your upper torso toward the right. Look over your right shoulder. Do the same movement to the left side, switching your hands (right hand holding right foot) and looking over your left shoulder. Repeat five to 10 times on each side.
- Rocking back arch (to stretch and strengthen the muscles of the back, hips and abdomen). Kneel on all fours with your weight evenly distributed between your hands and knees and your back in a straight line (not sagging or arching). Rock back and forth to a count of five. Return to the starting position and arch your back up as much as you comfortably can. Repeat five to 10 times.
- Back press (to strengthen the upper back and promote proper posture). Stand with your back against a wall, your feet about 10-12 inches from the wall. Press the lower part of your back against the wall. Hold for a count of 10. Release and repeat 10 times.
- Arm raises (to strengthen shoulders and upper back). Get down on all fours, making sure your back is flat as in the Cat Stretch (not arched or sagging). Raise your right arm straight out in front of you to shoulder level. Hold for five seconds. Lower and repeat 10 times. Switch arms and repeat. When this becomes easy, add a second set. Holding a one- or two-pound dumbbell or wearing wrist weights will make the exercise even more challenging.
- Overhead pulldown (to strengthen your middle and lower back). Stand with your knees relaxed and extend your arms up and over your head. Imagine that you're holding a barbell in your hands. Now pull your arms down, bending your elbows out to the sides until your hands are shoulder height. The "bar" should be behind your head. Return to the starting position. Repeat 10 to 15 times, and complete three sets. When this becomes easy, hold a one- or two-pound dumbbell in each hand.
- Upright row (to strengthen your shoulder and upper back muscles). Stand with your feet shoulder-width apart and your knees relaxed. Let your arms relax at your sides, palms facing back. Pull your elbows up and back until they are at shoulder height. Contract your muscles in order to resist the movement. Now lower to the starting position. Repeat 10 to 15 times. Complete three sets. When this becomes easy, hold a one- or two-pound dumbbell in each hand.
North American Spine Society. Back Pain During Pregnancy. http://www.spine.org/articles/backpain_pregnancy.cfm
Spine Health.com. Exercise for Back Pain During Pregnancy. http://www.spine-health.com/topics/conserv/preg/preg01.html
March of Dimes. Exercise. http://www.marchofdimes.com/pnhec/159_515.asp
American Academy of Family Physicians. Pregnancy and Exercise: What You Can Do For a Healthy Pregnancy. Updated April 2008 http://familydoctor.org/305.xml
YMCA. Fit For Two: The Official YMCA Prenatal Exercise Guide. YMCA of the USA with Thomas Hanlon. Human Kinetics Publishers, Inc..
American College of Obstetricians and Gynecologists. Exercise During Pregnancy. Brochure. http://www.acog.org/publications/patient_education/bp119.cfm
The American College of Obstetricians and Gynecologists. Planning for Pregnancy, Birth and Beyond. Second revised edition, Signet, New York, A Healthy Lifestyle. pp 93-96
University of Michigan Health System. Beginning Strength Training. August 2008 http://www.med.umich.edu/1libr/aha/umfit07.htm