Proactive Pregnancy

Proactive Pregnancy

The pregnancy journey is an unpredictable one. Why not take a proactive approach to minimize the chances of a painful pregnancy? Strategies to prevent common injuries can go a long way toward making this journey a smoother one.

Pregnancy can be a beautiful and joyous time. But occasionally finding its way into the pregnancy journey is the unwelcome experience of pain. Adopting a proactive approach is crucial in minimizing physical pain during and after pregnancy. Awareness of our posture and movement habits, common contributing factors, and strategies to prevent common injuries can go a long way toward making this journey a smoother one.

Lower back pain

Many women experience lower back pain during pregnancy, with the highest prevalence reported during the third trimester.

Common contributors

An expectant mother’s centre of gravity experiences a forward shift as the baby grows, which increases the mother’s lower back curvature. Combined with the lengthening of the abdominal muscles, the result is an increased demand on the lower back. After delivery, new physical demands, such as lifting a newborn, coupled with poor body mechanics during this vulnerable stage, are common culprits of lower back pain.

Preventive hack: Establish good posture

1. rib cage stacked over the pelvis
2. level chin, long neck, ears in line with shoulders
3. collarbones wide, shoulders gently away from ears
4. lower abdominals engaged to lift pubic bone; tailbone gently tucked under
5. slight bend at the knees

Preventive hack: Practise good body mechanics

Movement Ideal body mechanics
lifting from the floor • Place one foot in front of the other and stand hip-width apart.
• Bend your knees while keeping your back straight.
• Keep the load close to your body and use the power in your legs to stand up.
moving between sitting and standing • Hinge at your hips, sending your hips behind you to sit down.
• Lean forward from your hips and use the power in your legs to stand up.
moving from lying in bed to sitting • With bent knees, roll onto your side, moving your shoulders, hips, and knees at the same time.
• Allow your legs to fall over the side of the bed while using your arms and core to sit up.
• Do this sequence in reverse to move from sitting to lying.

Preventive hack: Drop the heels

Wearing heels can exacerbate the postural changes that occur with a growing belly, as well as hinder our stability. If the thought of losing this height is overwhelming, settle for shorter or wedge heels, alternating them with flat but supportive footwear, such as running shoes, whenever possible. Be selective as to when you wear heels: choose a dinner outing over an event involving long periods of standing.

Pelvic girdle pain

Although similar in nature to lower back pain, pelvic girdle pain is a distinct condition. Pain is typically one-sided, presenting in the area of the buttocks, between the lower back and tailbone, or at the front of the body, where the pelvic bones connect at the pubic symphysis.

Common contributors

Relaxation of the ligaments around the pelvis due to hormonal changes is believed to play a role in pelvic girdle pain. In addition to strenuous labour involving frequent bending and twisting, previous lower back and pelvic pain are also risk factors for future pain.

Preventive hack: Plan your positioning

Minimize one-legged activities, such as standing when dressing, and take care to stand with weight evenly distributed between both legs at all times. Although it’s practical to carry your baby on one hip, a carrier distributes the load more evenly while keeping your hands free. Similarly, use a stroller whenever you need to transfer your baby while they’re in the car seat. A car seat’s design forces you to hold it far away from your body, placing strain on your back and pelvis.

Preventive hack: Undo bad posture

Adrienne Murawiecki, physiotherapist and owner of Toronto’s Roncesvalles Physiotherapy, admits that “keeping your back straight while lowering your baby into the crib, or into or out of the car, is impossible.” For these instances, she suggests “undoing” the movement immediately afterward. Even if it’s just a mini backbend right after loading the car, Murawiecki stresses the importance of doing a movement in the opposite direction to prevent your posture from deteriorating.

Preventive hack: See a physiotherapist

Prenatally, learn cues from a physiotherapist that help recruit your pelvis-supporting muscles during movement. If necessary, a physiotherapist may recommend a sacroiliac belt for additional support of your pelvic joints.

De Quervain’s tenosynovitis

De Quervain’s, also known as “baby or mother’s wrist,” is an inflammation of the sheaths covering two tendons at the base of the thumb, and presents as pain along the thumb side of the wrist.

Common contributors

De Quervain’s can develop during the postpartum period while fluid retention is still playing a role, with frequent lifting and holding of your newborn. A hand that is angled toward the pinky side of the hand with the thumb outstretched in the opposite direction is a common aggravating position for this condition.

Preventive hack: Ergonomics

To keep tension off the thumb tendons when holding your newborn, allow your forearms to take as much of the weight as possible and maintain a neutral wrist position. A neutral wrist involves not only keeping the wrist straight from top to bottom but also ensuring the knuckles stay within the borders of the wrist. Similarly, when lifting your baby, keep the pinky side of your hand in line with your wrist, and allow your upper arm and shoulder muscles to do the majority of the work.

Upper back and neck pain

The natural postural changes that occur during pregnancy to accompany the growing baby can lead to stiffness and pain in the upper back and neck. Postpregnancy tasks like feeding, lifting, and carrying can exacerbate this stiffness and result in pain.

Preventive hack: Pillows and more pillows

For feeding, consider a reclined position for less tension in your neck and back. Pillows across your lower back and neck may offer additional support. Murawiecki reminds us that pillows are also useful for propping your baby when feeding, limiting slouching and the need to hold your baby in position.

Preventive hack: Support your chest

A properly fitted maternity or nursing bra can ease the strain on your upper and mid-back, allowing you to maintain an upright posture. This also limits compression of the nerves and blood vessels as they travel through your upper arm.

Preventive hack: Consider your height

Important for preventing both thumb and neck or upper-back pain is a stroller with adjustable handles, set to a height where your shoulders are relaxed, your wrists and forearms are in a straight line, and your palms are resting on the top surface of the handles. Keep a loose grip to limit hand fatigue and avoid straining the thumb.

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