Further resources

Healing of low back pain in pregnant women

Pregnant with low back pain want to be more active in their daily lives, want their pain to heal and their babies to be healthy. Exercise approaches are generally carried out on this basis. The primary goal for pregnant is, of course, to improve back pain, but increasing the level of physical activity is also important for long-term goals as it will be beneficial for the postpartum period.

Prerequisites

Before starting the exercises, the physiotherapist should evaluate the patient:

– pain (severity, duration, frequency of lower back pain)

– posture (anterior pelvic tilt, shoulder protraction, lumbar lordosis, etc.)

– joint range of motion and mobility

– emotional state (change in body image, social isolation, loneliness, anxiety)

– edema

– Diastasis recti (a disorder characterized by separation between the rectus abdominis muscles and a widespread protrusion in the upper midline abdomen and can be seen in the postpartum period.)

Step 1. Aerobic exercises (Third trimester)

Aerobic exercise may be recommended for a pregnant woman in the third trimester. However, aerobic exercise should have some standards. It is recommended to do it at lower intensity. Examples of low-impact aerobics include walking, riding a stationary bike and using an elliptical machine. (Details will be given in e manual)

Step 2. Piriformis Stretch (Postpartum)

Sciatica is a prevalent and painful condition frequently experienced during pregnancy. It often arises due to the tightening of the piriformis muscle, which is situated deep within the buttocks. The ensuing muscle tension can lead to inflammation of the sciatic nerve. This stretching exercise serves as a practical approach for mitigating or preventing sciatic pain. For long-term exercise goals, it may be recommended to make this exercise a little more difficult and lie on your back. Assume a supine position with your lower limbs fully extended. Elevate the leg on the side affected by the condition and flex the knee joint. Utilizing the contralateral upper extremity, proceed to perform a cross-body motion by reaching towards the opposite side. Subsequently, apply gentle force to medially displace the knee towards the contralateral shoulder. Maintain this stretch for a duration of 15 to 30 seconds.

Step III. Prenatal Yoga

Prenatal yoga aims to help the mind and body prepare for birth by ensuring that the pregnant woman and the fetus have a healthy, peaceful, and calm pregnancy. Although it can be suitable for every trimester, its effect is intense in the third trimester. It improves balance and physical coordination, increases strength and endurance, reduces back pain especially during pregnancy, and provides easy birth by strengthening the muscles working during birth. It is an absolute recommendation for the physiotherapist to interview the patient, conduct a clinical examination and perform appropriate tests before taking the exercises to the next stage or making them more difficult for pregnant women. Attention should be paid to the occurrence and form of pain (does the pain occur at the beginning, does it occur during exercise, is it continuous, does it increase, does it always occur in the same place, does the pain occur after exercise?). The patient’s mental, spiritual and emotional state should also be evaluated after birth. The time, intensity or intervals between subsequent exercises should be determined according to the patient’s clinical condition.