I have written previously about how the benefits of exercise and how it can prevent pain. I have also written about listening to your body after birth to judge when it is time to restart exercise. Today I am going to discuss already being in pain but still starting to exercise.
Pain in pregnancy is often caused by the pure fact that your body has changed shaped quickly due to the growing bump and your muscles have not kept up to date with this change and are shortened and lengthened into a non-optimal position for the muscle to work functionally and support and hold up your body in a pain-free way.
As your bump gets bigger it is pulled forward. Now, just as your biceps and triceps work together, as one lengthens, the other one shortens and vice versa, so too this is true with your back and stomach muscles. In pregnancy as the tummy is pulled forward these muscles shorten and the back muscles lengthen. They are not strong in this position as they are not used to supporting your body in this position and this is what causes pain.
Now, as the pain is caused by weak muscles, even though you are in pain it is still a good idea to exercise and yes to even restart exercising. But it does need to be specific to the root of the problem; I am not suggesting you start taking up training for a marathon.
In this case I suggest – especially if you are more of a couch potato and have not really done any cardiac work out recently – regular walking, as this is not too strenuous but will start training your heart to become fitter. I also suggest some gentle back and stomach exercises to strengthen the muscles that are giving you the pain. Tucking your bottom and stomach in at the same time (posterior pelvic tilt) is always the best one to start with, and just gently repeat this action. Lying down with your knees bent and gently moving them from side to side is another great one that will gently stretch the side of your back. Another favourite is putting yourself in the all fours position and gently raising and lower your back.
If you are suffering from pregnancy-related pain and would like to book an appointment, please contact me on 0544485086 or by email to tamaramay.physio@gmail.com. I can arrange to see you privately or through Leumit in Bishvilaych Women’s Comprehensive Medical Centre in Givat Shaul, Jerusalem or a home visit if you live in Gush Etzion.
Back pain
When Massage Could Help Relieve Your Pregnancy Pain
Pregnancy is an exciting time period in one’s life. However it can also be an extremely daunting time and high stress levels don’t do you any favours. With rockets flying it is good to do everything you can to keep as calm and healthy as possible.
The body undergoes some big changes during pregnancy, including postural changes, change in hormone imbalance, weight gain, enlarged breasts, increased plasma and blood volume and the shifting of some of your organs. As a result of these changes many women suffer from pregnancy aches and pains.
Now some of these pains need addressing by a doctor or physiotherapist as they are beyond the realms of normal but some are completely normal and don’t need addressing by a medical professional. So what do I advise to those patients that don’t fit into the category of medical help but who are uncomfortable and want to do something about it? Firstly I suggest exercise, which has many benefits; if you are unsure what is safe you can read previous blogs or get in touch with a physiotherapist.
I also suggest pregnancy massage by a qualified professional. This is a safe, drug-free relaxing way to reduce and relieve the common discomforts that one can experience. It can improve not only your own physical and mental well being but also your baby’s.
Back pain and sciatica are very common in pregnancy. As the posture of one’s body changes during pregnancy so so does the centre of gravity, which in turn effects the musculoskeletal system. As the muscles adapt to the new posture they can compress the sciatic nerve, which in turn causes radiating pain from the lower back down to the leg. Massage loosens those muscles and releases the pressure on the nerve. It can also help increase range of motion and elasticity in the joints and muscles.
As the muscles begin to work harder due to the increased weight gain, there is an increase in the production of toxins that literally stick the individual muscle fibres together, which then aggravates nerve endings and causes pain. Massage releases that pain by breaking down the adhesion, releasing trigger points and pushing circulation into the area to increase oxygen and to stimulate the removal of toxins.
Let’s move onto leg cramps. Although the reason is not known there are theories that the extra load on the leg muscles may well be a factor. Low levels of minerals and the lack of blood flow through the muscles during prolonged siting or lying could be a cause. As well as eating bananas, massage can also help by again stimulating blood flow and stretching the muscles
Muscle balance can be caused by the quick postural changes and sudden increase in breast size and are often the main cause of sudden upper back pain. Headaches are often caused by the surge of hormones along with an increase in the blood volume circulating the body. Massage relieves the muscle tension and stretches the shortened muscles in the head, neck and shoulders.
Massage can also reduce stress levels which reduces anxiety, improves mood and can increase sleep, which is very important to do before the baby comes and keeps you up at night.
The weight gain and increase in plasma and blood volume increase pressure on the hip, knee and ankle joints. Swelling is often caused by the decreased circulation and increased pressure on blood vessels. Massage helps stimulate soft tissue to reduce the collection of fluids in swollen joints, which also improves the removal of waste products carried by the lymph system. So massage can help flow of blood to the legs to reduce the chances of swelling, varicose veins and blood clots.
With all that being said it is important to determine whether your aches and pains are within normal range and therefore a massage will help or whether to go to a physiotherapist for a more long term treatment to treat the cause of a problem (with the option of a massage on the side). It is also best to discuss the options first with your doctor and if you still not sure what is the best treatment to call a physiotherapist to determine the most appropriate cause of treatment.
If you are suffering from pain during your pregnancy and would like to book an appointment, please contact me on 0544485086 or by email to tamaramay.physio@gmail.com. I can arrange to see you privately or through Leumit in Bishvilaych Women’s Comprehensive Medical Centre in Givat Shaul, Jerusalem or a home visit if you live in Gush Etzion.
Tips for Lower Back Pain
During pregnancy as your bump gets bigger your tummy will naturally stick out leading to your bum also sticking out. This automatically leads to a change in posture. Therefore it is no surprise that lower back pain during pregnancy is common. Over the course of nine months, your body will go through a very quick posture change. This leads to shortening and lengthening of different muscles that have previously not been used as regularly.
This is the reason that exercise (even without pain) is very important during pregnancy. Exercises such as sticking your tummy and bum in are essential, and this also helps working out what I like to call your core muscles.
Wearing high heels only exacerbates this change in posture, so wearing flat shoes throughout the pregnancy is preferable. You could also wear a support belt. This helps support your back into a more desirable posture, although this still needs to be coupled with appropriate exercises.
Taking a rest and getting off your feet regularly is also helpful, as well as sleeping on your side, with pillows for support. Many find that sleeping on your back will increase the pain, due to the larger curve in your back from your change in posture, as well as it being better for the baby as well.
Instead of bending down to pick an item off the floor, squatting down with one leg is much more desirable. This is a preventive treatment, to avoid lower back pain.
A physiotherapist will also ensure that your spine and joints are aligned properly; this can be quickly fixed sometimes, relieving the pain of your lower back straight away.
If you are suffering from lower back pain and would like to book an appointment, please contact me on 0544485086 or by email to tamaramay.physio@gmail.com. I can arrange to see you in Bishvilaych Women’s Comprehensive Medical Centre in Givat Shaul, Jerusalem or a home visit if you live in Gush Etzion.
Ergonomics and Pregnancy
When taking a history of a patient I always ask about social history, their lifestyle, family life and job situation. Now you may think this is just chit-chat, while others conclude that I am just plain nosy. But in actual fact the answers to these questions can tell me a lot about the patient’s health.
Ergonomics in its simplest sense is making sure that the things you work with do not cause you harm. Ergonomics is very important for those that are not pregnant, and this is multiplied during pregnancy due to the quick postural changes seen over a pregnancy. If you are in a office job all day it is important to stretch regularly, get up from your desk and take a quick walk.
Ensuring the height of the chair is correct is also important, and the knee bend should be at 90 degrees with a foot stool to support your feet if you are on the shorter side. You should also sit at a 90 degree angle at the hips. Lumbar support for the lower back is also important, and this can be achieved with a small pillow. Your wrists should be straight when typing. The vision distance should be 18-24 inches, positioned at eye level.
If you want to start a new trend in the office you could even bring your gym ball along and switch between your chair and gym ball, this is a great exercise just by sitting on it and you probably won’t even realise it.
Whether you are in a class room, office or factory, most jobs require carrying of equipment (or children). Posture here is very important, ensuring the object is not too heavy. Don’t bend your back but rather bend your knees down towards what you are picking up, holding it close to you at mid level.
Remember if you think the object is too heavy to carry, don’t carry it, get someone to help you or get someone to carry it for you.
I have always liked a tidy home but a reorganisation of the work place can also be important too. Ensuring regular objects are placed at waist height and not on the top or bottom shelf is really important.
Repetitive movements are also a good thing to avoid, like constantly clicking a computer mouse. However, if it cannot be avoided it should be performed in the best way possible, in this case with your wrist in a horizontal position.
If you are suffering from any type of muscle problem and would like to book an appointment, please contact me on 0544485086 or by email to tamaramay.physio@gmail.com. I can arrange to see you in Bishvilaych Women’s Comprehensive Medical Centre in Givat Shaul, Jerusalem or a home visit if you live in Gush Etzion.
Breastfeeding: Don’t Let it be a Pain in the Back(side)
There are many advantages for both you and your baby to breastfeeding. I am personally very much in favour and breastfed all 3 of my babies. However, this is not the place to go into the pros and cons of bottle and breastfeeding; there are many sites that have detailed discussions on that to help you make informed decisions.
However, I do notice that some women that breastfeed tend to complain of back pain. Now this does not have to be the case. I do sympathise, especially with those middle of the night feeds that all you want to do is feed the baby and put them back to bed. But if you do one extra thing every time you feed it can spare you a lot of pain in the future.
It is very common to pick up the baby, let the baby latch on and for you to be in a sitting position with your back titled towards one side with your baby resting on your lap whilst feeding. However if you place a pillow on your lap and the baby on top of the pillow then there is no need to bend down towards the baby as the baby is at the right height to feed from you.
The next question you are probably wondering is, am I asking you to go out and buy those fancy feeding pillows that cost a lot of money. No I certainly am not. The breastfeeding pillows that look like 3/5 of a circle are very beneficial and if you have one I strongly encourage you to use it. That is because it gives a lot of extra support to your back as well as preventing you from leaning down. I also would recommending purchasing one of those pillows if you are prone to back ache or already suffering from back ache.
If you do not suffer from back ache and this is merely preventative then any old pillow (or two if needed) will do the job of raising your baby higher up to you to prevent you leaning and twisting your back in positions that can cause pain.
Another important thing to remember is to ensure that you are wearing a bra that fits your properly – not just when you are breastfeeding but at any stage of your life. This is another tip that can help prevent back pain.
If you suffer from antenatal or postnatal back pain and would like to book an appointment, please contact me on 0544485086 or by email to tamaramay.physio@gmail.com. I can arrange to see you in Bishvilaych Women’s Comprehensive Medical Centre in Givat Shaul, Jerusalem or a home visit if you live in Gush Etzion.
Thoracic Pain and How to Avoid It
The spine is split into different sections: cervical, thoracic and lumbar. This blog is going to focus on the thoracic spine, the middle bit of your spine but upper part of your back. Now technically thoracic pain can occur at any point during your pregnancy, but it tends to be more common during the third and final trimester.
There can be many contributing factors to your pain. I have mentioned the hormone relaxin on this blog many times; the one that relaxes your ligaments and soft tissue. Unfortunately it is not a de-stress hormone. It can sometimes be the cause of muscle spasm, as it makes the muscles work harder. Other possible reasons for thoracic pain include:
- As the size of the baby and uterus increase, your centre of gravity is shifted forward, placing more pressure on your back muscles
- The extra weight gain can also put more stress on these muscles
- The enlargement of breast tissue can alter your posture and place strain on the neck, shoulders and thoracic spine
There are ways to treat it once it has occurred, but as the saying goes, prevention is better then cure. Taking good care of your back is fundamental to hopefully preventing back pain ever occurring.
When looking after your back it is always important to keep it in a neutral position, when standing, sitting and even sleeping. When standing, stand straight and tall with shoulders back and relaxed, and don’t lock your knees. Use a wide stance and keep your weight evenly distributed between your sides. If you are standing still for a prolonged time rest one foot on a step stool and change feet regularly to change the weight distribution.
I often show my patients good sleeping positions. They can use a lot of pillows so I hope your partners don’t get too angry with you. It is recommended to sleep on your side especially in the second and third trimester. Place a pillow between your knees and another one under your bump to maintain a neutral spine. Also ensure you have a neutral neck or cervical spine position with an appropriate number of pillows under your head that is right and comfortable for you.
It is also important to wear a supportive bra and to ensure that it is not underwired. Make sure you wear comfortable shoes without a heel, to prevent and relieve back pain, by keeping the spine in a more neutral position.
Now the bit you probably won’t want me to say but I have written a lot about it the last two blogs, is exercise such as walking or swimming. This will keep your back muscles strong and help relieve discomfort. A few simple stretching and strengthening exercises can also make a big difference.
If you suffer from any type of back pain during pregnancy and would like to book an appointment, please contact me on 0544485086 or by email to tamaramay.physio@gmail.com. I can arrange to see you in Bishvilaych Women’s Comprehensive Medical Centre in Givat Shaul, Jerusalem or a home visit if you live in Gush Etzion.