Week 3-4 Exercise Progression:

• Step Matrix
• Clamshell
• Bent knee fall out and March
• Quadruped – Rockback; Pelvic Tilts, Cat/Cow
• Resisted Row
• Shoulder matrix < 90 degrees

Management of thumb and wrist pain:

Mommy’s thumb and wrist is the inflammation of the tendons that lift the thumb up or out to the side and the nerves that run along the inside of your wrist. Managing this early is important for symptoms to not get worse. Symptoms you may experience with tendonitis are pain and burning along the top of your thumb and wrist, tightness in your forearm and hand. Symptoms you may experience with nerve tension along your arm are numbness and “falling asleep” feeling along the inside of your upper arm and forearm or hand. Nerve tension presents from muscle stiffness surrounding the nerve which can present after sustained postures, for example, slumped posture while breastfeeding or holding your newborn for an extended period.

Treatment Strategies:

• Self Massage
  • Forearm- tennis ball or Lacrosse ball 2 min
  • Thumb massage – golf ball, focus on web space between thumb and index finger
  • Upper Trap – tennis ball or Lacrosse ball
• Movement
  • Wrist and finger circles
• Stretching
  • Wrist
  • Pec
  • Cat cow
• Nerve glides
• Bracing and Ice
  • Wrist and thumb brace while holding your child or breastfeeding
  • Ice Wrist and Thumb for 5-10 minutes
  • I found that the Lanisoh Therapy Breast Packs also made perfect wrist and thumb ice packs that I could wrap around my wrist
• Ask your partner or friend for a massage
  • Pressure should be tolerable not painful, if you find a sharp point maintained sustained pressure for 30-60 seconds until it releases and then move to next point

I tried to spend 5-10 minutes during the day to perform these movements or when I was actively experiencing the pain. Pick 2-3 of the 5 things and it will help manage your pain. If your pain progressively worsens for greater than 2 weeks and you have tried these exercises, I recommend seeking out help through Physical Therapy. It is much easier to manage and resolve your pain early on.

I hope these tips were useful. If you are looking for more one on one guidance and support MOTI Physiotherapy has a Pelvic Floor team that has an expertise in pregnant and postpartum population. We offer in person and telehealth visits that are covered by insurance. Do not wait for your first postpartum checkup if you are starting to experience pain from the new demands of motherhood. Our Pelvic Floor Doctors of Physical Therapy can guide you through a personalized plan of care that will support you!

The post Postpartum Recovery Weeks 3-4 appeared first on MOTI Physiotherapy.

Week 2-3 Exercise Progression:

1. Walking
   • I started with walking around my parents pool 3-5 laps and using a short stride because I was recovering from a cesarian delivery.
   • As I felt comfortable I continued with backwards walking and side walking for 5-10 minutes
   • At the end of week 2, I felt comfortable enough to walk to the end of the block and back with my abdominal binder
2. Weight shifting in a quarter squat position – the depth of each movement is unlocking the hips with a slight knee bend
   • Focused on maintaining my breath in the up and down phase of the position
     • See week one postpartum blog for breathing pattern
   • Quarter wall squat
   • Lateral squat
   • Quarter body weight squat
     • Focus is all on maintaining breath in the depth of the up and down phase
     • Spreading the floor with my feet
     • 5-10 reps max, 3-5 second pause at bottom
3. Pelvic Tilts
   • Lying in bed with my knees bent and feet on the bed
   • Small tilting of my pelvis
     • Anterior pelvic tilt: focus on moving your pubic bone towards your belly button
     • Posterior pelvic tilt: focus on moving your tailbone towards the bed
     • As you feel comfortable sink your inhale with the anterior pelvic tilt and posterior pelvic tilt with your exhale
4. Upper Body
   • Body weight wall angel
   • Body weight row
     • 5-10 reps, slow and controlled
     • Try to maintain length of your spine around the region of your bra strap

Cesarian Scar Desensitization

At week two postpartum I also began feeling comfortable with initiating scar tissue desensitization. It can be scary to look or have a material or physical touch to a healing incision. If you go too long avoiding movement or contact to the area muscle guarding and pain can occur in the long run. Desensitization is different than massage and stretching, avoid doing those things until after 8 weeks postpartum, scar tissue is not a bad thing and you want it to occur to have strong and healed incision. I highly recommend reviewing Dr. Lindsay Brunner’s post on Cesarian Scar Mobilization when it is appropriate in your recovery timeline.

Desensitization is using touch, after washing my hands I placed my hands over my scar and would breathe into the area, I would do this for only as long as I was comfortable and a few times a day. Ways to build on desensitization are with different textures, for example, your sheets or clothes. Finally, you can also have your partner gently place their hand on your incision. The goal is to introduce stimulation to the area that is non painful or threatening so that your brain does not create a pattern of needing to over protect the incision.

I hope these tips were useful. If you are looking for more one on one guidance and support MOTI Physiotherapy has a Pelvic Floor team that has an expertise in pregnant and postpartum population. We offer in person and telehealth visits that are covered by insurance. Do not wait for your first postpartum checkup if you are starting to experience pain from the new demands of motherhood. Our Pelvic Floor Doctor’s of Physical Therapy can guide you through a personalized plan of care that will support you!

The post Postpartum recovery weeks 2-3 appeared first on MOTI Physiotherapy.

I was grateful for an amazing nursing staff at the hospital we delivered at and my knowledge as a physical therapist for how to move without straining my incision. I realized that there was no discussion on expectations pre cesarian on pain management and recovery, all our focus was on the birth plan but not what to expect afterwards. I felt so disconnected from my body with not being able to exercise during the last part of my pregnancy and especially after receiving an Epidural.  I would like to share some bed mobility tips and gentle exercises I started in my first 72 hours after my cesarian birth. 

BED TRANSFERS

Log Roll: Going from your back to side to prepare for sitting

• Utilize your hospital bed to your advantage and adjust the head and leg rest to help assist yourself to a semi reclined position
• Exhale and roll to your side
• Once in this position exhale again and use your bottom forearm and top arm hand to push yourself upright. *Exhaling with movement reduces abdominal pressure and puts less stress on your incision
• Once in sitting scoot towards the edge of the bed, raise your bed height as high as you can go without feet coming off the floor
• Lean forward and exhale as you focus on pushing the ground away through your feet to stand

Shifting upward in your bed:

• Adjust the bed to be semi flat
• Hold the hand rails or push through forearms/hands and pull or push your self upwards without holding your breath or pushing through your legs

HOSPITAL EXERCISES

• Diaphragmatic breathing – sitting, sidelying, lying on my back 5 minutes. Focus on nasal inhale/exhale guiding my breath below my belly button, to the side of my rib cage and back of my rib cage
• Glute squeeze – Lying on my back, squeezing my butt cheeks for a 3 second hold
• Quad squeeze – Lying on my back, squeezing my quads to make my legs straight and rigid, for a 3 second hold
• Shoulder blade squeeze – Sitting upright or standing, squeezing my shoulder blades together and pulling my elbows behind me, for a 3 second hold
• Weight shift – standing weight shifts in place working on loading evenly into each foot going side to side and forward/backwards

HOME EXERCISES

*wearing my belly support wrap, here is a link to the one I used https://itsbodily.com/products/belly-band

• Walking 5 minutes – forward, backward, side step…small steps to not pull on incision. Standing weight shifts in place working on loading evenly into each foot going side to side and forward/backwards
• Diaphragmatic breathing – sitting, sidelying, lying on my back 5 minutes. Focus on nasal inhale/exhale guiding my breath below my belly button, to the side of my rib cage and back of my rib cage
• Toe Yoga – Seated – focus on grounding through my feet with even weight bearing through my big toe, fifth toe and heels. Then lift only the big toe off the ground without losing contact on the rest of the foot after about a minute switch to lifting the other four toes without lifting the big toe

Continuation of Hospital Exercises *can be performed during naps or breastfeeding

Breastfeeding:

I felt like Goldielocks trying to find the right spot that felt the most comfortable for breastfeeding. I moved from the bed to the couch, sitting on the toilet or kitchen chair. I was happy I did not purchase a rocking chair or glider because I have moved around so much and found the most comfortable spot has been my home office chair and using my nursing pillow. My friend gifted me the My Breast Friend Nursing Pillow which has been great and when I attempt to nurse in bed I also use a Foam Bed Wedge Pillow.

Breastfeeding has definitely been challenging and anxiety driven, and I learn something new each day. I highly recommend a lactation consultation in the hospital, when you get home and even before you deliver to help with expectations. When my milk first came in it was painful and overwhelming. I found my neck, wrist and thumb starting to hurt, making sure he was maintaining a good latch.

Movements I started to incorporate early on to help ease this pain were:

1. Massage to my forearm and hand

2. Wrist circles

3. Double hand cradle to support my sons head so that the arm supporting his body wasn’t overstressed by taking on the full weight of his head as well

4. Thumb and wrist position – Supporting his head with both my hands allowed me to not wrap my thumb around his head

   • Try to make sure the tip of your thumb is relaxed and not pointing backwards towards your wrist, this will alleviate the stress placed on your thumb extensor tendons

5. Mom’s head and neck position while feeding – Pause every minute or to look forward, roll your shoulders back and sit upward. Gaze along the horizon and gently draw your chin in towards your neck making a double chin and hold for 5 seconds, release and repeat 5 times with a shoulder blade squeeze

6. Diaphragmatic breathing

   • This is a great time to practice your diaphragmatic breathing utilizing your breastfeeding pillow for feedback and focus your inhale going into all aspects of your pillow that is wrapped around you

Changing table and Bassinet lifting mechanics:

• Just like your bed transfer mechanics exhale with lowering and lifting
• Wearing your belly band can help support your back
• Unlock your knees with bending and lifting and don’t round through your mid back
• If you are not ready to lift ask for help from your partner

I hope these tips were useful. If you are looking for more one on one guidance and support, MOTI Physiotherapy has a Pelvic Floor Specialilst team that has expertise in pregnant and postpartum population. We offer in person and telehealth visits that are covered by insurance. Do not wait for your first postpartum checkup if you are starting to experience pain from the new demands of motherhood. Our Pelvic Floor Doctors of Physical Therapy can guide you through a personalized plan of care that will support you!

The post My first week Postpartum: Cesarian birth recovery and body mechanics appeared first on MOTI Physiotherapy.

In order to understand what pelvic organ prolapse is, we must first understand female pelvic anatomy. At the front (anterior) of the pelvis, there is the bladder and urethra, in the middle there is the vagina, and in the back (posterior) there is the rectum. The vagina has two main walls, the anterior wall and the posterior wall. What supports these structures is a muscular sling known as the pelvic floor.

Causes

When the pelvic floor and ligaments supporting the pelvic organs weaken, the pelvic organs can descend causing a bulge, or prolapse, of one or more walls of the vagina. This can be caused by any condition that increases pressure on the pelvic floor such as pregnancy and vaginal delivery, chronic cough, chronic constipation, obesity, or repetitive heavy lifting. Prolapse can also occur after hysterectomy or pelvic surgery.

Symptoms

A person with pelvic organ prolapse may experience incontinence, difficulty having a bowel movement, pain or numbness during intercourse, and/or the sensation of heaviness around their vaginal opening.

Management

Many conservative treatments can be used to manage the symptoms of pelvic organ prolapse, such as:

• Breathing correctly to manage pressure placed on the pelvic floor
• Performing pelvic floor exercises to improve the strength of slow and fast twitch muscles of the pelvic floor
• Improving body mechanics while lifting heavy objects
• Treating constipation by increasing fiber/water intake, correcting toileting body mechanics, and using breath to decrease straining during bowel movements
• Strengthening core and hip muscles to support the pelvic girdle
• Using a pessary, a device inserted into the vagina to support the vaginal walls

Hormone therapy and surgery are also options used to treat pelvic organ prolapse if conservative measures do not improve symptoms. If you suspect you may have prolapse, you should consult with your primary care doctor, gynecologist, or pelvic floor physical therapist for treatment.

The post What is Pelvic Organ Prolapse and Ways to Manage It appeared first on MOTI Physiotherapy.

1) Normalizing Sensation 

When we have any surgical incision that heals into a scar, the nerves surrounding that tissue get temporarily disrupted.  This can result in numbness or heightened sensitivity at the healing incision and eventual scar. Frequent touch and movement to the scar and surrounding skin will help recalibrate the sensations that these nerves feel, so that both numbness and increased sensitivity start to move back towards normal.  

2) Improving Scar Tissue Mobility 

When an incision heals, scar formation is a normal part of the process. However, sometimes when scar tissue forms it adheres to the surrounding fascia and muscles. This can result in uncomfortable pulling as anything around the scar moves. Scar tissue is naturally less flexible than our normal skin and connective tissues, so we also want to make sure that it can move as well as possible. Directly moving a scar can reduce the chance that it develops uncomfortable adhesions and is able to move well with you. 

You can think of scar mobilization as having two phases. The first phase is while the incision is not yet closed or fully healed. The second phase is after the incision is fully closed and healed. 

Phase One: The emphasis in this phase is on normalizing sensation and gently moving the skin around the healing incision. This includes lightly running your fingers over the incision and surrounding tissue and gently pulling the skin around the incision in different directions. At this stage there should be no direct pulling or movement of the incision to ensure that it is able to close and heal properly. 

Phase Two: Once the incision is fully closed and there is no scabbing left, more direct scar mobilization can begin. Using a neutral lotion or oil, you can apply direct pressure to the scar and move your fingers in multiple directions. This can be circles, up/down, and side to side movements. The more directions the scar is moved in, the more flexible it will be. When that feels comfortable you can progress to lifting the scar by lightly pinching it between your fingers and pulling it away from your abdomen. This helps make sure it is not adhering to any of the tissues below it. 

We encourage you to seek out a pelvic health physical therapist for further assistance and guidance in recovery post C section! 

The post C Section Scar Mobilization appeared first on MOTI Physiotherapy.

Mastectomy from breast cancer can present multiple challenges in and of itself as the tissues heal and the shoulder is initially limited to lifting. If your mastectomy involved lymph node removal, there is a 20-30% chance that you may develop lymphedema. This is a fluid build up in the lymphatic system near the surgical site, into the arm of the affected side, often down to the wrist or fingers. The result winds up in a “heavy arm” with symptoms that can range from just pressure and/or fullness, to numbness, achiness, and pain that limit use of that arm. 

To move waste fluids away from the damaged area, lymphatic massage, which uses a gentle pressure, can help. It’s one technique used to reduce lymphedema. Immediately following lymphatic massage, it is crucial to apply gradient compression to the limb to maintain appropriate pressure on the lymphatic vessels. This will assist in decreasing  fluid retention and  stress on the skin to promote mobility. Gradient compression is NOT simply an ACE wrap! It is layers of different compression that apply even pressure to the limb without damaging the lymphatic vessels.  Here are the various supplies we use: 

Lymphatic massage is NOT something a masseuse does!! You need to see a licensed physical therapist or lymphedema specialist for treatment. They will perform the massage, which takes about 45minutes, followed by application of the layers of compression. After wrapping the arm, you would do very light exercises to further promote strength training while the muscles themselves pump fluid out of the limb and back into your circulation. Your arm will look like this!

In time, you will learn how to sequentially perform the massage on yourself and apply your own bandages so that you can bathe or remove it for a short break.

Lymphedema treatment can last from 4-8 weeks on average, depending on the grade of your lymphedema to begin as well as your compliance with the home program. The goal is to attain a limb girth equivalent to your non-operative side and “graduate” to a custom compression garment, which would fit like a pantyhose sleeve for your arm. 

I am excited to work with you! 

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Pain with penetration can be a symptom of pelvic floor hypertonicity or having pelvic floor muscles that have too much tension. When your pelvic floor muscles have too much tension you might experience these other symptoms as well:

-Pain with penetrative sex (during or after)

-Pain or inability to use tampons or menstrual cups

-Urinary urge and frequency

-“Shy” bladder or having to strain to urinate

-Constipation or straining with bowel movements

-Pain with bowel movements or urination

-Painful orgasm or difficulty reaching orgasm

-Tailbone pain

-Clitoral or penile pain

-Perineal or anal pain

-Hip pain

How do I know if I have a hypertonic pelvic floor?

A hypertonic pelvic floor can be identified with an exam by a Pelvic Floor Therapist. Your therapist can determine if pelvic floor muscle tone is normal or abnormally high. For more information regarding what to expect on your first visit with a pelvic floor therapist, check out this article.

How can Pelvic Floor Therapy help a hypertonic pelvic floor?

A pelvic floor therapist will help facilitate the lengthening of your pelvic floor muscles. Treatments with a pelvic floor therapist can include:

-Manual therapy (external, intravaginal, or intrarectal, depending on patient needs)

-Patient training to use vaginal dilators

-Biofeedback

-Home exercises including stretching and coordination exercises

What about other treatments?

Medical management of hypertonic pelvic floor muscles can include pharmaceuticals or procedures such as trigger point injection or botox. These options will have to be discussed with your doctor. 

How do I schedule with a Pelvic Floor Therapist?

Consult with your doctor to see if you are a good candidate for pelvic floor therapy and to get a referral for pelvic floor therapy. The pelvic floor therapy team at MOTI have undergone additional training to be able to perform pelvic floor examination and treatment and are ready to help you on your healing journey!

Exercises to Try Today

The following exercises are helpful to relax your pelvic floor, give them a try today.

Diaphragmatic Breathing

The diaphragm and pelvic floor are both soft domes of muscle in the abdomen that move together when you breathe. Diaphragmatic breathing can help restore rhythm between the two and balance tension in your abdomen. Start in a seated position or lying down on your back. Place one hand on your chest and one hand on your stomach. As you inhale, allow the pelvis, belly, and lungs to expand and fill with air. Both hands should rise and fall at the same time. As you exhale, you’ll feel the air gently leave the body, without any strain. Repeat for 5-10 minutes.

SINGLE KNEE TO CHEST

Begin laying on your back. Bring one knee to your chest, cradling the knee with the arm/hand. Hold the stretch for 30-90 seconds. Breathe. Repeat on the other side.

MODIFIED HAPPY BABY

Laying on your back, hug both knees to the chest, using your hands or a stretching strap/towel behind the thighs. Hold the stretch for 30-90 seconds while performing your diaphragmatic breath.

CAT COW

Start on all fours, exhale as your round the spine like an angry cat. As you inhale, come into a back extension, allowing the belly to sink towards the mat and eyes towards the sky. Move slowly with controlled movement. Perform 5-10 reps. 

CHILD’S POSE WITH SIDE STRETCHING     

From all fours, stretch the glutes towards the heels, walking fingertips forward. Hold the stretch for 30-60 seconds while perform deep breaths. Walk the fingertips toward the right side of the mat, until you feel a side stretch on the left. Hold for 30-60 seconds. Repeat on the other side. 

SUPPORTED SQUAT STRETCH

Come into wide leg squat onto a low stool, a stack of sturdy books or yoga blocks. Focus on dropping the pelvic floor and perform diaphragmatic breathing. Hold for 30-90 seconds. 

The post Pain with Sex or Tampons? How Pelvic Floor Therapy May Help You and Five Exercises You Can Try Today appeared first on MOTI Physiotherapy.

As with orthopaedic physical therapy, pelvic floor rehabilitation starts with examination to understand what different factors may be contributing to your dysfunction.
 
An intial pelvic floor therapy exam will typically involve the following elements:

-A thorough intake of your health history. 
Your pelvic floor therapist may ask you questions regarding your bowel and bladder habits, sexual function, and pelvic pain.  Any prior abdominal or pelvic surgeries will be discussed, as well as any falls, accidents, or traumas involving the area. For those with female anatomy, this may include asking about any gynecological issues such as endometriosis, pain with menstruation, previous pregnancies, labors, and deliveries. 

-External examination 
The external examination is typically done fully dressed and may resemble other orthopaedic physical exams, your therapist will assess your full body movement, strength, and flexibility in order to take the whole system into account. 

-Internal examination
Internal exams are performed intra-vaginally or intra-rectally, depending on the condition being treated. Your therapist will discuss with you what type of exam is recommended and what you’re comfortable with. The internal exam will help your pelvic floor therapist determine factors such as pelvic floor muscle strength, coordination, and whether your pelvic floor muscles are hypertonic (too active) or hypotonic (underactive). 

After getting a complete picture from the examination, your pelvic floor therapist will discuss their findings and share your plan of care with you.

Treatment:

After your initial examination, follow-up visits will focus on treating the issues that were identified. Treatment will depend on what your condition is and what your therapist finds upon examination. Pelvic floor rehabilitation may include:

• Internal and external manual release of restricted muscles
• Pelvic floor muscle strength training with or without biofeedback
• Pelvic floor muscle relaxation training
• Bladder and bowel behavioral retraining strategies
• Dilator training for increasing penetration tolerance
• Core and gluteal training
• Body mechanics training

For more information regarding the pelvic floor conditions we treat, check out this page.

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According to the American Society of Clinical Oncology, the following symptoms contribute to depression if they last two weeks or longer. 

Mood-related symptoms: 

• Feeling down 
• Feeling sad 
• Feeling hopeless 
• Feeling irritable 
• Feeling numb 
• Feeling worthless 

Behavioral symptoms: 

• Loss of interest in activities  
• Frequent crying 
• Withdrawal from friends or family 
• Loss of motivation to do daily activities 

Cognitive symptoms: 

• Trouble focusing 
• Difficulty making decisions 
• Memory issues 
• Negative thoughts of self-worth or hurting self 

Make sure you implement a form of self-management or seek professional help to provide emotional support for you and your family.  

The Cancer Support Community of Pasadena is a great FREE resource for all cancer patients and family members, that creates a safe environment surrounded by other people that share the same concerns and understanding. 

Check out their website for weekly events and workshops: 

https://www.cscpasadena.org/

However, sometimes a group setting of sharing stories and group emotions could be overwhelming for some. If you want a more personal and private approach, here are some Healthcare Providers in the Los Angeles region that are highly recommended: 

Dr. Maryam Javanbakht, DPT, Physical Therapist 

Approach: Dr. Maryam helps bridge the gap between the emotional and physical body through meditation, pain and neural science education, cranial sacral techniques, and self-coping techniques. 

https://www.clearbodymethod.com/

Dr. Mallory Aye, ND, Naturopathic Doctor 

Dr. Aye specializes in women’s health, pelvic pain, and mental health concerns, working with each individual to understand all the components of their mental and emotional health. 

https://pasadenanaturalhealth.com/about-us/our-doctors/dr-aye/

Dr. Roxanne Prilutsky, Ph.D, Clinical Psychologist 

Dr. Prilutsky treats patients with compounded medical and psychological issues, including trauma, anxiety, and pain. 

http://www.pasadenapsychologist.net/ 

Dr. Dylan Firsick, Ph. D., Clinical Sport Psychologist 

Dr. Firsick is a sports psychologist for the USC Athletics and clinical assistant professor of psychiatry and behavioral science at Keck Medicine of USC. His professional interests include sport psychology, injury recovery, alcohol and other drug treatment, men’s issues, sexual assault and relationship violence awareness and prevention, spirituality, cognitive-behavioral and interpersonal process therapy (CBT/IPT), depression, anxiety, diversity, and multiculturalism. 

(661) 916-2940 
Email: dylan.firsick@med.usc.edu 

The post 11- Boobs are Temporary but Mental Health is Forever appeared first on MOTI Physiotherapy.

Postural Changes 

All that weight in front can pull you into a more arched position in your low back, which adds to compression of the joints and overactivity of the lower back muscles. To help counterbalance this, try tucking your tailbone underneath you periodically to unload your back and let it stretch. Perform the below exercise to work on your posture. 

Posterior Pelvic Tilt 

In standing or sitting, feel your tailbone tuck underneath you, as if you were a dog putting their tail between their legs. Hold this position for a few seconds and then release, repeating 10 times. Putting your hands on your hips can help you feel the movement of your pelvis. 

Gentle Movement 

One reason your low back can get achey is stiffness. Giving your back some gentle, rhythmic movement can help ease stiffness and move more comfortably. Perform the below exercise to practice some gentle back and pelvic movement. 

Pelvic Circles 

If you have a birth ball, sit on it with legs wide. If not, you can sit in a regular chair or stand. With your hands on your hips, slowly begin making small circles with your pelvis. Make them larger as you get more comfortable. Perform about 10 circles in one direction, and then 10 circles in the other direction. 

Unload and Stretch 

Sometimes you just need to give your back more of a break to allow the muscles to fully relax and take some pressure off of your spine. Sitting can still create some compression in your back, but using a supported stretching pose can help stretch and unload it. Perform the below exercise to give your back a break. 

Supported Child’s Pose 

Begin in a kneeling position, placing a pillow between your bottom and your heels if needed. Place a bolster or stack of pillows in front of you, with knees wide. Straddling the pillows, lay your chest down onto the bolster or stack of pillows. Leave room for your belly, placing a supportive pillow underneath it if needed. Let yourself relax into the pillows while your back elongates and stretches. 

Strengthen and Support 

The best way to alleviate back pain is preventing or minimizing it ahead of time. The more you can use the right support muscles, the less excessive strain will go into your back during pregnancy. Your abdominals will certainly stretch in pregnancy, but they can still be helpful support muscles, along with the deep muscular stabilizers in your back and your butt muscles. Keeping these muscles strong and active in pregnancy can help reduce back pain overall because you will be giving yourself better support. Perform the below exercise to work on strength and support for your back. 

Bird Dog 

Start on your hands and knees. Feel your lower belly tighten to support the weight of your belly. Slowly lift one leg and the opposite arm so that they are in line with your torso, and imagine reaching the arm and leg long. Make sure nothing moves but the arm and leg, no back arching or hips twisting. Come back to the start position and switch to the other side. If this feels too difficult, try only moving the legs, alternating between sides. This can be modified further by sliding each leg out straight behind you without lifting it. 

If persistent back pain continues in pregnancy, seek out a Women’s Health physical therapist to get an assessment and personalized plan! 

– Dr. Lindsay Brunner, PT, DPT, OCS

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