Back To Basics

As your pregnancy progresses, and your bump gets bigger, you start compensating for the extra weight by changing how you carry yourself. In the third trimester especially, your growing tummy will pose a strain to your back, and that’s when many mums-to-be start developing back pain. Dr Bernard Lee, consultant anaesthesiologist at Pacific Pain Care Centre, says that while women begin to experience lower back pain with the onset of pregnancy, “those who are most at risk for back pain are those who are overweight or had back pain prior to pregnancy.”

Eight in 10 cases of back pain experienced during or after pregnancy are a result of sprain in muscles and ligaments, says Dr Lee, who specialises in pain management. And it’s no wonder — ligaments, joints, discs and muscles are all under strain during this time. For the remaining women, their back pain may have to do with existing conditions such as a torn, injured or slipped disc. Fortunately, most back pain disappear after birth, unless the new mum continues having bad habits such as poor posture or breastfeeding in an uncomfortable position.

WHY BACK PAIN HAPPENS
Back pain during pregnancy has several causes, which include:
• Increase of hormones. Hormones released during pregnancy result in softened ligaments in the pelvis and looser joints to prepare the body for the delivery. These changes may weaken support for the back.

• Posture changes. Your centre of gravity will gradually shift as your baby grows, which causes your posture to change. Poor posture, excessive standing, and bending over can all lead to back pain.

• Extra weight. Your bigger belly creates additional weight that your back must support, causing strain.

GOOD BACKCARE, ALL DAY
Maintain good posture at all times. Many people are surprisingly unsure about correct posture. Says osteopath Dr David Tio: “The right posture is not the old-fashioned military posture of chest out, shoulders back. Instead the chest should be down and the shoulders relaxed, with shoulder blades separate, not together.” Pregnancy is probably the best time to relearn good posture habits. Dr Tio points out that if parents maintain good posture, they will serve as good examples to their kids.

When standing
• Hold head up straight, chin in. Do not tilt head forward, backwards or sideways.

• Make sure earlobes are in line with mid-shoulders.

• Keep shoulder blades back but relaxed, not stiff.
• Keep chest forward.

• Keep your knees straight.

• Stand tall — stretch the top of your head towards the ceiling.

• Tuck your stomach in. Do not tilt your pelvis forward or backward, especially when you’re no longer pregnant.

• Avoid standing in the same position for a long time.

• If possible, support one foot while standing. Eg when doing dishes, open cabinet under sink and rest one foot on inside of cabinet. Change feet every 5 to 15 minutes.

When lifting
• If you must lift a child or objects, avoid lifting bulky heavy things or a child who is more than 12 kg. Lift anything, including baby, close to the chest. Don’t lift her at arm’s length away.

• Before lifting anything, make sure you have firm footing.

• To pick up something lower than waist level, keep back straight and bend at knees and hips. Do not bend forward at the waist with your knees straight.

• Stand with a wide stance close to your child and keep your feet firm on the ground. Lift him using your leg muscles without jerking your child to your body. Straighten knees in a steady motion.

• If you are lifting your baby from a table, bring him across the table and closer to your body. Bend knees so that you are close to the baby. Use your legs to lift off and come to a standing position.

• Avoid lifting heavy objects above waist level.

• To lower the child, place your feet as you did to lift, tighten stomach muscles and bend your hips and knees.

When stooping, squatting and kneeling
• Kneel when you need to stay close to the floor for some time. It’s less tiring than squatting. When stooping, squatting or kneeling, face the child or the object you’re working on. Keeping feet apart, lower yourself slowly, especially when your tummy is quite big.

When sitting
• When nursing, bring baby towards breast, rather than leaning over towards him. Maintain good posture throughout feed by supporting baby with a pillow if needed.

• Sit up with back straight and shoulders back, with the upper back, mid-back and lower back in a natural S-shaped curve. Buttocks should touch the back of your chair. You may want to use a lumbar support pillow or a rolled-up towel.

• Distribute body weight evenly on both hips.

• Bend knees at a right angle. Keep knees level with, or slightly higher than hips. A foot rest or stool comes in useful. Don’t cross legs.

• Keep feet flat on the floor.

• Avoid sitting in the same position for more than 30 minutes.

• If your chair is on wheels and pivots, don't twist at the waist. Instead, turn your whole body.

• When standing up from the sitting position, move to the front of the seat. Stand up by straightening legs. Avoid bending forward at your waist. Stretch your back with several slow and gentle backbends.

Giving back pain the boot
Having back pain? Here are solutions to help you feel better.

▪ Maintain good posture at all times.

▪ Sit and stand with care. Sit with feet slightly elevated, and don’t cross your legs. When sitting, support your back with a lumbar cushion or rolled-up towel. Change position often, and avoid standing for long periods. When standing, rest one foot on a low stool.

▪ Sleep on your side. Keep one or both knees bent. Try placing a pillow between your knees and another under your abdomen, or use a full-length body pillow.

▪ Get the right gear. Wear low-heeled shoes with good arch support. Wear maternity pants with a low, supportive waistband. Consider using a maternity support belt.

▪ Try heat, cold or a back rub. Apply heat to your back. Soak in a warm bathtub, or use a hot water bottle or a heating pad. Some women alternate ice packs with heat. Rubbing your back also may help. Better yet, ask someone to give you a backrub.

▪ Stay fit. Regular exercise can keep your back strong and may actually relieve back pain. Check with your doctor if it’s acceptable to swim, walk, do yoga or ride a stationary bike.

▪ Try stretching exercises. Check with your doctor about stretching exercises that could help alleviate back pain.