Exercises to Strengthen the Lower Back
by Laura Roe Stevens
Back pain is especially common during pregnancy due to the pressure from the growing baby and throughout the first years after birth. Lifting an ever-growing baby and all the accompanying baby gear—think car seats and strollers and heavy diaper-changing bags—can wreak havoc on your back. A proper exercise program can help. For that I turned to Meredith Soelberg, MPT, MBA, a Los Angeles–based physical therapist and co-founder of MyBlankhurts.
“Strengthening the abdominal muscles, back muscles, pelvic floor, buttock, and thigh muscles can help to prevent and decrease back pain. The strengthening exercises should be performed in a slow and controlled manner and repeated ten to thirty times. Breathe out during the exertion phase of the exercise and inhale as you relax,” Soelberg explains.
The following are Soelberg’s suggested exercises for each of the major muscle groups mentioned:
Pelvic Tilts (for abdominal muscles): The simplest way to learn the pelvic tilt is to lie on the back with knees bent, feet resting on the floor. Place your hand in the small of your back, and you will likely feel a space between your back and the floor. Now try to flatten the lower part of the spine against the floor, so that you feel no space between your back and the floor. At the same time, you can imagine a string pulling the pubic bone upward toward the ceiling. The buttocks should be relaxed in order to isolate the abdominals. The pelvic tilt can be performed while lying on your back, standing, on your hands and knees, or sitting. I recommend doing the pelvic tilt in the hands and knees position, especially after the first trimester as it may be the most comfortable position for the exercise as the baby gains weight and the uterus grows.
Arm and Leg Raises (for back muscles and buttocks): Kneel on your hands and knees with a straight spine. Do a pelvic tilt to keep your pelvis stable and then lift your right arm and left leg to form a straight line with your spine. Pause in this position and then slowly lower your arm and leg. Alternate lifting the opposite arm and leg. If you have difficulty keeping your balance in this position, modify the exercise by performing the leg or arm raises separately.
Kegels (for pelvic floor muscles): The easiest way to isolate the Kegel muscle is to attempt to stop the flow of urine briefly. Once you’ve been able to isolate the muscle, it can be strengthened by repeatedly activating the muscle and holding it for longer and longer durations. To begin, squeeze and hold for three seconds, repeating thirty times. Then progress to the “elevator”; hold the tightened position of the muscle while envisioning an elevator going up one floor at a time to the tenth floor. Release once you’ve reached the top floor. Repeat ten times. These should be done daily. Kegels can be done any time, and anywhere, like at the red light or in a meeting. You should not feel your buttocks, thighs, or abdominals tightening as you do this.
Wall Squats or partner squats (for abdominal muscles, buttock muscles, and thigh muscles): Stand with your head, shoulders, and back against a wall with your feet about one to two feet away from the wall. Press your lower back into the wall and squat as if you were going to sit down, with the knees approaching a 90-degree angle. Come back up slowly, keeping your back and buttocks in contact with the wall. Squats can also be done with your partner by facing your partner and holding your partner’s hands, together you can squat as if you are about to sit into a chair, hips and knees bent, chest dropping slightly forward. The motion should be slow and controlled both squatting (count to four) and returning to stand (count to four). Repeat thirty times.
Stretching Exercises for Back Pain During Pregnancy:
“Stretching is as important as cardiovascular and strength training for back pain prevention and treatment during pregnancy. In order to improve flexibility, it is recommended that stretches be performed daily after you are warmed up. Hold the stretches (never bounce) for twenty to thirty seconds, and repeat three times,” says Soelberg.
She explains that the most common muscles that cause low back pain during pregnancy are the back muscles and the hamstrings (in the back of the thighs) and the quadriceps (front of the thighs). To isolate those, Soelberg has outlined to following:
Back stretch: Start on your hands and knees, with your legs wide apart and hands placed forward just a little in front of your head. Place a small pillow under you to give support to your abdomen, if needed. Sit back on your knees and stretch your arms forward to feel a stretch along the spine. This stretch is called child’s pose in yoga and is slightly modified to make room for the baby by separating the knees and placing a pillow there if needed.
Hamstring stretch: Face a chair and place one foot up on it, keeping both hips and feet facing forward. Keep your back straight and lean forward from your hips to feel a stretch in the back of the thigh. If you can’t stand tall or your knee bends, try a lower step.
Quadriceps stretch: Face a chair, hold on to the back of the chair with one hand for balance, bend the opposite knee, and reach back with the hand of the same side, grasping the top of the foot. Gently pull the heel of the foot toward the buttock. Be sure to tuck the bottom under you, giving the pelvis a posterior tilt. The stretch should be felt on the front of the thigh.
If back pain continues after correcting your posture and following a recommended exercise program, your doctor or physical therapist may recommend that you wear a support for your lower back and abdomen such as a maternity girdle or abdominal binder. Soelberg explains that these supports can help correct improper postural alignment and relieve the strain on the muscles that are stretched by the increasing size of the uterus during pregnancy.
It is important to always discuss your symptoms with your health care provider to ensure that the exercise is appropriate for you and to be informed of any guidelines or restrictions that may be recommended. Some pregnant women may benefit from more intensive or individualized treatment for their back pain.