At over 30 weeks pregnant, I wanted to share some strategies I’ve implemented to work and live as comfortably and pain-free as possible. Preventing pregnancy-related back pain has been a top priority, especially given the physical demands of my job as a chiropractor. Although my physical activity routine hasn’t changed significantly (aside from adjustments made in the first trimester), the techniques I use to prevent back pain are the same ones I recommend to my patients.
“Loosen up the tight joints, and tighten up the loose joints” is a phrase I often use to reduce pain and optimize biomechanics. During pregnancy, this principle becomes even more relevant due to the shift in the center of gravity and the release of the hormone relaxin.
1. Maintain Joint-Specific Flexibility
Prioritizing flexibility in the hips, ankles, and thoracic regions is essential to preserve mobility as the body undergoes changes. The body comprises alternating joints that transition between stability and mobility. For instance, the toes are stable with limited movement, followed by the ankle, which offers multi-directional mobility. This is followed by the knee, which primarily allows flexion and extension, and then the hip, a ball-and-socket joint with significant mobility. Discomfort and pain can arise when mobile joints become stiff, causing excessive movement and stress on stable joints.
2. Maintain Core and Joint-Specific Stability
The core functions as a cylindrical system, with muscles working together to enhance intra-abdominal stability and pressure, providing “good stiffness” to the lumbar spine during movement. My core exercises are primarily anti-movement exercises, where the spine remains neutral, and the core muscles contract isometrically (without movement) to stabilize the spine. This approach minimizes excessive movement in the lumbopelvic area, which is crucial given the increased laxity of my ligaments. These exercises are consistent with the core routines I often prescribe to patients.
3. Strength/Resistance Training (3+ times per week)
I have always advocated for resistance training to enhance bone strength and build lean muscle mass. The stronger I am, the less physically demanding my job feels, and I experience fewer aches and pains. Additionally, I have more energy throughout the day and enjoy better sleep quality. My injury prevention plan as I age is “to get as strong as possible and own the essential movement patterns.” This includes various horizontal and vertical pushing and pulling exercises, squats, deadlifts, and lunges.
4. Walking Goal of 8,000 Steps per Day
While aerobic fitness has become less of a focus during pregnancy, I still aim for 8,000 steps daily. Due to the increase in my resting heart rate, I find resistance training more comfortable than maintaining a high level of aerobic activity.
5. Protein Intake
To preserve lean muscle mass and maintain strength, I’ve resumed macro tracking with a coach. My protein goal is one gram per pound of body weight, a target I maintained before pregnancy. After overcoming the first trimester’s food aversions and fatigue, I returned to this practice to regain a sense of normalcy. Recent studies emphasize the importance of a high-protein diet for longevity, and I believe this has been fundamental to maintaining strength and aiding recovery throughout my pregnancy.
6. Fiber Intake
Research shows that a fiber-rich diet may reduce the risk of certain cancers, especially colorectal cancer. It also supports weight management, helps reduce insulin levels, and stabilizes blood sugar. The National Academy of Medicine (NAM) recommends 25 grams of fiber daily for women aged 19-50 and 21 grams for those aged 51+. For men, it’s recommended they consume 38 grams per day (ages 19-50) and 30 grams per day (ages 51+). I often reach my fiber goals with high-fiber foods, including all-bran cereals with raspberries and blackberries, as well as high-fiber vegetables like broccoli, artichokes, and green peas.
7. Self-Care and Chiropractic Treatments
I’m fortunate to have access to a team of amazing providers at Boulder Sports Chiropractic and support from my chiropractor husband. I receive regular maintenance treatments, including massage, adjustments, and physical therapy, to keep my body moving well and pain-free. If I feel a twinge or an ache that doesn’t resolve after a day or two, I address it quickly to prevent it from escalating. Incorporating the Webster technique into my chiropractic visits helps ensure my pelvis is aligned optimally for delivery. The Webster technique also encourages the baby to move into a head-down position during the third trimester, and it helps with SI joint alignment, which can reduce back pain and round ligament pain.
8. Kinesiotape for Lower Back Relief
As the baby grows, increased stress is placed on the lower back. I find relief using kinesiotape on my abdomen, which gently lifts the belly and reduces pressure. Others may benefit from sacroiliac belts, like the Serola belt, which provides additional pelvic support.
9. Concerns About Diastasis Recti Abdominis (DRA)
DRA, a condition where the abdominal muscles separate at the midline, commonly occurs in the second trimester and affects 66% to 100% of women in the third trimester (PMID: 30839304). Incorporating deep core stability exercises is effective for managing DRA. This underscores the importance of strength training and core stability, whether pregnant or not. There comes a point where crunches become increasingly uncomfortable, so I’ve been avoiding them since the second trimester. Instead, I’ve become more mindful of getting out of bed or sitting up, often rolling to one side and using a modified Turkish get-up to prop myself up.
10. Going with the Flow
While I strive to meet my daily goals, there are days when I simply don’t feel up to it. When asked whether to “push through fatigue” or “rest,” I believe it’s a personal choice. I’ve tried both: on some days, I’ve mustered up energy for the gym only to end up resting, while on others, I’ve completed a workout and felt accomplished. Both outcomes are fine. Give yourself grace, and you’ll find a rhythm that works for you.
By focusing on flexibility, core stability, strength, and proper self-care, I’m working to support a comfortable pregnancy and smoother recovery. These habits have lifelong benefits, helping ensure I’m at my best for both personal and professional life.
Dr. Alyx Brown, DC, MS, CCSP