Back Pain in Pregnancy - and Why Men Can Get It
Friday, May 04, 2007
Jolie Bookspan, M.Ed, PhD, FAWM
In school, we were taught about the "unavoidable lordosis of pregnancy." Lordosis (technically, hyperlordosis) is when you allow too much inward arching in the lower spine - Drawing 1 at right.Over-arching causes one kind of lower back pain. It was taught as something that "just happens" to the spine during pregnancy. I asked the professors why women could also get it before and after pregnancy, and why men got the same kind of compressive force on the joints of the spine, called facet joints. It became a focus of study in my lab with lifters for many years.
The post Neutral Spine or Not? and What is Neutral Spine and Why Does Sticking Out In Back Harm? show how slouching so that you increase the inward curve in the lower spine (increase the lordosis so that it is no longer neutral spine) pinches the lower back under the weight of the upper body. Both also show what neutral spine looks like compared to lordotic.
The upper body should be upright (vertical) and the hip level to be in neutral spine. Drawing 2, with x-ray, shows what hyperlordosis looks like when the front of the hip tilts down and the upper body leans backward. This is not the normal curve - it is too much. The back of the spine gets pinched and pressured.
I found that hyperlordosis is not caused by a pregnant belly or beer belly or carrying groceries or backpacks. The over-arching (hyperlordosis) is not unchangeable anatomy. It is leaning back to offset the load in front.
Note the same over-arching occurring with the overhead lift in drawing 3, below left.
Overarched spine position is something that you can decide whether to allow or not. You can easily use your muscles to prevent hyperlordosis and hold you in healthy upright position.
Try it for yourself:
- Stand up and pick up your chair (bend right to pick it up for more exercise and back injury prevention).
- Hold the chair like any package in front, or on your hip, and notice if you lean back to shift the weight off your muscles (make it easier). Where does the weight shift to? On to your lower spine.
- Instead, stand straight. You will get free, built-in healthful exercise that protects your spine.
The pelvic tilt to tuck the spine to restore an overly arched lower back to neutral spine was introduced in Throw a Stronger Punch (or Push a Car or Stroller) Using This Back Pain Reduction Technique and Healthier Carrying - Get Free Ab Exercise and Stop Pain.
Don't overarch or lean the upper body backward while you stand and carry - center and right-hand figures in the drawing at left. That is the missing link. Stand upright in neutral spine - left hand figure. There is a small lower spine curve, not a large one, and the lower spine is not pinched and folding backward, which squashes the soft tissue, discs, and vertebral joints called facets.
I have heard argument that nine months is too long to expect someone to think about their spine, and the muscles get tired. As they say in computers, "that's not a bug, that's a feature." It's good news that you get a free core muscle workout and free back pain prevention. Pregnancy (and any weight lifting) is a key time to have that.
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Read success stories of these methods and send your own.
Subscribe to The Fitness Fixer, free. Click "updates via e-mail" (under trumpet) upper right.
See Dr. Bookspan's Books, take a Class, get certified - DrBookspan.com/Academy.
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Drawing of Backman!™ © copyright Dr. Jolie Bookspan
x-ray courtesy of Orthopedic TechnologyLabels: disc, facet joints, facets, fix pain, lordosis, lower back, neutral spine, posture, pregnancy
2 Comments:
At Wednesday, August 08, 2007 1:41:00 PM,
Anonymous said…
Dr. Bookspan,
Just last week, I came across your materials online in a desperate search.. =)
I thank G-d that you are here, and that you have continued as you have with such strength and beauty.
I'm writing in behalf of my wife who feels like she's caught in a vicious cycle. She almost feels like an atrophy has set in. Not enough muscle strength or ability to cope with the pain of attempting the proper posture. Trying to keep the Neutral Back you describe being almost impossible, and sliding ever so painfully in to what seems like the beginnings of Sciatica (effecting her Left Leg)
At first we figured it was just because of heavy breasts, and feeding/caring for our now 14lb 8week old.
(Her back only started to hurt during the 9th month, and after she started breast feeding.)
From browsing your articles it appears that her posture during both; Forward Head, Hyperlordosis have caused her current condition.
From your articles and site, I now believe that proper posture (non-forward head, neutral spine) is key to the fix. Though, we are faced with a strange dilemma (mentioned above) and at times wonder if we may too late.
Would you ever recommend seeing a Chiropractor to initially get the vertebrae aligned properly so that she can at very least hold proper posture, in order to begin strengthening the core muscles? Or would something like Thai Massage be more fitting to get the body ready to begin?
You and your wisdom are greatly appreciated.
Cheers
Post Script,
I need to purchase some of your books. Do you do Signed copies?
At Thursday, August 09, 2007 2:30:00 PM,
Jolie Bookspan, M.Ed, PhD, FAWM said…
James, thank you for kind words, being empowered to restore positioning, and keeping hope. All are healthy. It is far from "too late." Chiropractic and massage and posture braces (etc) will not make you hold positioning using your own muscles. That is the exercise needed. You easily do that yourself.
Holding neutral spine is easy. Do not tighten. I put one easy drill to learn how to tilt the hip until straight right in the post. Here is another, with more to follow in posts:
1. Stand with your back against a wall. Feel the large arch in the lower back making a large space.
2. Put your hands on your hips. Thumbs in back. Fingers in front.
3. Roll your hip so that thumbs roll down in back.
The large space between lower back and wall becomes a smaller space. Do not flatten against the wall. Just feel the strain come off the lower back. Simple. Do this together with your wife and compare notes.
See the post Breasts Causing Upper Back Pain is a Myth. Pain is far more from how you stand, than shape. Use the stretches in the comments to fix the problem (align things yourself) and then hold positioning yourself. Keeping healthful positioning is what strengthens the needed muscles.
Congratulations on the new baby too, of course. 14 pounds and 8 weeks? Wow.
Make sure not to lean back and arch when lifting baby overhead or bend wrong to pick up baby. Send before and after photos and I can feature you as the good examples in a post on how to stop back pain for new parents.
My books page (www.DrBookspan.com/books) has a link to e-mail me how you would like your books signed.
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