Back & Pelvic Pain in Pregnancy

Written by Caitlin Stannard women’s health & musculoskeletal physiotherapist 

This is a brief expert-led guide to exercising in pregnancy to relieve lower back or pelvic girdle pain.

Pelvic girdle pain and back pain involves musculoskeletal discomfort between your lower ribs and buttock. This pain is much more commonly experienced in pregnancy with around half of women having some degree of pain due to the hormonal shifts, weight changes and altered load. Pain can vary from mild to severe and can have a significant impact on your ability to work, sleep and enjoy your pregnancy.

“Exercise in back & pelvic pain

can be challenging due to discomfort.”

Management options include manual therapy (‘hands on’) from a trained health professional like a physiotherapist with experience treating pregnant women, exercise from a prenatal health and fitness professional or just ‘hoping for the best’. Pain reduces after birth for most women however for a significant proportion (30%) this pain will continue for twelve months after birth.

Exercise in back and pelvic pain can be challenging due to discomfort, fear and a feeling of instability however the research shows that considered exercises will improve outcomes both during and after the pregnancy for both you and your growing baby. Aggravating movements for pelvic pain tend to include single leg exercises, putting hips into a deep bend position, standing up from a chair and prolonged static positions (such as standing).

Physiotherapy led exercise can be done in a face-to-face format or via an online platform and can involve Pilates based exercise, resistance training and guidance on cardiovascular exercise that will be comfortable for your individual stage of pregnancy and the nature of your pain.

“Research shows that well designed

exercises will improve outcomes for back pain.”

A great circuit that I have developed and completed regularly through my pregnancy is detailed below – as always, we recommend chatting to a well-informed health practitioner about this especially if you have any conditions that make you at higher risk during your pregnancy.

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Details:

• Equipment:

  • Small set of weights (2-5kg) (can be something you find at home)

  • TheraBand to make it harder if you choose to use it.

  • The edge of a couch or bench

• Time: approx. 30mins.

• Intensity: moderate – can still talk comfortably during the session.

• Pain: minimal increase from baseline, should feel same/better after.

Circuit:

	Exercise A	Exercise B	Sets
Warm Up	Pelvic floor activation – Squeeze the entrance to the vagina/anus Reps: 10 x quick squeezes, add 10 second hold x 3-4 reps	Gluteal activation – side-lying with clams whilst activating through deep abdominal core and pelvic floor. Reps: 10 each side	1
Exercise Circuit 1	Squat – moderate depth knee bend Progression: TheraBand around knees, dumbbells in hands Reps: 12, add x 12 pulses if able	Bicep curl – seated, dumbbell Reps: 12	2-3
Exercise Circuit 2	Split squat – standing supported against the wall, one leg slightly in front of the other Progression: dumbbell in hands Reps: 12, add x 12 pulses if able, each side	Wall push-ups Progression: lower body closer to horizontal Reps: 12 x through range	2-3
Exercise Circuit 3	Bridge with shoulders on edge of couch/fit ball Progression: add dumbbell into overhead press, add TheraBand around knees Reps: 12, add x 12 pulses of arms or hips if able	Low row – seated with TheraBand or dumbbell Reps: 12	2-3
Cool Down	Mobility– back mobility with cat-cow in hands/knees position, child’s pose with side bend Reps: 2-3 of each, 10-15 seconds of each with slow belly breathing	Stretching – hip flexor in forward kneeling lunge – can add side bend Glut/buttock stretching as comfortable Reps: 2-3 of each, 10-15 seconds each with slow belly breathing	1

Exercise is really important in your pregnancy both for you and your growing baby, talk to a women’s health physiotherapist about how you can make this part of your week. The Australian health exercise guidelines recommend strength twice a week which helps contribute to the 150-300 minutes of physical activity encouraged each week.

Author of this article:

Caitlin Stannard has a B.App.Sc-Physiotherapy with 1^st Class Honours at University of Sydney. Caitlin is a women’s health and musculoskeletal physiotherapist undertaking her Masters in Pelvic Health at Melbourne University. She works at Evoker Premium Physiotherapy in Martin Place in Sydney’s CBD.

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