Pelvic floor physiotherapy for all women in Cambridge and beyond

Your pregnancy posture explained. Tips on how to stay fit and pain free during pregnancy.

by Kathryn Levy, DPT, CSP | 15 December 2020
Kathryn Levy smiling at the camera in a black top

Congratulations on your pregnancy

Whether this is your first, second, or third pregnancy, your body is about to change in the most amazing way. These changes may often bring about lower back pain, pelvic girdle pain and/or pelvic floor symptoms. Your posture will change dramatically during your pregnancy, and it is often these biomechanical changes that can bring on joint/muscle pain or pelvic floor symptoms.

So, let’s take a closer look at how your posture changes during pregnancy, the impact these changes may have on your strength and mobility, and tips on how to keep fit and strong throughout.

What happens to your posture during pregnancy?

During pregnancy, there is an immense stress and strain on the muscles and ligaments surrounding the spine and pelvis. Muscles and ligaments stretch and there is more pressure on your joints. As your baby grows, there will be considerably more stress on your pelvis, abdominal wall and pelvic floor muscles.

As your baby grows, your centre of gravity will move forward and down causing an increase in your anterior pelvic tilt. This will cause an increase in your natural lordosis which is the curve of your lower back. These changes can lead to muscle imbalances around the spine and pelvis which can cause lower back or pelvic girdle pain. If you are someone who has struggled with lower back or pelvic pain in the past, you are more at risk for developing pelvic girdle pain during pregnancy.

Your rib cage expands, and your respiratory diaphragm will move upwards 2-3cm. This can lead to pain around the ribs and shoulders. It can also cause other problems such as reflux and shortness of breath. These changes may also have a significant impact on your postnatal body and make it more difficult to strengthen your abdominal and pelvic floor muscles.

Your knees may hyper-extend and your foot arches may collapse. This matters more than you think. Both of these mechanical changes can cause knee and/or foot pain. More importantly, these changes may impact your ability to recruit your hip and leg muscles during walking and exercise which can lead to glut insufficiency and pelvic girdle pain.

During your third trimester, there is considerably more stress on your stomach and pelvic floor muscles. There will be a natural separation of your recti abdominis muscles and a widening of your linea alba, the connective tissue that lies between the two muscle bellies. You may start to notice that your abdominal muscles form a cone shape above or below your tummy button when you move in a certain way. You may develop pelvic floor muscles symptoms like urinary leakage or a vaginal heaviness.

Now these changes are normal, and our bodies are designed to accommodate them. Many women will move through pregnancy without difficulty or pain – but for some, these changes can cause pain and discomfort particularly around the lower back and pelvis.

What can you do about it?

First and foremost, pregnancy does not and should not equate to pain and discomfort. While it is common to suffer from lower back pain, pelvic girdle pain and pelvic floor symptoms, it is not normal. It is important to discuss your symptoms with an antenatal specialist physiotherapist who can provide safe and effective treatment for your symptoms.

Tips to get started.

  1. Keep moving. Research supports women staying active during pregnancy. It is important for both health of mum and baby. Unless you have been advised to stop exercising either from your GP, consultant or mid-wife, it is safe to exercise during pregnancy. It is important to try and stay fit with a combination of gentle aerobic exercise, strength and pelvic floor exercises. If you have questions about your current exercise programme, your antenatal specialist physiotherapist can help you modify and make any substitutions necessary so that you feel confident in continuing.
  2. You will notice the most obvious change to your posture during your second trimester. This makes sense. This is when there is a big change in your baby bump which can take months to show up, especially if it is your first pregnancy. During this trimester- maintaining your strength is key. Focus on exercises that target your gluts, back and chest. Make sure you are incorporating gentle pregnancy-safe core strengthening and pelvic floor exercises if you haven’t already.
  3. During your third trimester things will start to get a bit more complicated. You may find it more difficult to move freely, and you will start to feel the stress and strain on your abdominal muscles and pelvic floor. you may even show early signs of diastasis recti abdominis (DRA) and pevlic floor muscle (PFM) symptoms.
  4. During your third trimester – maintaining your mobility is key. Try and keep your muscles and joints moving freely in all planes. Focus on stretching your chest, back and hip muscles. In preparation for birth, you want to introduce controlled relaxation and stretch of the pelvic floor muscles.
  5. For your knees and feet – consider your footwear. Wear a supportive shoe with a flexible sole and arch support. Some women may benefit from a soft heel cushion in their shoes to help reduce hyperextension of the knee.
  6. Do not ignore your symptoms. If you have any pain or discomfort or develop early signs of diastasis recti abdominis and/or pelvic floor muscle problems, an antenatal specialist physiotherapist can help. We can provide safe, effective treatment and a tailored exercise programme to help keep you fit and pain-free throughout your pregnancy.

At Prima Women’s Health, we offer a unique Pregnancy Wellness programme that supports women from 12-weeks in pregnancy until 6 weeks postpartum.

For more information on our range of antenatal services please visit the antenatal section of our website.

Join the Prima Women's Health community

Join the Prima Women's Health community to receive our updates, educational resources and exercise videos dedicated entirely to women's health.