Back Pain Pregnancy 1: Back Pain During Pregnancy & Strategies To Prevent It.
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Introducing Back Pain Pregnancy 1: Back Pain During Pregnancy & Strategies To Prevent It.
Many women experience back pain during pregnancy. Indeed, back pain pregnancy statistics suggest that 85% of women will experience back pain at some stage during pregnancy. So, should women simply accept they will experience back pain during pregnancy or are there strategies that can be employed to reduce the risk of pain and even avoid it altogether?
In this episode we discuss some of the physiological reasons why back pain commonly occurs during pregnancy and highlight the best practices that can be employed to help to avoid pain. We give considerations to the tissues that are often the source of pain and discuss preventative measures to minimise risk, as well as highlighting why some people suffer more than others.
Show Highlights
We discuss why some people will be more prone to injury than others and what you can do to minimise your risk of back pain. We discuss hormonal changes that begin in the early stages of pregnancy and how they impact the soft tissues of the low back, contributing to the risk of lower back pain and injury. Finally, we give consideration to the exercises that can be considered to support the back, and build resilience.
Interview Transcription
Speaker 0:00
When we’re young, we move with freedom and confidence with a great resilience to injury. But somewhere along the line we develop poor habits and become more vulnerable to back pain. Back Pain solutions features evidence based and practical advice to help you take back control of your health and get back to the activities you love. This is your guide to better back health through movement. So join us as we demystify some of the commonly held beliefs about back pain and build your confidence to a stronger back the smart way.
Ben James 0:28
Okay, welcome back to the back pain solutions podcast everybody with me, Ben James, and as always my co host, Jacob, stay. Hi, Jacob.
Jacob Steyn 0:35
Hi there, Ben.
Ben James 0:37
So today we’re talking back pain and pregnancy. So the evidence and research suggests that 85% of women are going to suffer back pain during pregnancy. I know my wife experienced some back pain herself. She gave birth last year to our daughter Hettie, and she was exercising. She’s healthy. She suffered some back pain. So, Jacob, is everyone going to just expect to suffer back pain during pregnancy? Is it just something that goes with the territory? Do you think? Or is there something that women can be doing to prevent it, or at least manage it?
Jacob Steyn 1:17
I think I think with a number like 85%, almost every woman can go out with the idea that they’re going to experience back pain throughout pregnancy, especially in the last stages. As you know, when my wife was also pregnant and gave birth to our son last year, coincidence, and also experienced low back pain, especially towards the end of a pregnancy. Yes, I think, yeah, I think a fair I think you have to definitely go out with the notion that you’re gonna suffer from low back injury and definitely have an approach to prepare for it at least.
Ben James 1:57
So you mentioned low back injury, there. You say low back injury or you just say low back pain? Because is it an injury that women are experiencing that’s causing the back pain? Or is it just something that goes with the territory because of the hormonal changes and the physical changes that is causing back pain?
Jacob Steyn 2:15
That’s a good point. I think there’s a little bit of overlap. And let me clarify. So your typical injury would be something that may come from specific postures or prolonged postures or job requirements that you have to fulfill with your body, you know, or a lack of strength to maintain structures being stable when you do stuff when you’re in a gym, for example. But I think, with women, when they’re getting pregnant, you always have these changes that they go through, which we’re going to discuss in a moment. And so they’re much more prone to actually developing low back pain. So I don’t know if we want to classify that as an injury but it can definitely lead to an injury because of prolonged strain on the tissues. And then you have a similar effect, you know?
Ben James 3:12
Yeah I think you mentioned about work, because that’s an interesting point, because most women are not in the privileged position that they’re not working, when they find out they’re pregnant. And they’ve got to continue working to a certain point in time, rather than just quitting the job, obviously. And so work postures and whatever that might be whether it’s sitting for long periods, or standing manufacturing work, whatever it is, there’s still going to be a period of work during that pregnancy. And actually what is known is that even early on from the first trimester, there are hormonal changes. So in those hormone mono changes, increased progesterone, relaxing, relax the ligaments to prepare for childbirth even early on, we see We see those changes. And so we’ve talked before about how the ligaments contribute stability to the spine. Now, we’ve talked also a lot about how the muscles are more important. And we don’t want to be relying on the soft tissues, the passive tissues such as the ligaments, but naturally, if you don’t have the control of those muscles, as we’ve talked about before, and you’re relying more on the soft tissues, and you’re going to be at increased risk of injury anyway, and that goes with people that are pregnant or not pregnant. But clearly, if those ligaments are relaxing, so early on, in the first trimester, we’re talking that time of the last period to 12 weeks, then clearly, there’s an increased risk there. If you slip then the likelihood of injury is going to be increased, but, but even so, with some of those micro movements, there’s local level instabilities that are potentially going to be worsened and therefore, there’s a definite increased risk of back pain. I think certainly in, in women.
Jacob Steyn 5:02
And Ben, what would you say? You know, a lot of our patients quite often they already have some sort of instability or or a relaxed tenderness or ligamentous tissue. Well, young.
Ben James 5:18
Yeah, I think this is the most important. Absolutely. I think your this is the point that I wanted to kind of focus in on, women are going to be an increased risk of injury because of those relaxed ligaments. But we’ve talked before how we don’t want to be relying on those relaxed ligaments, those passive tissues. So are women more vulnerable, because of a lack of conditioning ahead of pregnancy rather than directly the pregnancy? So for example, would there be guys out there with a similar lack of conditioning, that if they were to go undergo those same changes they would also experience back pain but because they don’t undergo those all interchanges, because clearly, they can’t get pregnant. They’re not at that increased risk, if that makes sense. That’s an interesting topic to debate, I think, because, like we’ve discussed before, often, the problem with low back pain is a lack of conditioning around the core muscles, the endurance and understanding of spine neutrality and stability. That is the root cause of the problem. Now, clearly, if you’re going to increase that risk of instability, then clearly the risk of injury, or the risk of back pain is is increasing.
Jacob Steyn 6:39
So Ben, would would you say yoga would be a good way of training and preparing as a as you’re approaching pregnancy?
Ben James 6:53
Well, it’s interesting because Yoga is often one of those things that, that people a the general population, it’s a popular activity for a lot of people in terms of overall health, not just with a focus on low back pain, but certainly women that are becoming pregnant seem to kind of focus in on yoga, certainly over here in the UK, it seems to be one of those activities that they like to do from a relaxation point of view more than anything, it makes them feel like they’re doing something, they’re staying healthy, etc, etc. And, you know, that’s, that can’t be a bad thing, because it can be a stressful period. Yes, it should be a period that is enjoyable but it can be a stressful period, because there’s so much to think about in terms of preparation, and you’ll know that and I’ll know that from from having children very recently. There’s so much to think about. There’s so many things to prepare for. So doing anything that can relax you mentally is a good thing. Now, the problem I have with yoga is quite often it’s focused on flexibility. It’s focused on stretching of, of the lower back, or it certainly incorporates movements that stretch.
Jacob Steyn 8:00
Especially flexibility through the joints, right.
Ben James 8:03
Exactly. And this is, this is the thing. Now if it’s focused on the hips, as we talked about before, then that’s a good thing. We want flexibility and movement in the hips, but we don’t want it through the low back. So if you’re now pregnant, and you’re at an increased risk of injury, because those ligaments are becoming more relaxed, really early on, and then you’re doing yoga and stretching through the low back, then that is a concern, because that the movement and the flexibility through that low back could then lead to injury and certainly increased pressure on some of those tissues that we know cause pain and that we want to avoid.
Jacob Steyn 8:40
Exactly. So would it be fair to say that we’re we’re going to stretch those ligaments, joint capsules, recreating a lot of mobility between the vertebrae and the low back, for example. And now we get this effect of the hormones on top of that. And then quite often we wonder, why do I not have the necessary stability to look after me during pregnancy?
Ben James 9:05
Exactly. It’s almost a vicious cycle. In that case, you know, you’re, you’re you’ve potentially got some underlying instability anyway, because of a lack of conditioning. Same with a lot of the general population, then you become pregnant. And in those first 12 weeks, you you notice or I say, you notice, you will experience hormonal changes, those hormonal changes, hormonal changes, will increase your risk of ligament laxity, which is a good thing for childbirth, further down the line, but it’s not a great thing for spine stability if you haven’t got control of those muscles and the awareness of spine stability, then potentially, you’re adding yoga as an exercise in there that is stretching the low back, then it’s a vicious cycle because now you may feel some instant relief, that stretch reflex that we’ve talked about before, that causes some relief of those symptoms, but it’s not a good thing over the long term, so then you kind of repeat or you might do more and more yoga when in the hope that it’s going to help with your problem. But actually, the problem is just going to get worse. And then throughout pregnancy, you then start to add on the weight gain factor. And then you’re even more vulnerable, and you’re putting more pressure on those tissues. And then the back pain potentially gets worse and worse.
Jacob Steyn 10:22
I want to say, that’s usually where what you mentioned before the unwanted micro movement comes in. That’s when we, if I may explain that’s where we don’t have the necessary neuromuscular control. In other words, the brain communicating to the muscles to actually keep something stable. And now the ligaments and the discs and everything that are supposed to give us an added stability or the integrity of the joints now undergoes this micro movement, which can cause damage of the discs and the joint capsules.
Ben James 10:58
Exactly, exactly. And I suppose the message there is You’re no different to a lot of the general population and by the general population really what we’re saying what we’re talking about men who can’t become pregnant. So they’re not going to experience those hormonal changes, but a lot of them will have that underlying instability, that deconditioning, because they don’t know how to control those muscles, or they’ve got no endurance of the muscles that surround the spine and support the spine. And so it’s important for spine stability. So that is a common factor that we find. The problem with women that become pregnant is the hormonal changes can lead to laxity in the ligaments. And so those passive tissues that you’re now more reliant on because of a lack of control of those muscles or conditioning, those muscles, those ligaments becoming more lax mean, you’re at increased risk of injury, local instability as you talk about Jacob that can then influence, irritation of discs and other material that can become damaged, potentially leading pain or that instability that local level movement is in itself causing that discomfort, add yoga into the equation, particularly, we’re talking specifically about movements that flex or move the lower back stretching the lower back, then you’re going to compound the issue, for sure. Now, that’s not to dismiss yoga completely, because if it’s very much focused on hip mobility and keeping neutral spine, then great, you know, then it could be really beneficial for you. Pre pregnancy during pregnancy, it can be really helpful. What we’re saying is just be careful with those particular moves that do stretch the low back and take it out of neutral because that is a potential problem for for women during pregnancy and in the general population as well. Let’s be honest, again, it’s just compounded because of these hormonal changes. The physical changes that are experienced during pregnancy, which can’t be avoided, let’s be honest,
Jacob Steyn 13:06
For the general population, but especially for pregnant women or women who are thinking of getting pregnant, I would say, having the or going for the approach of weight training, where you consider spine sparing exercises. And if you’re, if you’re a complete novice in this, you might want to get guidance from somebody who knows more about this would be a better option than going for the yoga path. Especially to start with.
Ben James 13:38
Yeah, I agree. And I think if you if you haven’t done but again, if I think if you haven’t done those movements in the past, then I think the focus should be more on the endurance than the strength. I think that’s a that’s a factor that is often confused. People often think if I get stronger, than I’m going to have a healthier spine. That might be the case you do the right exercises. But quite often, extra strength or strength gains need more pressure. And if you haven’t got that underlying endurance and stability, then that’s an increased risk as well. Again, general population people going to the gym. But I think the focus here should be more on the endurance and those exercises that help to absolutely keep the spine neutral, helped to create stability and create endurance of those muscles. Because over time, as your as you gain weight during and throughout pregnancy, then those muscles are going to become more fatigued more quickly. And therefore better endurance is going to be much better than better strength. I think that’s absolutely key.
Jacob Steyn 14:42
Absolutely. I agree there the endurance is always the first step.
Ben James 14:47
Exactly. Exactly. Yeah.
Jacob Steyn 14:49
So
Ben James 14:50
I guess the question sorry to jump in Jacob there. We’ve kind of we’ve we’ve thrown a lot of information out there. A lot of people are going to be saying Well, okay, so if I do a lot of this stuff, before I’m pregnant, and in some cases, that’s difficult because unless you’re trying to get pregnant, then there’s, you know, the thinking about low back pain and preventing low back pain isn’t your number one priority? But let’s say pre pregnancy or, or even in the early stages of pregnancy, is it something that can be avoided through building endurance? That’s a big question I think.
Jacob Steyn 15:28
And I think that’s a good question because we, we have, you know, we have so many possibilities when we prepare for things. If we don’t prepare, we’re leaving it up to chance. And then we might end up in that 85% bracket, or we’re going to end up with back pain and I’m not saying the the goal should be not to have back pain at all. Because I think as you progress through the pregnancy, you reach a point where, you know, the weight in the front and losing the The muscular function in the front because of the belly being so big, just especially for some body types, some woman will experience a lot of difficulty to actually manage doing their or doing the usual things another day So, but you know, anything you can do to limit the possibility of it getting really bad, or increase your chances of self functioning and having normal days with rest periods in between. That should be the goal. And it starts with what you’re doing already before pregnancy.
Ben James 16:38
Yeah, I think that’s a good point. Limit the risk of back pain because I’m not aware of any studies, any research there that has followed a cohort of women pre pregnancy that have been split into an activity group focused on spine sparing exercise for core strength and back stability versus you know, a control group of doing nothing, for example, I’m not aware of any study that has done that. And so knowing the results of that such research, you know, without conducting it, we don’t know for sure that that that would prevent back pain. But for sure, we know that these factors, whether it be anterior abdominal endurance, overall spine, endurance, healthy neutral, brace, all of these factors that contribute to spine stability and spine health, we know how effective they are at managing back pain. So common sense says, if we know that in advance of any back pain, then that’s going to be a good thing. So the same rule applies. So women during pregnancy or pre pregnancy if we’ve got that insurance got that knowledge of back health and back stability there Clearly, you offset some of those increased risks and those hormonal changes, you offset some of that surely, to help limit the risk of back pain?
Jacob Steyn 18:10
Absolutely. I want to just add to that, because I’ve seen a considerable number of pregnant women, usually as patients. And I just always think, you know, quite often, like anybody, not only brilliant woman, but we all quite often end up in an injury, we think back, oh, you know, I could have prevented this. Or maybe if I spent a little bit of time just informing myself about what I can do to prepare myself as my body is going to undergo huge changes. I would have maybe prevented being in this dilemma of, you know, really bad back issue when I’m having to deal with the fact that I’m pregnant. I mean, those are two big things you have to deal with at the same time. And so Like we’ve said a few times now, I think, you know, if I can say something, it would be spent a little bit of time, find out about what you can do, especially with managing your hormones. Because if they’re offset to start with, they quite often just get even more offset during the pregnancy. And that might lead to weight gain, it might lead to other problems. But especially what you can do to prepare your body because, you know, nine months is a long time and especially if you think that the first half of the pregnancy when your baby’s not that big, it’s going to be alright, but especially the last half, it becomes quite a challenge. And those who had children already will testify, as you know, when your wife and my wife we live next to it. So, my what I would suggest is just really make some effort and find out about these things and, you know, start making a little bit efforts towards preparing your body and you’re gonna you’re gonna really enjoy the results.
Ben James 20:05
Yeah, I think and like you say, I mean, hindsight is always a wonderful thing. And there’s going to be very few women that I think are listening in and thinking, right? I’m listening to this podcast to prevent my risk of back pain during pregnancy. That’s gonna be very few individuals because it’s always when you’re experiencing pain. Or maybe you’ve maybe there’s some people that have had friends, family that really experienced back pain during pregnancy and therefore they they are listening to do everything they can to avoid it. But hindsight is a wonderful thing. But I think even during pregnancy, if you’re pregnant now and you’re experiencing back pain and discomfort, then there are always exercises that you can be doing to help build endurance safe for the spine, safe for fetal development that you can be doing to start to build that endurance even now, because we know you know, there’s a lot of evidence now supports the continuation of exercise particularly for people that have been doing a lot of exercise in a considered pretty healthy, maybe even athletic, pre pre pregnancy. So, what always, you know, seek certain advice from from doctors seek some guidance. If you are if you haven’t done exercise before, and you’re thinking of doing any high intensity kind of work, but, but we’re really talking about low intensity, intensity work that is spine stabilizing exercises, because you can you can build that in endurance and start to build that endurance because it’s as important postpartum, as it is, in terms of preventative work, because we’ve talked a lot about pre pregnancy, but actually the reality is post pregnancy. There’s there’s increased risk because you’re lifting the baby or lifting it baby out of a court, put in it in the car seat in a pram, etc, etc. That’s the bonus recovering, and the body’s recovering. So these hormonal changes don’t suddenly revert, once baby’s born, it’s going to take some time and there is definitely an increased vulnerability then, and particularly at that stage, because if we imagine that the muscles of the abdominal wall are going to extraction expand as the baby grows, the tension on those muscles is retained as that baby grows, because the growth of the baby continues to put pressure on the muscles and tension on the muscles. But as soon as baby’s born, then suddenly those muscles don’t revert back to pre pregnancy tension as it were. And so the muscles that we know are so important, the spine stability as suddenly a little bit lacks a little bit slack, you are definitely more vulnerable. Because even if you’ve got the control and the endurance of those muscles at that time, or you’ve done a bit of work pre pregnancy, and you consider yourself pretty healthy, then you’re still going to be a great vulnerability. So if you’ve done nothing of that, then definitely your risk is increased.
Jacob Steyn 23:05
And you the exercises been that you’re talking about. They are not heavy or high intensity exercises. These exercises are small, very basic light exercises, which you can build up a little bit. But they’re not going to put a lot of strain on the body, and they generally very safe. So, so those exercises that you said, you know, it’s they’re not high intensity, low intensity, they’re easy exercises. But it’s one of those things, it’s if it works well, the effect of your exercises on your body, that those little and small movement exercises has such a huge impact on your daily life and maintaining normal movement, which if the movement is just offset a little bit, but repetitively That’s where you have the chance of getting a back injury or any other injury. So I want to emphasize what you said they’re small exercises, very gentle. Obviously, depending on your level of physical ability, you can build it up a little bit. And like you said, also doing them as a maintenance or having them as maintenance exercises throughout with a plan, of course, can give you so much relief throughout the pregnancy.
Ben James 24:31
Absolutely. And, you know, just jumping in there, Jacob these exercises, again, back to the general population, these are exercises that would be just as beneficial for the general population, non pregnant women or or men that clearly can’t get pregnant. So then on always non pregnant, but these are exercises that would be beneficial for everybody in terms of neutral spine, spine stability endurance. That would always be recommended and would always form part of a rehabilitative program for low back pain, low back discomfort. And it’s probably a good time. Just to mention about the the ebook we wrote, that includes a lot of these advice, this advice in terms of avoiding pain triggers, and learning key movements that are going to be spine sparing and contribute to the endurance of the abdominal wall and also the extensors the obliques, all those muscles that form a barrel around the spine that contribute and is so fundamentally important for spine stability. These exercises are just as relevant for the ladies that are pregnant as they are for other sufferers of low back pain. So head on over to www.smartstrong.co.uk and you can get a free copy of the book there a lot of information, a lot of content that really will provide a great guide and blueprint for you to really start to take control of your your back pain within the next seven to 10 days. Just empowering to give you that knowledge to be able to take some control because that’s often one of the most frustrating things for anyone with back pain, but particularly for women that are experiencing discomfort and back pain. This is not the focus for your journey through pregnancy, you don’t want to be worrying about the back pain is the as the fundamental thing at the front of your mind, you want to be looking forward to the birth of the baby and all the excitement that comes with it. You don’t want to be frustrated by the back pain. So head on over to the website and get a copy because it it really will help give you more info more insight to help you take back some control. Because like we say, it’s not a nice experience when you’re not pregnant. So I know for sure that that Han towards the end of pregnancy was getting a bit frustrated with with back pain. And I just want to introduce that a little bit in that that story because, as I say hands healthy, regularly goes to the gym, heats up pretty good diet I would say very well balanced, etc, etc. But she experienced some discomfort. But I realized the complacency from my end, because she’d never suffered. I didn’t really scrutinize her movement patterns. And there’s undoubtedly some of the movements she was doing towards the end of pregnancy that weren’t healthy for the spine. And as that baby develops, and the tummy starts to expand, some of these movements become more and more difficult. But actually, some of the spine sparing techniques become more and more important because you’ve got to move differently. And in moving differently, you start to get yourself in weird and wonderful positions, positions that actually aren’t greatly beneficial for the spine. I think that was a key for him to focus on with some of these healthy movement. And Jacob you probably saw the same because Marisha again was very healthy goes to the gym. But there’s certain things that just fundamentally start to happen. Bad Habits start to creep in because of these changes, and it’s important to be aware of those to support back.
Jacob Steyn 28:08
Similar story Yes. And especially now because our boys five and a half nearly six months old, six months young and now especially, we’re paying a lot of attention how she’s moving because she did experience low back pain also after the birth of our son and it’s, she’s doing very well now it’s almost as good as gone as long as she pays attention to how she moves, lunging, you know, she’s of Bulgarian heritage so she can do a an Eastern European deep squat with very good technique and you know, that’s actually picks them up from the floor and always square on to the bed or to the court. And, you know, she’s in an upholder says she follows the rules and I only have to tell her once and then she gets on with it.
Ben James 29:01
Yeah, no, I know you mean I mean, it’s, it’s it is definitely a hugely important subject though post postpartum, when you’re starting to lift, what becomes a significant weight. You know, when you’re trying to lift out of the car, I’m always saying to hand keeping that spine in neutral and she’s become so good now at kind of keeping that back straight and almost the modified golf is lift to get the hell out of the car. Because growth, otherwise, it’s very difficult to do. And there must be so many people that if you’re, if you’re experiencing back pain, and you’ve given birth, just think about some of those movements when you lift your baby out of the car. How is your back position, your posture during that movement. There’s going to be a lot of people that are just bending through that back and if that’s what you’re doing, you’re experiencing back pain, then that is absolutely a pain trigger. Most likely for a lot of people and This is one of the things we focus on, we have to remove the pain triggers. So how can you get that baby out of the cart, and keep your back straight and arch over those hips. This is where hip mobility and hip flexibility that we talked about a short while ago, it becomes so important, because the movement has to come from the hips. If you keep the back straight and be able to get the baby out of the cot as one example, no, Jacob, you mentioned getting a baby off the floor. Similar rules apply. You’ve got to keep that back straight.
Jacob Steyn 30:30
And we don’t want to scare people. But even if you don’t have pain at the moment, not paying attention or how you pick up the baby from a bed or out of a quarter from the floor will most likely lead to developing back pain or some sort of protective behavior. You know, you don’t necessarily have pain but something’s going on with your back. And then quite often you’re treading on ice and that’s what we don’t want to do. We want to avoid even going in that direction. When you move without picking up weight, and your back is feeling good, you have more freedom to move through the back. But when you pick up weight, like our son is now, eight and a half kilograms, you won’t believe. At five and a half months, I was told that’s quite heavy. Then you need to, you need to pay attention to your form. You need to know how to brace you need to know how to keep the shoulders low when you pick up that weight when you’re bending forward.
Ben James 31:31
Yeah, and it’s all of that advice. Again, you know, not wanting to reiterate that message that we would advise anybody suffering from back pain, it’s bracing the core is engaging the lats, bringing that weight close to your body, you know, so that you can pick up effectively and deploy the right muscles and save the spine and, and this has become even more important for us now, as you know, Hettie was diagnosed with hip dysplasia. She’s just had an operation is now in a spika cast. And for those that don’t know what that is a spika cast is from the chest down to both ankles. And that’s going to be for a period of three, four months. Now that is a significant additional weight. And if we’re not employing these spine sparing techniques, then all of the movement is coming through the low back. And anyone that hasn’t suffered from back pain and has been lucky enough to be part of that maybe the 15% that haven’t experienced back pain, pre during pregnancy, you are absolutely at increased risk. Once that weight is added to your life in terms of picking up the floor, picking out your car, getting out of a car seat, getting out of a pram, all of these things become potential risk factors that you never had before. And back to what we’ve said earlier in the show that instability or that lack of control of the muscles that inherently is there for a lot of people in the population that now is a fundamental problem when you’re trying to lift this dead weight off the floor of the car, etc, etc. and you are going to be at risk if you don’t pay heed to this information and start to make some consideration for spine sparing techniques because it is it is a big problem post pregnancy for sure.
Jacob Steyn 33:19
I think, Ben, why don’t we mention a couple of topics that we’ll discuss in the next podcast like especially talking about weight gain diastisis recti.
Ben James 33:32
Yeah, I think yeah, there’s a lot of information that we could talk around in terms of of pregnancy today, though, you know, we focused in on the hormonal changes and, and how that they can increase your risk compared to non pregnant women or certainly the general population of men out there as well who don’t have this stability, that it’s just that increased risk factor rather than it is a specific reason why pregnancy can cause back pain. So to kind of clear that message there, these hormonal changes just exacerbate fundamental instability that’s already already there for a lot of people. That’s the problem. But as we work through that journey of pregnancy and that weight gain occurs, there are increased pressures on specific muscles. And that risk, or that incidence of diastasis recti, which is what we’re going to focus in on on the next episode, because there’s a lot of content to discuss that we don’t want to focus in on overall people in this one episode. So the take home message here is you’re going to experience hormonal changes that you can’t avoid. That’s going to happen during pregnancy. If you’re listening and you’re pre pregnant, then there’s certainly work that you can do in terms of spine stability, muscle endurance, that’s really going to help set you up for that journey and put you in a much more positive, beneficial position to avoid back pain during pregnancy. But if you’re already pregnant and you’re suffering some discomfort, don’t be despondent because there are things you can do to manage it and set yourself up for better spine health post pregnancy, which is also very important. So, the focus on the next episode is going to be all about diastasis recti, weight gain, and some of the impact that that has on the muscles particularly the extensors that the research has shown. So, reiterating the point from earlier, get on over to the smart, strong coda UK, download the ebook, lots of information there which will help support the journey give you some reassurance that you can manage this discomfort can manage the problem, and then we’ll talk to you on the next episode about sweating and weight gain, and how we can manage that and particularly some of the exercises. Next we want to focus on postpartum which is really, really important. Jacob, anything you want to add before we close on this show?
Jacob Steyn 36:03
Yeah, just a quick point, I want to say, you know, we’re so far removed from our natural environment. So if you’re pre pregnancy, get busy preparing your body get information about what would be the best time. You know, we’ll be discussing that also a little bit in the next podcast. But just get it get busy preparing your body and your mind. And you know, and knowing what to expect. That would be my message.
Ben James 36:32
Yeah, I think a good point there on the nutritional side of things. We’ll definitely focusing on that on the next show. And that’s not just about avoiding or managing some of the weight game, but it’s just regarding general again, health, managing inflammation and a healthy journey throughout pregnancy. So we’ll catch you again on the next episode. Thanks for listening in. As always, give us some feedback on iTunes. Any ratings help with the show, get the message out to additional people that are suffering from low back pain, not just women experiencing pregnancy. We always appreciate the support. We’re seeing some increasing ratings and reviews so far in the last few weeks, which is great to see. So thanks again for those that have gone over and put a rating on iTunes for us. And we’ll see you again on the next show.
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