It has been estimated that about 50% of pregnant women will suffer from some kind of lower back pain at some point during their pregnancies or during the postpartum period. Studies estimated that 50% of pregnant women will suffer from LBP. One third of them will suffer from severe pain, which will reduce their quality of life. These exercise’s will improve quality of life as well as reduce any lower back pain that is already present. These exercise’s will also prevent any postpartum pains felt afterwards. 

 

  1. Pelvic Clock Exercise

12 o’clock: Slowly draw in your stomach muscles toward your spine as you roll your front hip bones toward your head and flatten your back onto the mat. This puts your pelvis in a “posterior tilt.”

6 o’clock: Drop your front hip bones down toward your feet and roll onto your tailbone. The stomach muscles will relax and your back should arch off the mat slightly. This puts your pelvis in an “anterior tilt.”
3 o’clock: Drop your left hip bone down toward the mat and as you do your right hip bone should lift toward the ceiling. Be careful not to hike your hip up toward your shoulder. You want to feel that your pelvis is trying to face left. 9 o’clock: Repeat as for 3 o’clock but drop your right hip bone down toward the mat, lifting your left up one toward the ceiling. The pelvis will try and face to the right.
Clockwise: Sweep around the clock, touching each number in a clockwise direction Counterclockwise: Sweep around the clock, touching each number in a counterclockwise direction.

 

2. Standing Push up

  • Standing, facing a wall, feet pointing straight forward, shoulder-width apart, and approximately an arm-length away from the wall.
  • The palms are placed on the wall at shoulder height.
  • Have the woman slowly bend the elbows, bringing her upper body close to the wall, maintaining a stable pelvic tilt, and keeping the heels on the floor.
  • Her elbows should be shoulder height. She then slowly pushes with her arms, bringing the body back to the original position.

3. Supine bridging

  • Supine in the hook-lying position.
  • Have the patient perform a posterior pelvic tilt  and then lift her pelvis off the floor.
  • She can do repetitive bridges, or hold the bridge position and alternately flex and extend her upper extremities to emphasize the stabilization function of the hip extensors and trunk musculature

4. Quadruped leg raising

  • On hands and knees (hands may be in fists or palms open and flat).
  • Instruct the woman to first perform a posterior pelvic tilt, and then slowly lift one leg, extending the hip to a level no higher than the pelvis while maintaining the posterior pelvic tilt
  • The knee may remain flexed or can be straightened throughout the exercise.
  • Monitor for stress on SI jt. or ligament

If the woman cannot stabilize the pelvis while lifting the leg, have her just slide one leg posteriorly along the floor and return

5. Modified squatting

  • Wall slides and supported squatting exercises are used to strengthen the hip and knee extensors for good body mechanics and also to help stretch the perineal area for flexibility during pregnancy.
  • In addition, if the woman wishes to use squatting for labor and delivery, the muscles must be strengthened and endurance trained in advance.
  • Standing with back against a wall and her feet shoulder-width apart.
  • Have the woman slide her back down the wall as her hips and knees flex only as far as is comfortable, then slides back up
  • For optimal success with squatting during stage 2 of labor (pushing), increase the duration of the squat gradually to 60 to 90 seconds as tolerated.

6. Corner press out

  • When scapular retraction exercises become difficult in the prone position, the woman should continue strengthening in the sitting or standing position

 

7. Perinium and Adductor Flexibility

 

  • flexibility exercises prepare the legs and pelvis for pregnancy
  • Supine or side-lying
  • abduct the hips and pull the knees toward the sides of her chest and hold the position for as long as is comfortable (at least to the count of 10).
  • Sitting on a short stool with the hips abducted as far as possible and feet flat on the floor. Have her flex forward slightly at the hips (keeping the back straight), or have her gently press her knees outward with her hands for an additional stretch.

 

References:
Therapeutic Exercise: Foundations and Techniques, 6th Edition
Katonis P, Kampouroglou A, Aggelopoulos A, et al. Pregnancy-related low back pain. Hippokratia. 2011;15(3):205-210.