Have you ever wondered what Chiropractic care in pregnancy looks like? Having been through 4 pregnancies with pelvic girdle pain and difficult recoveries trying to rebuild my pelvic floor and core, I have a lot of experience in how to support your body through pregnancy and the postnatal period.
In this blog post, we will revisit the biomechanical changes your body goes through during pregnancy and postnatally. We will then look at how chiropractic may support your pregnancy journey and beyond, including some self-help tips you can do at home.
Biomechanical Changes in Pregnancy
During pregnancy, your body is going through many changes. The hormone relaxin helps prepare your pelvis for birthing babies with large heads. Humans have evolved to have very large brains, but because we walk upright on two legs, our pelvis remains fairly narrow in comparison. So humans are born fairly immaturely before baby's head gets too large to fit through our narrow pelvic outlet (compared to other mammals, who are walking within a few hours, we take a good 12 -18 months or so to mature to that stage). To ease up the whole journey, relaxin loosens all the pelvic ligaments so that your pelvic girdle can flex and stretch as baby's head descends through to the birth canal. Your sacrum and coccyx are designed to lift out of the way, which is why giving birth on all fours, squatting or standing is easier than flat on our backs! This is all perfectly designed. However, relaxin doesn't just target the pelvis. As a circulating hormone in your blood stream, all of your ligaments get a bit loose. This can flare up old injuries, predispose you to new ones, and your postural muscles have to work overtime to hold you upright to compensate for the fact your joints are rocking and rolling.
Add to this a whopping 10-12.5 kg of average weight gain during pregnancy (NHS, 2022), most of this on the front of your body (bump and boobs), your spine changes it's curvature to compensate and your back, neck and buttock muscles can end up pretty achy at the end of each day.
I want to add a little ode to the sacrotuberous ligament at this point. An often overlooked yet fabulous little stretch of wonderful stretchiness, this ligament spans the back of your pelvis from your sacrum to your sits-bones. This is often a site of achiness as this marvellous ligament gets a battering in pregnancy and birth. Massage across this ligament can give so much relief in those suffering from low back pain, buttock pain and sciatica in pregnancy. I like my pregnant clients to give this ligament a bit of extra love with gentle hip and pelvic openers, self massage and pelvic circles on a gym ball.
Recovery Postnatally
The changes that have occurred slowly over the course of the past 9 months, don't suddenly spring back into place. You'll immediately notice an improvement in how much weight your body was having to carry around and for some, this is enough to resolve a lot of the aches and pains they experienced during pregnancy. However, the hormone relaxin takes months to return to it's pre-pregnancy levels, and your posture will still be affected by your core strength recovery, and the fact you are now lugging around a newborn and all their stuff! Your pelvic floor can take a while to recover regardless of how you gave birth, so even if you have no symptoms or urinary and/or faecal incontinence, it is worth taking the time to ensure you reconnect with your core and work on rebuilding your pre-pregnancy stamina and resilience. I consider the postnatal period to be at least 12 months after giving birth; it took 9 months of dramatic changes to build and birth another human being, it makes sense to take at least that time to rebuild your body back together. At the time of writing this, I am 4.5 years postpartum and am still slowly getting back to the strength and stamina I had before I started having children 12 years ago. It is a journey! The more pregnancies and births you go through, your age, whether you birthed multiples and your general overall strength and fitness going into pregnancy all impact on your recovery. Lets not forget that tiny humans are time and energy sponges too, making it harder to concentrate on rehab and rebuilding a body that lasts. It all takes time.
Chiropractic Care in Pregnancy
Chiropractic care is suitable for most people throughout their whole pregnancy. If you are used to regular chiropractic adjustments, then modifications are made to accommodate your bump and the natural loosening of your ligaments and joints. I tend to stop high-velocity, low amplitude chiropractic adjustments until 3 months postpartum, unless there is a specific need for it, in preference for mobilisation instead. This is just the way I work, opting for fine tuning versus overall pummeling. Treatment at Melyn Chiropractic involves pregnancy massage, gentle stretching, gentle mobilisation of any joints that may be a bit stiff and a focus on the ligaments and musculature of your pelvis in preparation for birth. A rebalancing of the pelvis and spine as it were, including your mid-back and neck, so that everything is moving wonderfully and you are way below that painful threshold by the time you enter labour.
I have a special and truly fabulous pregnancy pillow which supports all parts of your pregnant body and is adaptable as you move through the second and third trimester. I continue to use the pregnancy pillow postnatally until you are comfortable lying on your tummy without it. This is brilliant for those who have had a C-section as it eliminates any pressure on your incision. Some clients continue to use it whilst breastfeeding as no-one likes a sore boob during their treatment, especially in the early days where milk supply is settling down.
The most valuable part of treatment is the assessment of your changing body and the information and knowledge you receive as to how to manage any aches and pains at home. I also equip my clients with the resources they need to support their birth and recovery. These are completely tailored to you, no one pregnancy or postnatal recovery is the same.
Pregnancy massage and postnatal massage are brilliant ways of reducing stress and increasing the love hormone oxytocin. Massage is such a wonderful tool in fact, that I have had many full-term (after 38-40 weeks) clients go into labour within days (one lady, gave birth within 24 hours) of getting that oxytocin boost needed to allow an overdue labour to initiate. Other benefits such as improved sleep and better mood all apply with chiropractic treatment. Sometimes we just need someone to take care of us so we can carry on taking care of others.
Self-help for the Achy
If you are finding pregnancy tough or are just in need for some TLC and relaxation with a good pregnancy massage, get in touch.
Pregnancy is a huge period of change and getting ahead of those aches and pains will pay off in your recovery and your ability to show up fully as a new parent. The old adage of putting your oxygen mask on before helping others, really applies here. You cannot pour from an empty cup!
My top three tips (out of many) for keeping your body going through pregnancy are as follows:
Treat your pregnancy like a marathon, not a sprint! You are doing an enormous task of building a new human being. Go easy on yourself. Think of each day as a mammoth workout and take the time to hydrate, nourish yourself, and stretch and mobilise. I have a fantastic pregnancy routine that takes 5 minutes to do and helps reset those overworked muscles ready for the next day. Don't forget to support your pelvic health with a decent core routine including pelvic floor exercise. Contact me for further information.
Sleep well. Get yourself set up with a pillow between your knees, your pillow at the correct height under your head and on a supportive surface, so that those 6-10 hours spent on your side are working for you, not against you.
Keep moving and changing position if you are not moving. Never underestimate the benefit of taking a short (or long) stroll around the block, even if you are feeling like you have the worst hangover known to man (thank you pregnancy sickness) or that you are lugging around a baby rhino strapped to your front. Just a bit of fresh air and getting the blood circulating can do wonders for your core stability and overall wellbeing. If you are desk sitting, set an alarm every 30minutes so you change position regularly to reset your spine. I teach clients how to do a check of their desk set up so that they don't end slumped over like a prawn.
I hope some of this information is useful. It is not uncommon to feel a bit like you're doing an ultra-marathon during those 9 months and most of us need a bit of extra support during these great times of change. There is lots you can do at home to give yourself some respite from any aches and pains. Chiropractic care and massage are excellent tools for reducing pain, improving mobility, encouraging better quality sleep and better mood and preparing your body for birth. Rehab and improving your core stability including your pelvic floor, can help in your recovery journey too.
Remember, a marathon not a sprint! Take the time to take care of yourself.
References:
Dehghan F, Haerian BS, Muniandy S, Yusof A, Dragoo JL, Salleh N (2014). The effect of relaxin on the musculoskeletal system. Scandinavian Journal of Medicine & Science in Sports 24(4):pp.220-229 (online), available at: The effect of relaxin on the musculoskeletal system - PMC (nih.gov) [accessed 20.08.24].
NHS (2022), Weight gain in pregnancy (online), available at: Weight gain in pregnancy - NHS (www.nhs.uk) [Accessed 20.08.24].
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