Pregnancy Posture-Interview 2

Question BBF -Dr A, can you list the muscles that become tight during pregnancy and the muscles that become weak during pregnancy as the body changes?

Dr. A- A woman's posture changes significantly throughout pregnancy. This is accompanied by many imbalances in the body where some muscles become too tight while others become too weak. The end result of all of this is pain - usually in the neck and low back area. With regards to pain in the neck/shoulder area the muscles that become too tight are the pectoral (chest) muscles and the muscles in the back of the neck. This occurs because the shoulders are often rounded and the head juts forward. When you're pregnant this rounded posture occurs to compensate for the added weight gain in the belly and breasts. Post-partum this posture occurs out of habit with breast-feeding and holding your baby. The muscles that become weak are those between the shoulder blades and in front of the neck. When these muscles are strong they allow your shoulders to be drawn back together and your head to be tucked in (rather than poked forward).

With low back pain the muscles that become tight are the hip flexors and low back. With pregnancy the low back assumes a sway (arched) position because of the added weight gain. This posture often continues after delivery because the abdominals and glutes (bum) aren't strong enough to hold a more upright position.

Question BBF - Dr A Can you explain pregnancy related piriformis syndrome and what is the best way to manage this issue?

Dr. A. The piriformis is a muscle that travels behind the hip joint. This muscle helps with external rotation (turning out) of the hip joint. It is thought that when the piriformis muscle is tight it may put tension on the sciatic nerve, causing compression and irritation. The result is pain, tingling and/or numbness in the buttocks and along the sciatic nerve (down the back of the thigh). This is by far one of the most common conditions that I treat in pregnant women. I often see women during the third trimester but it can happen at any point during pregnancy.
There are many causes for this condition. Some of the common culprits include over-pronation (flat feet), weak glutes, tight adductors (inner thigh) and overuse. The higher incidence occurs during pregnancy because the feet tend to turn out to make more room in front for your growing belly. This position of the feet puts added tension on the piriformis because it is now is a shortened position all of the time. The glutes also have to support more weight during pregnancy so they are put under more tension.

Management for piriformis symdrome includes a combined approach. Treatment should be aimed at releasing the tension in the glutes, adductors and other tight muscles. I have found Active Release Techniques (activerelease.com) to be very helpful in treating these types of patients. Stretching and foam rolling of the adductors (inner thigh) and glutes is an important supplement to treatment. Strengthening of the glutes and any other weaknesses is key for full healing and prevention of future episodes.

Dr. Erica Ainsworth
Chiropractor, Active Release Techniques, Acupuncture
The Urban Athlete505 Eglinton Ave W, Suite 302Toronto, ON M5N 1B1416.481.8880www.theurbanathlete.ca
www.drerica.com