Do you have lower-back ache and chalk it up to being pregnant? When some of my clients recently complained that their lower backs hurt, I figured out what they had in common other than growing a baby and not having had prior lower-back pain; They were all full-fledged backpackers. If you too are pregnant and having back pain, have you asked yourself; Is it because of the pack on your back? This scenario is often overlooked by most women, their partners and their healthcare providers because back pain is commonly expected during pregnancy.
Well-known sporting goods and luggage manufacturers are designing backpacks to be stylish, contoured for women's bodies, filled with compartments, and laden with tech-smart features. They are the perfect solution for carrying everything and anything, from your creature comforts of home to office paperwork. Pregnant women have joined the ranks of school, and college-age kids sporting backpacks. While some women are accustomed to wearing a backpack long before pregnancy, many are newly drawn to the convenience, making it a "must have" necessity for getting around town hands-free. Where else can you store your laptop, iPad, water bottle, change of clothing, sneakers, food, makeup and toiletries, yoga mat and exercise gear, all in one place?
I asked Dr. Rob Shire, a chiropractor of 20 years' experience, located in midtown Manhattan (www.drrobertshire.com), to weigh in. He said, “Significant structural changes take place to accommodate the growing baby. Lower-, mid- and upper-back pain are common ailments that afflict pregnant moms. The weight of a backpack can exacerbate the problem and will further stress the spinal system and surrounding musculature.”
Pregnancy in and of itself creates miraculous changes in the body. However, there is no denying that these changes may bring discomforts including weight gain, shifts in the pelvis, varicose veins, hemorrhoids, heartburn and slower digestion, to name a few. In addition, the hormone relaxin relaxes your ligaments but can also create symphysis pubis discomfort. These all can affect well being, balance and lifestyle, which is all the more reason to be proactive and not add to or compound discomforts.
Many backpackers are complacent with their extra appendage, with some confessing candidly, "I'm used to the pain.” It’s not on anyone’s radar until the back pain intensifies, and even then the pack isn’t always suspected. Why would it be? During prenatal visits women often leave their coats and backpacks in the waiting room or closet, so busy providers don’t see them. “Do you wear a backpack?” is not a question a provider asks because it’s not on the medical intake form -- but it should be. If I had my way, a mandatory safety label, “Caution! Do Not Wear During Pregnancy,” would be sewn into every backpack, similar to those washing and drying instructions labels that are sewn into garments.
Back complaints can start at any time during your pregnancy, however, it’s usually around 20 to 23 weeks gestation when the pain becomes more prominent. At this time the baby has a significant growth spurt and moves out of the pelvis and into the abdominal cavity.
Dr. Shire stresses, “The physical stress is primarily the changing center of gravity, which is of particular importance, as it relates to the pelvis, hips, sacrum and lower back. Now. if you add a back pack to the equation, you’re compounding the effects of stress on the entire spinal system.”
Physical stress usually leads to emotional distress. If wearing a backpack can create tension, pain, or exacerbate back pain, then it seems counterintuitive to harness up a backpack. Dr. Shire explains, “Spinal subluxations (areas of fixation causing nerve stress and interference) can interfere with the development of the fetus if there is nerve supply that is being compromised. The nerve system controls and coordinates all life in the body. The first system to organize in the development of the baby is the notocord, which becomes the brain and spinal cord. Any interference to the flow of information to anywhere in the body (including the restriction of blood flow) can affect how the body works, forms and heals.”
Additionally, the added weight can effect the position of your baby, which can also impact your labor and delivery. When there is proper alignment between you and your baby, the pelvis has optimal room for the baby to engage. Misalignment can keep the baby positioned high in the pelvis or create difficulty for a breech baby to turn vertex, or head down. This in turn can create high risk factors for your labor and delivery, including induction, cesareans and risk of cord issues. If the water releases, we also need to ensure safety of the umbilical cord.
Here’s a classic example of the pregnancy backpack dilemma. A lovely couple transferred to my midwifery practice at 32 weeks. When they arrived for the first prenatal visit, she had her backpack strapped on and the word "pretzel," immediately came to mind. I palpated her abdomen and felt her baby was in the breech position, or head up. I picked up her heavy pack and asked her husband to place it on the scale. He was not surprised that it weighed in at almost 20 pounds -- almost triple the weight of an average newborn baby. With the pack on the scale I explained that perhaps years of backpack use, coupled with pregnancy changes, had transformed and twisted her body like a pretzel. I suggested she buy a rollaway pack on wheels and visit a chiropractor for an adjustment. She was a loyal backpacker, extremely attached to using it. So it wasn’t until her next prenatal visit two weeks later, that she acknowledged that her lower back pain was steadily increasing. Her office was near Dr. Shire’s, so it took only a few adjustments with him for her to feel improved alignment, flexibility and motion. She bought a rollaway backpack and was thrilled that her lower back pain and shoulder discomfort were gone. To help turn her breech baby, Dr. Shire also utilized "The Webster Technique," a program of specific chiropractic adjustments to realign her structure to take pressure off her hips and pelvis. The baby did turn head down and she had a beautiful vaginal birth.
In the medical literature of studies published by the American College of Sports Medicine (ACSM), many women ask for cesarean sections when their back pain intensifies, while others seek to induce pregnancy to end back pain. While the exact causes of back pain in pregnancy have been thought of as multifactorial and not well understood, what’s clear is that induction has its own set of problems, which I addressed in several of my recent website blogs and Second Blog.
Here are a few guidelines to ensure optimal back health for the benefit of your back, baby and delivery.
Use a rollaway pack. It may not be as fashionable as a backpack, but as Dr. Shire says, “Let the wheels do the work and save your spine. You’ll need it later on when you have to carry the baby around.” It makes a great baby shower or mom’s day gift.
Bonafide backpacker? Tell your healthcare provider. This information could lead your provider to make referrals to other health care professionals to rule out other possible diagnoses related to lower-back pain. If you do not wear a backpack, let your provider know that as well.
Can a prior back injury or surgery make back pain worse? It could. However, medical research reveals that you don’t necessarily have to be an athlete with past back injuries, or have other back issues, to have lower-back pain during pregnancy.
Pregnant and carrying your toddler on your back? The same principles apply. While many back carriers and wraps may be safe for carrying a child on your back, toddlers move around, and this can also impact your balance and create a safety issue.
Exercise regimen. Discuss with your provider strength
-building programs and classes that increase flexibility, strength, endurance and stamina, i.e., prenatal yoga, pilates, swimming, general PT and pelvic floor PT.
Heavy shoulder tote bag? Can also cause havoc with your spine and alignment.
See a healthcare professional who specializes in back treatments. Contact a chiropractor, acupuncturist, physical or massage therapist. The American College of Physicians just came out with a report that these specialties, once considered "alternative" treatments, should become more mainstream for people with back issues.
Pain with walking or standing? Discuss this with your healthcare professional. Chiropractic adjustment may not be appropriate, and you may require other medical treatments including massage, acupuncture and a pelvic support.
Protein snacks and water. Don’t forget to pack them in your rollaway.
Be proactive to optimize your baby’s position and alignment. Store your backpack or lend it to a friend until you are six weeks post-partum. As parents we will do anything and everything to protect our children, and now is the time to start practice that.
I hope you found this useful.
Do you have creative ways to downsize what you carry in your rollaway pack so it’s lighter?
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