With pregnancy comes additional forces acting on the body – the most obvious being the weight of the baby pulling forward on the mother’s lower back.Martinan/Getty Images/iStockphoto
Working toward a more ideal posture is important for everyone, but it is particularly important for anyone who is currently or has ever been pregnant; ideal posture decreases the frequency and intensity of back and pelvic pain, prolapses and incontinence, while simultaneously increasing ease and quality of movement and breath.
By "ideal posture" I don't mean the stiff stereotype of "proper" posture. Instead I am using "posture" as a framework for how well your body functions as a unit; the more ideal your posture, the more capacity your body has to optimally absorb, dissipate and transfer forces.
With pregnancy comes additional forces acting on the body – the most obvious being the weight of the baby pulling forward on the mother's lower back. Every pregnant woman's capacity to optimally absorb, dissipate and transfer forces (i.e. maintain posture) is challenged to some degree on a daily basis. Therefore, postural biomechanics become relatively more significant.
Key concepts
1. Posture and "capacity": Conceptualize posture as "capacity needed versus current capacity"; If your muscles don't have the endurance capacity to withstand the forces being placed on them, the tissues will respond negatively. For example, if your upper back doesn't have the capacity to withstand gravity, you will start to round forward.
I am not suggesting that pregnant women do heavy bent-over rows to strengthen their upper back. Not only would that be unsafe, but lifting heavy weights would create absolute strength, which is not the goal. To improve postural capacity one needs muscular endurance. The sample exercises below will help increase postural endurance.
2. Posture, intra-abdominal pressure and incontinence: Posture doesn't just affect your outside appearance; it also affects your intra-abdominal pressure (i.e. the load distribution within your body). Less-than-ideal posture will stress your fascia unnecessarily and increase intra-abdominal pressure. Intra-abdominal pressure causing increased downward pressure contributes to incontinence.
For example, if the rib cage is perpetually rotated to one side, the diaphragm will be held in a relative downward position, causing increased intra-abdominal pressure and load on the pelvic floor.
Kegel exercises to strengthen the pelvic floor – although important – are only part of the puzzle. Relative to the amount it needs to support, the pelvic floor is a small muscle. Ideally, strengthen your pelvic floor while simultaneously working on your posture to decrease the load it has to bear.
Sample exercises
1. To increase the capacity of your upper back, try standing band rows. Wrap a band around something at chest height. Step backward until the band is taut. Your shoulders should be stacked over your hips. Without letting your lower back arch, use your upper back muscles to draw your elbows backward. Pause, then slowly release and repeat 15 times.
2. To increase the capacity of your pelvic floor, do Kegel exercises in all positions (standing, sitting, walking, etc). Completely relax your pelvic floor. Then – without clenching your bum – gently stop an imaginary flow of urine. Repeat 10 times. Next, activate the back portion of your pelvic floor by gently stopping an imaginary fart. Again, don't clench your bum. Repeat 10 times.
3. To increase the capacity of your core and pelvis, do pelvic tucks in all positions (standing, sitting, hands and knees, etc). First engage your pelvic floor. Keep the pelvic floor engaged as you tuck your hip bones toward your ribs. Your lower back should gently move backward in space. Imagine you are pulling your lower abdominals wide to your hip bones like taffy.
Does your posture need tweaking?
1. Stand facing a mirror. Let an imaginary plumb line drop down from your nose; it should fall down your breast bone, through your pubic bone and land half way between your feet. It should divide your body in two equal halves; your pelvis and ribs should not be rotated.
2. Stand sideways. Get a friend to drop an imaginary plumb line down from your ear. The line should fall through the middle portion of your upper arm bone, through the greater trochanter (bone on the side of the hip) and land in the middle of your lateral malleolus (ankle bone). Your body shouldn't fall in front of or behind the plumb line, you shouldn't be rounded forward and your head should not be jutting forward.
Final note
You don't have to have had a baby to care about your posture. Even the simple act of sitting causes postural shifts and intra-abdominal pressure. If you see from the above tests that your posture needs tweaking, don't worry. Most of us need a few corrections. Consider making an appointment with a physiotherapist, Pilates instructor, or personal trainer who specializes in movement biomechanics. On a positive note, once you become mindful of your current less-than-ideal movement strategies, you can form new, more productive norms.