Why a Big Belly Can Be a Pain in the Back



Take a look at this picture. Apart from the beautiful pregnant woman (me!), what do you notice? Take a good look at my back. My hands.

My back is swayed, curved, saddleback or whatever you want to call it. My hands and arms are on my hips, helping me to stick both my belly and butt out.

Now, after undergoing back pain throughout my entire pregnancy and back labor during birth, I know there's a name for that curve and that it may have been the cause of my back problems. It's called lumbar lordosis.

Turns out that hyperlordosis (another fancy name for it), while not an exclusively pregnant ailment, can lead to all sorts of nasty problems for a pregnant lady because pregnancy changes your center of gravity, tends to tilt your hips forward (called an anterior pelvic tilt) and places strain on your low back and abdominal muscles.

Lordosis is a muscle imbalance combined with bad posture, which imbalance can significantly influence the lordotic curve of lumbar spine and affects your whole body - arms, legs, head, pelvis, and rib cage. Because with lordosis you are essentially thrusting your belly and bottom out in opposite directions, your abdominal muscles get stretched, which makes them weak. Don't forget (how could you?), your pregnant belly is already stretching at an alarming rate, which in and of itself is weakening them! Because the ab muscles are weakened by all this stretching, your lower back has to compensate. With lordosis you only use your lower back & hamstrings to lift the weight.

Guess what? Your back is not a good sport about compensating for your glutes and abs. It fights against all this overuse with pain and fatigue.

All this stretching, expanding, weakening, misalignment and muscle misuse allows the uterus to bulge forward even further, creating a more pronounced lordotic curve and anterior pelvic placement, which further aggravates lordosis. When your pelvis tilts forward, it’s called an anterior pelvic tilt. You don’t ever want your pelvis tilting forward, especially during pregnancy because doing so causes your hip flexors, quads and spinal erectors to become tight and overactive. Once there, they exert an unequal pull on the hip, forcing it out of alignment and, you guessed it, forward. This is particularly bad for a pregnant woman because having a pelvis that is tilted too far forward can cause problems with the baby’s engagement and positioning.

So what's a poor pregnant woman to do? For starters, strengthen your core before you get pregnant and continue exercising those muscles religiously during pregnancy. If your core is strong, you will have less of a problem with your belly stretching, weakening and the other cascade of problems that come with it. There are so many exercises and stretches out there that are specifically for fighting this malady! I have included lots of links in this article - be sure to check them out!

Be mindful of your posture. Yes, locking your knees and pushing your butt and belly out may feel most comfortable in the moment, but in the long run it will just be a pain in your back. Again, there is a whole slew of articles on the internet about posture to correct lordosis or an anterior pelvic tilt. Use the links I’ve included in these two paragraphs to get you started.

I would also suggest going to a chiropractor. It has many benefits, and if you are insured, you're going to hit your deductible with the birth of a baby - why not get some (almost) free chiropractic care, too?

I wish I could go back in time and tell pregnant me that a swayback was not a normal, unpreventable part of pregnancy. It would have saved me a great deal of pain and suffering. So please, do me a favor. If you're pregnant or plan to be soon, please pay attention to this important aspect of pregnancy. Don't accept lordosis as a normal part of pregnancy. Fight it and send back pain packing.