So, are YOU up for the challenge?  Here we go!

I’ve been very fortunate to be able to work with my patients throughout all stages of their motherhood – starting from the pre-natal period (providing pain-relief in a safe and gentle manner) to post-natal period (ensuring that an optimal level of function is restored after delivery).  As moms enter the exciting stage of expecting a new baby, this excitement may be curtailed (briefly!) with an air of concern in her voice asking: “Why am I experiencing discomfort in my low back/neck/shoulders during pregnancy when I’ve never even had these concerns in the past?”   You may even identify with this question since you are definitely not alone.  A study in the journal Orthopedics reports that 50 to 90% of pregnant women will most likely experience back pain.

Why are these statistics so high?  Let’s take a brief look at the major biomechanical and physiologic changes occurring at different points of motherhood that may manifest as back, hip, neck, shoulder or neck pain:

During Pregnancy:  there are (3) curves naturally present in our spine – in the neck, mid-back and low back.  The significant weight gain in the abdominal region accentuates the loading through the individual bones (vertebrae) in the lower back.  The corresponding curve becomes accentuated and the joints have a greater potential of becoming inflamed and causing pain.  The same phenomena may occur in the upper-back/neck region as the increased weight in the chest area may strain the supporting mid-back musculature.  Since muscles attach to bones, any prolonged strain in the muscles is also going to have a consequence on the normal movement of the joint.  

Furthermore, throughout the skeletal system, we have fibrous tissue bands that behave like rubber bands to connect two bones together, known as ligaments.  Ligaments typically ensure that just the right amount of movement at a given joint is occurring to allow for pain-free bending/twisting/leaning.  During pregnancy, there is an increase in the hormone relaxin, which causes the ligaments of the pelvis and back to loosen in preparation for delivery.  Consequently, this hormone also allows for excessive motion at the other joints in the body.  The body’s response may be that of inflammation and pain as it tries to stabilize the excessive movement.

Post-Delivery:  Low back pain may persist as the rapid weight loss after delivery leads to an equally rapid off-loading of the natural curve in the low back.  The decline in relaxin causes the ligaments to stiffen which may lock the sacroiliac joint in a less than optimal position, and give rise to discomfort when bending over to pick up baby, or taking a step after getting out of chair.

Infant/Toddler years:  There are a multitude of repetitive ‘mommy-related’ activities such as getting in and out of the car, nursing, carrying your toddler, vacuuming that can strain your back.

Considering the immense transformations that occur in the body in order to house and nurture the fetus, it probably doesn’t seem mysterious anymore as to why expectant mothers may experience some “growing pains” during the peri-natal period.  Even though the body is pretty amazing at compensating and adapting, when it comes to pregnancy, there is somewhat of a disconnection between the speed of adaptation and the rapid postural changes of carrying the baby.  With timely treatment and awareness of potentially aggravating activities in day-to-day life, you can ensure that these temporary ‘growing pains’ remain temporary and you can go on being the best mom you can be, in comfort.

Stay tuned for Back Care Boot Camp Part 2 where you’ll find out about training a special “Mommy Muscle” that will help you perform all your mom-tasks with greater efficiency and even insure against chronic injury!

Midwives and chiropractors offer care that is personal to each individual and specific to every case. Midwives and chiropractors share the unique ability to assess a patient’s status with their own hands, and both professions are blessed with the privilege of touching others to bring about a greater quality of life.

These common bonds have been enough to establish life-long supportive relationships between our two professions. However, there is another cause for alliance and reciprocity between us. It is a specific chiropractic adjustment called the Webster Technique. Developed by Dr. Larry Webster and formerly called the Webster Breech Turning Technique, this particular chiropractic adjustment was previously used during the seventh through ninth months of pregnancy. It was primarily focused on women whose babies were presenting breech or transverse.

Since discovery of the Webster Technique, its protocol has been revised to include women of all stages of pregnancy. Doctors of chiropractic reported a greater than 85% success rate in the technique’s ability to balance pelvic structures and remove constraint to the woman’s uterus, thereby allowing the baby to turn into the vertex position. The Webster technique is therefore becoming an important part of prenatal care for all women looking to optimize their potential for more natural deliveries.

Midwives around the country are hearing about the technique and seeking chiropractors trained in its use. The two groups are forming alliances in communities, sparing mothers and babies the irreparable damage caused by the growing number of cesarean sections. Midwives are referring patients to chiropractors even before malpresentations are evident; and their practices are reaping the benefits of easier, safer deliveries for both mother and baby.

Doctors trained through the International Chiropractic Pediatric Association have learned how to apply this specific adjustment, along with other chiropractic techniques, to benefit the mother and baby throughout pregnancy. Because we are working specifically to balance pelvic muscles and ligaments with their adjustments, we are removing constraint to the woman’s uterus. This allows the baby to get into the best possible position for birth in a timely manner and the need for “crisis care” in the last couple of months of pregnancy is being eliminated. Today, the association maintains the only database available of chiropractors who have been tested and are proficient in the Webster Technique.

ICPA-trained doctors of chiropractic have learned how to apply this specific adjustment, along with other chiropractic techniques, to benefit the mother and baby throughout pregnancy. The need for “crisis care” in the last months of pregnancy is eliminated as more and more midwives refer their women to trained doctors of chiropractic.

As a doctor of chiropractic, I know that one of our greatest objectives is to eliminate as many variables that lead to traumatic birth and potential injury to the newborn’s spine, cranium and nervous system as possible. To achieve this goal, we need the help of midwives! We need your valuable services and care for the women in our communities. Specific chiropractic care helps to provide an environment for safer, easier, faster deliveries. Midwifery care is known to do so as well.

Excerpted from “Midwifery and Chiropractic: Bonding for Life,” Midwifery Today, Issue 69, Article Written by Jeanne Ohm, DC

What we cannot see are the millions of different hormonal changes and chemical reactions occurring both in the mother and the developing baby, all of which are controlled and coordinated through the nervous system. Now more than ever, during pregnancy you need a nervous system that responds immediately and accurately to changing requirements in all parts of your body, and therefore you need a healthy spine!

Chiropractic care prior to conception promotes a more regular menstrual cycle and optimal uterine function. It prepares the body to be strong, supple, and as balanced as possible to carry the pregnancy. Restoring proper nerve supply to reproductive organs has helped many couples who thought they were infertile. And adjusting women throughout pregnancy is one of the most rewarding parts of our work, because a healthier pregnancy means an easier labour and delivery, and a better transition for the baby into this life.

A person’s spine is made of 24 moveable bones called vertebrae, plus the sacrum (tailbone), pelvis, and skull. From the brain, nerve impulses travel down the spinal cord, branch out into nerves, and exit between the vertebrae. When the vertebrae become misaligned or unable to move properly a condition called vertebral subluxation, it irritates and interferes with the nerves. The message from the brain is slowed down and the life-energy carried by the nerve is unable to reach the organs and tissues at full potential. A doctor of chiropractic aligns the vertebrae and pelvis through gentle adjustments to the spine, relieving the pressure on the nerves and allowing the full nerve energy to reach the tissues it serves.

As you gain weight, especially in the abdomen, this exerts a downward, forward pull on the lower spine. This extra weight combined with changes in your gait and centre of gravity can set the stage for backache and neck pain. Additionally, as labour approaches, your body secretes a hormone called relaxin, which loosens ligaments. This may exaggerate the effects of an existing spinal or pelvis problem. The positioning of the baby and its movement as well as expansion of the lower part of the ribcage to accommodate your growing baby can also cause discomfort in the ribs and upper portion of the lower back. Additionally, your increasing breast size in preparation for lactation can create upper back subluxations.

According to recent studies, chiropractic care may result in easier pregnancy including increased comfort during the third trimester and delivery and reduced need for analgesics (pain medication). In one study, women receiving chiropractic care through their first pregnancy had 24% reduction in labour times and subjects giving birth for the second or third time reported 39% reduction in shorter labour times. In another study, the need for analgesics was reduced by 50% in the patients who received adjustments. In addition, 84% of women report relief of back pain during pregnancy with chiropractic care. When women receive chiropractic care throughout pregnancy, the sacroiliac joints of the pelvis function better. As a result, there is significantly less likelihood of back labour (contractions and sharp pain felt in the lower back during labour). Chiropractic care has helped new mothers become more comfortable breastfeeding (posture-wise) as well as to produce more milk. Chiropractic care has also been shown to reduce the likelihood of postpartum depression.

As your pregnancy advances, some chiropractic techniques will need to be modified for your comfort. Your chiropractor is aware of this and will make the necessary changes. In particular, special pregnancy pillows and tables with dropaway pelvic pieces are used to accommodate your growing belly. A chiropractor trained in the techniques that address uterine constraint or mal-presentations will check for misalignment of the pelvic bones, misalignment of the sacrum and vertebrae, and spasm of the ligaments that support the uterus and help hold the pelvis together.

Body position during delivery is also critical. Any late second stage labour position that denies postural sacral rotation denies the mother and the baby critical pelvic outlet diameter and moves the tip of the sacrum up to four centimetres into the pelvic outlet. In other words, the popular semi-recumbent position that places the labouring woman on her back onto the apex of the sacrum closes off the vital space needed for the baby to get through the pelvic outlet. This delivery position is the main reason why so many births are traumatic, labour is stalled, the mom becomes fatigued and overwhelmed by pain, so the utilization of epidurals, forceps, episiotomies, vacuum extraction, and caesarean increases. This is why squatting is the preferred position—gravity works to help and the pelvic outlet can open to a greater degree. Squatting during delivery results in decreased use of forceps and a shorter second stage of labour than the semi-recumbent position! Moreover, research has shown that coached pushing in the second stage of labour does not improve the short-term outcome for mothers or babies, except when the baby needs to be keep “baby blues” at bay, regain their energy and lose the weight they gained during pregnancy.

Pregnancy Exercise Tips

Don’t exercise for longer than 30 minutes at a time.

Always include a 10-minute warm-up and a 10-minute cool-down period (in addition to the 30 minutes of exercise).

Pregnant women should not exercise to exhaustion—but being fatigued is okay.

Avoid forced, passive stretches, such as reaching for your toes. Pregnancy hormones make your joints looser, so overstretching—which can cause a muscle injury—is a greater risk during pregnancy. Also, avoid sudden jerking or bouncing movements or quick changes in position.

Limit aerobic activity to the low-impact variety, especially if you weren’t exercising regularly before getting pregnant. Brisk walking, swimming, and riding a stationary bicycle are good choices. Keep it moderate (30 minutes per day), particularly if you weren’t exercising before pregnancy. Ensure weight training is done under proper guidance.

Measure your heart rate at peak activity to be sure you are not exceeding 140 beats per minute.

Avoid overheating: drink plenty of water, and don’t exercise in hot, humid conditions.

Avoid activities that put you at high risk for injury, such as horseback riding or downhill skiing.

Avoid sports in which you could get hit in the abdomen (e.g. softball).

Especially after the third month, avoid exercises that require you to lie flat on your back for an extended period of time since this can reduce your heart rate, lower your blood pressure, cause dizziness, and may reduce blood flow to baby.

Never scuba dive because it can cause dangerous gas bubbles in the baby’s circulatory system.

Before starting any new exercise routine, always check with your health care provider.

Stop exercising immediately and consult your midwife or doctor if any of the following symptoms occur during or after exercise: bleeding, cramping, faintness and/or dizziness, elevated blood pressure, or severe joint pain.

Here’s an easy pelvic tilt exercise to get you started. It will strengthen stomach and back muscles and reduce stress from the growth of your uterus. You may want to make sure you haven’t eaten for an hour or so before doing this exercise for comfort.

1. Lie flat on your back with your knees bent (this can also be done standing if you are uncomfortable on your back).
2. If needed, place a small pillow under your neck and/or lower back for support. Make sure you maintain a small curve in your neck to reduce the likelihood of strain.
3. Pull in abdominal and buttock muscles (this should flatten the lower back). Imagine you are peeling your buttocks and spine up off the floor. Slowly, vertebra-by-vertebra, rise to approximately bra-strap level (as long as there is no pain or tension felt in your neck).
4. Hold, breathe out, and count to five.
5. Relax. Inhale. Roll down slowly, and with control, vertebraby- vertebra.
6. Repeat five times.

Additional Hints to Help Prevent Pregnancy Backache

Stand erect; do not allow your belly to sag.

Change positions often to ease lower back strain.

When lifting, bend your knees and keep your back straight.

Consult your chiropractor for exercises to reduce lower back strain (an easy one to start with is the pelvic tilt shown above).

Your mattress should be supportive and comfortable.

Sleep on your side with a pillow between your knees.

Adequate rest is essential.

Keep daily chores manageable. Seek those who can most help you make this experience meaningful. Whether it’s a friend to walk with to the pool, a doula to help with your labour plan, or your mother offering to watch the kids or help clean the kitchen, take advantage of the help around you.

Know your limits. If you are working throughout your pregnancy and/or have other children to care for, try not to overdo it.

Practice good postural habits.

Plan and do regular exercise.

Kegel exercises are a great way to prepare and tone the pelvic floor muscles for delivery and can be done anytime. To do Kegels, contract the muscles around your urethra and vagina— imagine you are trying to prevent yourself from urinating. Hold for several seconds, then release. Repeat sets of ten, several times each day.

Have regular spinal check-ups; they are an important part of preventative health care.

Other Factors to Consider in Maintaining a Healthy Pregnancy

Proper nutrition is essential to maintaining a healthy pregnancy. This includes adequate intake of folic acid, good sources of protein and iron, calcium-rich foods, and lots of fruits and vegetables. Drink plenty of pure water to keep well hydrated. Avoid eating too much sugar and sweets including fruit drinks as they can cause you (and the baby) to gain excessive weight.

Research has found that a pregnant woman can help protect the health of her child by avoiding smoking and second-hand smoke alcohol, excessive caffeine (e.g. tea, coffee and cola), unnecessary exposure to x-rays (especially in the first trimester), unnecessary medication (including over-the-counter remedies), and foods with chemical additives, artificial sweeteners, and artificial ingredients.

Regular exercise, good nutrition, and periodic spinal adjustments can make pregnancy the pleasant, exciting experience you want it to be! Pregnancy should be an opportunity to reflect on your family’s plans and dreams— not a time to struggle with pain. Preparing for a new baby is a daunting challenge for even the most organized mothers-to-be. So, during this meaningful time, be proactive: work to prevent backache before it affects your peace of mind or distracts you from focusing on your family’s well being. Chiropractic care is safe and natural, simply removing interference to your body’s own controlling and healing ability.

“It’s very important that a child have both a pediatrician and a pediatric chiropractor. A pediatric chiropractor is not there to replace the role of the pediatrician,” says Dr. Hewitt. “The pediatrician provides medications when necessary and delivers care in times of serious illness and injury. A pediatric chiropractor is there for preventative wellness care and maintenance of the child’s structure. The two are very complementary.”

Increasing Number of Children Receive Pediatric Chiropractic Care

Survey data indicates that the percentage of chiropractic patients under 17 years of age has increased at least 8.5 percent since 1991, says the American Chiropractic Association. Further, a recent Centers for Disease Control and Prevention study indicated that nearly 3 percent of children in the United States were treated with chiropractic or osteopathic manipulation in 2007, making it the most common form of doctor-directed complementary or alternative medicine used by children.

According to Elise Hewitt, DC, a Portland-area doctor of chiropractic and president of the American Chiropractic Association’s Pediatrics Council, chiropractic care isn’t just for adults. Infants and children can benefit from spinal manipulation and other forms of chiropractic care just as much as their parents and grandparents.

“It’s very important that a child have both a pediatrician and a pediatric chiropractor. A pediatric chiropractor is not there to replace the role of the pediatrician,” says Dr. Hewitt. “The pediatrician provides medications when necessary and delivers care in times of serious illness and injury. A pediatric chiropractor is there for preventative wellness care and maintenance of the child’s structure. The two are very complementary.”

Studies are beginning to show that chiropractic can help children not only with typical back and neck pain complaints, but also with issues as varied as asthma, chronic ear infections, nursing difficulties, colic and bedwetting.

Chiropractic spinal manipulation is a highly skilled treatment, and in the case of children, very gentle. Doctors of chiropractic—commonly referred to as chiropractors—practice a hands-on, drug-free approach to health care that includes patient examination, diagnosis and treatment. Following their undergraduate education, doctors of chiropractic obtain a four-year degree consisting of more than 4,500 hours of study and clinical experience. Pediatric specialists receive additional post-doctorate training.

“The vast majority of parents report that their children enjoy their chiropractic adjustments and look forward to subsequent visits. They also report that their children experience a greater level of health while under regular chiropractic care,” Dr. Hewitt notes.

The American Chiropractic Association (ACA) is the nation’s leading chiropractic organization representing more than 15,000 doctors of chiropractic and their patients. 

A recent study published in Nature Neuroscience  created a media buzz that hit many major news outlets. The study concludes that adenosine is released during acupuncture treatments. Adenosine is a neuromodulator with anti-nociceptive attributes. A nociceptor is a sensory receptor that responds to stimuli by conducting nerve signals to the spinal cord and brain. The process itself is referred to as nociception and commonly results in the perception of pain. Lead investigator Maikin Nedergaard, co-director of the Center for Translational Neuromedicine at the University of Rochester Medical Center in New York stated, “We have produced the first evidence that acupuncture releases a natural pain-relieving molecule into the body…. Adenosine is a key to reducing pain during acupuncture treatment.”

Adenosine and the Heart

Adenosine not only blocks pain transfer but also promotes sleep due to its role as an inhibitory neurotransmitter. Adenosine also functions to dilate the coronary arteries and relaxes the smooth muscle inside the artery walls. Adenosine is an antiarrhythmic agent and is responsible for helping individuals cardiovert from an abnormal heart rhythm to a normal heart rhythm. Interestingly, since caffeine’s chemical structure tends to bind to the same receptors are adenosine, the pharmacological effects of adenosine can be reduced from the intake of coffee, tea, and chocolate.

Fertility

The discovery of the adenosine release helps to understand the function of acupuncture in a western clinical model. However, numerous studies show that acupuncture stimulates the release of beta-endorphins which are also pain-killing chemicals. Generally, any major news of acupuncture mediating the pain response makes headlines. However, recently singer Celine Dion, age 42, notes that she used acupuncture to help get pregnant. This also created a media flurry.  Studies show that acupuncture patients have a lower miscarriage and ectopic pregnancy rate and a higher rate of live births than comparative non-acupuncture groups. In one randomized, double-blind study in Fertility and Sterility it was found that acupuncture improves implantation rates for in-vitro fertilization by 180% while discovering a significant reduction of gonadotrophins.

Research and Diabetes

There are many chemicals that are mediated by acupuncture treatments and what research on an individual chemical release fails to show is the natural homeostatic drive of an acupuncture treatment. Homeostasis, the tendency toward a relatively stable equilibrium in physiological processes, goes far in explaining why acupuncture is able to stimulate entire cascades of chemicals within the body to help stimulate optimal health.  For example, Life Science published research showing that the homeostasis model assessment (HOMA) index changed with acupuncture. HOMA is a method used to quantify insulin resistance and beta-cell function. The thrust of the study showed that acupuncture significantly improved glucose tolerance in rats with diabetes. In conclusion, studies support acupuncture’s effects on chemical pathways that help restore normal physiological processes. While researching the release of individual chemicals helps to understand acupuncture, it is only one part of understanding acupuncture’s ability to balance entire system of chemicals and neuropathways within the body. Continuing educational research into the methods of acupuncture’s actions now begin to uncover a broader picture of its effects on bodily responses.

The shoulder complex is by far one of the most fascinating structures in the body because it has an amazing range of motion, but this all comes at the expense of stability.   Many of us have probably experienced some degree of shoulder pain during exercise, and wrote it off as simply being exercise-related.  However, that same shoulder may have started to become achy, lasting hours even after the exercise, or the range of motion of the arm became limited.  It’s usually at this point where patients present clinically,  wondering “which muscle they can stretch out or strengthen” to avoid this discomfort.  The answer, once again is not simple, due to the complexity of the shoulder complex.     This article will look at the basic structure of the shoulder complex and how the athlete may be able to prevent shoulder injuries, including training considerations.

Shoulder Anatomy

When considering the shoulder joint, it is commonly thought of as simply that ball-and socket joint where the arm attaches to the upper body.  Technically, however the shoulder complex consists of 4 separate joints: 1) The gleno-humeral (GH) joint (aka “the shoulder joint”) is a ball-and-socket which joins the upper arm bone to the shoulder blade, 2) the sterno-clavicular (SC) joint located between the top of the breast bone/sternum and the collar bone/clavicle, 3) the acromio-clavicular joint, joining the shoulder blade to the collar bone, 4) the scapulo-thoracic joint which is a “virtual” joint between the underside of the shoulder blade and the thoracic spine and ribcage.  It is also one of the most mobile joints which permits the arm to go through a wide range of motion.

Stability & Flexibility

Stability of this complex is provided by the prime movers of the arm:  the pecs, lats and delts, assisted by four small strap-like muscles cumulatively known as the rotator cuff: supraspinatus, infraspinatus, teres minor and subscapularis.  These four muscles work in synchronicity to stabilize the shoulder blade and ensure depression of the shoulder’s ball-and-socket joint (GH joint) in order to counter the upward pull of the deltoid muscle.  If there happens to be an imbalance amongst these small 4 strap-like muscles, a squeezing of the rotator cuff where they attach at the arm bone (humeral head) and part of the scapula (coraco-acromial arch) may result in primary “impingement”.  Any activity that involves bringing the arms overhead such as bringing weights overhead (shoulder presses), swimming, throwing or racquet sports, has the potential to the compromise rotator cuff if functional stability measures are not in place.

Conditioning all the muscles of the shoulder complex through targeted strengthening and stretching exercises will help to ensure balanced development of both the primary movers (pecs, lats and delts) and the muscles of the rotator cuff.   It should also be noted that differences in the structural anatomy of the scapular acromion may also predispose an individual to impingement, so it is equally important to rule out structural causes through an x-ray.

Core stability is also another often over-looked component to ensuring an efficient shoulder complex.  In the September Issuer of Growing Y-ser, I went over the importance of developing core strength as an anchor to increase the power and stability. As mentioned prior, the core complex can be visualized as a cylinder – the diaphragm (a major respiratory muscle) as the lid, and the muscles of the pelvis at its base. This cylinder houses the bony structures of the spine, hips, pelvis, abdominal structures, and upper legs.  Since the core is located centrally in the body, a strong core provides the power source and stability for arm movement.

Training Tips to Keep Your Shoulder Healthy

Avoid lifting beyond your capacity.  Gradually increase training workload; avoid exceeding a weight increase of 10% per week.  Allow 3-4 weeks for accommodation.  Limit the increase of weight to one exercise per workout.

Be aware of exercise technique.  Incorrect form during training may place excessive stress through supporting structures, predisposing them to injury.

Avoid lat pulls behind neck, and upright rows

During one-arm rows, watch that the weight doesn’t allow the shoulder to traction at the beginning of this exercise

Focus on maintaining a balance in flexibility.  The goal for stretching  the internal and external rotators of the shoulder should be to achieve a balance between the two groups , relying less on the degree of flexibility;  excessive flexibility at the expense of muscle strength and control strains the more passive stabilizers of the shoulder including the capsule and ligaments which may predispose the shoulder to labral tears, or even dislocation

Prior to commencing any training program, seek the advice of a qualified health professional  if your shoulder has a history of instability where the shoulder has popped out of joint, if you notice joints in your body that are very loose or if you hear excessive popping sounds in the shoulder.

Click here to view a copy of the Workstation Self-Assessment.  Be sure to check out pages 11-13 for great images on how to set up your station.

Courtesy of WCB-BC.

I’ve been very fortunate to be able to work with my patients throughout all stages of their motherhood – starting from the pre-natal period (providing pain-relief in a safe and gentle manner) to post-natal period (ensuring that their optimal level of function is restored after delivery).  As moms enter the exciting stage of expecting a new baby, this excitement may be curtailed (briefly!) with an air of concern in her voice asking: “Why am I experiencing discomfort in my low back/neck/shoulders during pregnancy when I’ve never even had these concerns in the past?”   You may even identify with this question since you are definitely not alone.  A study in the journal Orthopedics reports that 50 to 90% of pregnant women will most likely experience back pain.

Why are these statistics so high?  Let’s take a brief look at the major biomechanical and physiologic changes occurring at different points of motherhood that may manifest as back, hip, neck, shoulder or neck pain:

During Pregnancy:  there are (3) curves naturally present in our spine – in the neck, mid-back and low back.  The significant weight gain in the abdominal region accentuates the loading through the individual bones (vertebrae) in the lower back.  The corresponding curve becomes accentuated and the joints have a greater potential of becoming inflamed and causing pain.  The same phenomena may occur in the upper-back/neck region as the increased weight in the chest area may strain the supporting mid-back musculature.  Since muscles attach to bones, any prolonged strain in the muscles is also going to have a consequence on the normal movement of the joint.  

Furthermore, throughout the skeletal system, we have fibrous tissue bands that behave like rubber bands to connect two bones together, known as ligaments.  Ligaments typically ensure that just the right amount of movement at a given joint is occurring to allow for pain-free bending/twisting/leaning.  During pregnancy, there is an increase in the hormone relaxin, which causes the ligaments of the pelvis and back to loosen in preparation for delivery.  Consequently, this hormone also allows for excessive motion at the other joints in the body.  The body’s response may be that of inflammation and pain as it tries to stabilize the excessive movement.

Post-Delivery:  Low back pain may persist as the rapid weight loss after delivery leads to an equally rapid off-loading of the natural curve in the low back.  The decline in relaxin causes the ligaments to stiffen which may lock the sacroiliac joint in a less than optimal position, and give rise to discomfort when bending over to pick up baby, or taking a step after getting out of chair.

Infant/Toddler years:  There are a multitude of repetitive ‘mommy-related’ activities such as getting in and out of the car, nursing, carrying your toddler, vacuuming that can strain your back.

Considering the immense transformations that occur in the body in order to house and nurture the fetus, it probably doesn’t seem mysterious anymore as to why expectant mothers may experience some “growing pains” during the peri-natal period.  Even though the body is pretty amazing at compensating and adapting, when it comes to pregnancy, there is somewhat of a disconnection between the speed of adaptation and the rapid postural changes of carrying the baby.  With timely treatment and awareness of potentially aggravating activities in day-to-day life, you can ensure that these temporary ‘growing pains’ remain temporary and you can go on being the best mom you can be, in comfort.

A one-size-fits all solution is not possible in the world of pillows since our body dimensions and sleeping positions differ.   Regardless or your sleeping position, the goal is to ensure that you find a pillow that conforms to your body shape, so that your head remains level with your upper back in order to distribue the weight evenly along the spine.  A proper pillow, when compressed will make up for the distance b/w the ear and shoulder (side sleepers), or back of head and the back (back sleepers).  The good news is that there are a 3 key steps that will make your selection much easier.

Step 1:  Identify Your Sleeping Position

SIDE SLEEPERS

Side sleeping requires an individual to turn more frequently as there is greater pressure per square inch of body contacting the bed.  As a result, a thicker pillow is necessary for this sleeping position, and avoid sleeping with a hand or arm under the pillow.  If you find yourself needing to do this, it usually means that the pillow is too thin.  Instead, the bed side arm should be placed slightly forward on the mattress at ~ 44-60 degree angle from the body, with the upper resting on the side, or draped across the abdomen.  Knees should be bent 30- 90 degrees, stacked upon each other with a pillow between the knees to maintain pelvic/hip alignment.  Avoid scissoring the legs as this strains the low back region.

BACK SLEEPERS

Back sleepers should ensure that the head is nestled into a relatively soft and thin pillow, and not tilted to one side.  The pillow should not tuck your chin or tilt your head backwards.  If lower back pain in experienced in this position, simply placing a pillow under the knees should alleviate this discomfort.

STOMACH SLEEPERS

This sleeping position is not recommended as it tends to strain the supporting musculature of the neck, especially those of the upper shoulders.  Furthermore, the underlying spine tends to ‘corkscrew’ imposing undue torsion to the spine.  But if position is absolutely necessary, the pillow should be relatively slim or the head should rest directly on the mattress, to avoid excessive turning of the head on one side.  Another relatively flat pillow should also be placed under the stomach to maintain spinal alignment.

STOMACH SLEEPERS

This sleeping position is not recommended as it tends to strain the supporting musculature of the neck, especially those of the upper shoulders.  Furthermore, the underlying spine tends to ‘corkscrew’ imposing undue torsion to the spine.  But if position is absolutely necessary, the pillow should be relatively slim or the head should rest directly on the mattress, to avoid excessive turning of the head on one side.  Another relatively flat pillow should also be placed under the stomach to maintain spinal alignment.

Step 2:  Determine Required Pillow Thickness

Step 3:  Choose Your Pillow Filling

The most common types of pillow fillings are:  feather, fiberfill, and memory foam.  Some have great adaptability such as feather or fiberfill, and others have limited adaptability such as memory foam or foam rubber (polyurethane) – combination sleepers need the molding capability of the feather or fiberfill pillow to pump the thickness when on one’s side, compress when sleeping on one’s back.  Your comfort and personal preference will determine the best pillow filling for you.

Feather – very pliable, and soft.  The stuffing can be moved around to accommodate areas that require more support

Foam – firmer, sturdier pillow.  The higher the density, the less breakdown and greater support achieved.  Foam rubber tends to be more cost effective compared to memory foam, and in many cases works just as well.

Memory foam  – suited for those looking for additional neck support as they reduce pressure points if changing sleeping positions frequently.  Tendency to retain heat, so may get uncomfortable as the night progresses.

Latex- the firmest type of pillow, and very hypoallergenic

Water – supports head and neck in any sleeping position, customized support by adding/removing water

Buckwheat hull- suitable for sleepers who enjoy a firmer pillow, th e hulls conform to the exact contours of the head, neck and shoulders, the filling stays cool when sleeping

The acclimatization period for a new pillow can be around a couple weeks, where, during this time period, you may experience mild discomfort in the neck/shoulders, as your body gets used to the new position.  If however, this discomfort still persists, it may be time to experiment with another pillow and visit your local chiropractor to ensure that your joints are in their optimum positions to prevent strain of the supporting musculature.

Sweet Dreams, and as always, if you have any questions about this article or have a topic suggestion, feel free to e-mail us!