Lower back pain during pregnancy. We're told it's "normal." But does normal=natural? Does normal=required? I propose that what is normal in our society is what is typical or common, but not necessarily the way our body is intended to be. Rather, it is a result of our current movement (or lack thereof) and alignment habits. SO! If lower back pain is not a requirement of pregnancy, how do we fix it? Or better yet, prevent it?
It's about where your pelvis is, in relation to the rest of your body. Check it out:
Most people are *already* forward leaners. And then they get pregnant. It's not the pregnancy that is causing the back pain, but the habits we already have coupled with an extra 10, 20, 30 pounds out front. This habit of forward leaning and pelvic thrusting not only compresses the low back (lumbar spine), but also causes us to thrust the contents of our abdomen forward into the core (diastasis recti anyone?). It causes less mobility of the sacrum because we're using the muscles in the front of the legs instead of the muscles we should be using that are behind us. Not to mention, the implications all of these issues cause for pelvic floor health and optimal birth mechanics. Can't you see how related it all is? Why ALL THESE ISSUES ARE SO PREVALENT?! Why often times someone with core issues, for example, also has pelvic floor issues. Or people who have back pain also have diastasis recti (splitting of the '6 pack muscle'). Not all movement is created equal. We have to move more, yes! But we all have to move mo' bettah as well.
NOW- TEST YOURSELF!! Grab your cell phone charger and flip it over so that the heavy plug in part is on the ground. Make your own plum line like the one I drew on the picture above and stand how you normally stand and SEE where your pelvis is in relation to the rest of your body. It can be very revealing!! It may be helpful to have someone else test you because often times we need to shift a lot more back than we think we have to. You will probably need to lean your upper body forward to counteract just how far back you have to lean. Otherwise, you'll fall over.
I was talking to someone the other day about what a tough sell what I do is. It really is a paradigm shifting thing for most people. People want "3 simple exercises to do 3 times a day." But I can't offer that. Plus, if i did it wouldn't REALLY solve your problems. Especially if you're thrusting and forward leaning the rest of the day. What we NEED to do is get your alignment back where it should be... and what we need to do to get you there is to help your muscles to re-adapt to being at the proper length to hold you there. Got it?
Here's a few steps:
1. Get out of positive footwear.
You can't not lean forward and alter your alignment in any degree of positive footwear. I'm not just talking high high heels. Even most athletic shoes are positive in the heel. Any shoe with the heel higher than the toe box is positive.
2. Be mindful about your alignment.
Now that you KNOW it, you need to adjust it. It's a brain thing called proprioception. Your brian is used to you leaning forward all the time, maybe. So, it probably feels weird NOT to do that. This weird feeling doesn't mean that it's not more optimal. It just means that your habit needs to change. It might feel weird for someone not to smoke all the time, but that doesn't mean they shouldn't quit smoking. Ya feel me?
3. Walk. As much as you can. In your heel-less shoes, with your weight back in your heels and your feet staying hip distance apart. Some day I'll blog about gait mechanics more, I promise. But just WALK AS MUCH AS YOU CAN. My teacher, Katy, says in one of her books that walking is not exercise, it's a biological necessity. In the same way that we know we need certain vitamins (example: we'd get scurvy if we didn't get vitamin C) there is going to be a consequence if we are not walking. I'm not trying to freak you out.... and I'm not trying to say that every little bit doesn't count. But definitely want to stress that walking is really super important.
4. Lengthen and strengthen the muscles of your backside.
Here are a few to try right away:
Calf stretch (PS- old video and MY GOODNESS that girl has grown up since then!!)
Double Calf stretch (which is more about lengthening all the muscles along the back-side, not just the calf like the name implies
Hamstring Strap Stretch- keep the pelvis untucked and the opposite leg on the ground (opposite hamstring should NOT come off the ground at all). PS- I just happened to have this photo but now I'm thinking- I should take photos of my kids demonstrating all the exercises!! Photo booth gives me 3 SECONDS ONLY to get into a position to take a photo... hence all the vids.
Your feet, that is. Why? Our feet are our base and if they are not lined up, then it's going to jack up everything above it. Think about your car's alignment. If the wheels are not in alignment what it going to happen to the rest of the car? Well, I'm no car expert, but I'm pretty sure if the wheels are not aligned than the rest of the car is going to break down and the wear and tear is going to happen a lot quicker. I think people kind of look at me funny when I have them do foot exercises for/during pregnancy or postpartum. But it's YOUR BASE. We can try and fix other things, but if your alignment is not optimal starting at your foundation, than other stuff is not going to do you as much good. And remember? I'm lazy... or I guess the word is BUSY. I don't want to do something unless it's going to give me the optimal amount of benefit. Mama AINT GOT TIME.
Okay, you say, point my feet straight ahead. That's easy enough. But, can you do it all the time? While walking, while standing? What happens to your feet when you're not thinking about it? Check in with it!!
And, lots of us (myself included for a long time!) THINK we're pointing our feet forward, but actually we're pointing our toes forward. And our toes are attached to our feet, but they are subjective and based upon... you guessed it.... where they are placed most of the time. If they're placed in a pointy toe shoe most of the time, they'll probably start to look like a pointy shoe. Have you ever seen someone's feet who spent most of their life in tight shoes of a certain shape? It's amazing that their feet are actually a different shape! Our feet are designed to be wide, our toes are designed to spread. To lift. To be as mobile as our hands. But we've put them in casts, so to speak, for our whole lives. From the time our parents strapped on our first pair of "supportive" walking shoes.
But alas... this is not a post on foot mobility (but I should write one!). This is a post on foot position. SO.... tell me what you see in this photo:
Yes, it does look pretty good, but alignment is not about appearance. That's why we don't call it "posture." Because posture is about what we look like, alignment is about what our body is actually doing. It seems like a semantics thing, but it's really not. It's a totally different thing.
The anatomical markers for feet pointing straight ahead are the head of the 5th metatarsal (base of the pinky toe) and the lateral malleolus (bony knob sticking out the side of your ankle). The position of our toes are subjective, as I explained a bit above. So is judging by the inside of the foot, You can see in the photo above that it looks ike my right foot is ESPECIALLY lines up correctly, eh? Because you can see through the line on the hardwood floor that it's pointing straight ahead and lined up with the baseboard perfectly. BUT when you look at the anatomical markers take a look at what happens:
I was going to maybe draw on the photos that you guys posted on Facebook, but I decided that you can check in with them and see what you think. But, I did not see any aligned feet! I will tell you that this is one of my big struggles, especially my right foot. Like I've said, our body adapts to the way we are, most of the time. For me, it's a constant check in and I'm also addressing the way my body has adapted to turning out for so long via Restorative Exercise. So that I don't get foot, knee, hip... everything problems!! Fixing our feet can help us all the way up to our head!!
Before I continue on my series on stance (which started with backing up) I wanted to address a question that I received on my (NEW!) Facebook page and also from a few people in person and another person on a comment on my last blog post (yes I read them, so comment and I'll respond if I can!)
Here's the question, in a nutshell:
Where do I start?
For me, personally, it was (IS) easy to feel overwhelmed. And to feel like there could not possibly be TIME IN THE DAY for anything else. We are all pulled in so many directions that it feels like too much to do anything else. But the thing is, I'm lazy. I guess lazy isn't the right word. I like to take the easy road. Case in point: my kids sleep with me when they are babies so I can just nurse and keep sleeping and not have to stand up during the night. I use Hypnobabies (which, I will say, is a big time commitment during pregnancy FOR.SURE.) which enabled me to have calmer and more comfortable births. And I'm always looking for shortcuts. Mama aint got TIME. Check out the comedy bit below... I laughed so hard when he said having 4 babies is like drowning and then somebody handing you a baby. Maybe too hard.
Okay, back to alignment.
So, it's not about doing more, necessarily. It's about being smarter with how you are throughout what you are already doing during your day. And, every time you make an aligned choice, it helps. Every time you choose to stretch your calves while you are on the phone, or cooking dinner, or answering an email... it makes a difference! Every time you choose to walk somewhere instead of drive, or anytime you choose to stand instead of sit. Or sit on the floor instead of lounging on a couch.... you make a difference in your body!!
I am not going to give the "do these magic 10 exercises" because, it's not about the exercises, even though there are exercises. If we lived in a society that moved around all day and had from infancy, we would not developed the habits we currently have and we wouldn't need the corrective exercises. Did the hunter gatherer woman need to stretch her calves? No, because her calves had not shortened from habits and shoe wear choices.
So, even though it's not ABOUT the exercises, they are still important because they are going to take us to a place where in an ideal world we wouldn't need them. But, as you know, we do not live in an ideal world. At least I don't! So, here are some tips.
1. Start reading some alignment blogs, of course I hope you keep reading mine. Unless you hate Jim Gaffigan. Because then you'll probably hate me because I'm like the female birthy alignmenty version of him. Just kidding. But I do think he's really funny! Tangent. Focus. Also, check out my teacher's blog, KatySays. She has a podcast in the works as well! She also wrote a few books and I encourage you to check them out. Alignment Matters is a really good way of learning the basics of alignment and it has good pictures and exercises and there is even a study guide if you're a nerd like me and like that kind of stuff.
2. Start moving more.
The human body is really designed to walk (no, you can not substitute running for walking, it is completely different). And it's designed to walk several miles a day. This doesn't mean you go out and walk 6 miles right now in one spurt. It means, move more than you're currently doing. RPE...reasonable physiological expectation. If you're used to not moving at all, then you're doing more harm than good by walking 6 miles. Can you make simple changes. Park farther away in the parking lot and walk in? Is there any place you could walk to instead of drive? Can you get out and take a daily walk around the neighborhood?
3. Start sitting less.
We go from sitting all day at work, to maybe doing an intense hour or two of exercise, and then we sit back down, and then we go to bed. We can absolutely NOT replace all day full body movement with 1-2 hours of intense exercise. People who exercise 1-2 hours a day are simply NOT healthier than those who do not. We can not undo the damage of sitting all the freaking time with that intense bout. And some of what we are doing in that intense bout is damaging us, anyway. When you work or are on the computer... try a standing work station. I personally stand at my counter and answer emails, work on blog posts, etc. If you must sit.... sit on the floor, or on a bolster on the floor. There are a lot of ways we can sit that are not in a chair or lounging on the couch with the pelvis tucked under.
4. And I'd start with stance.
Which... yay! Is what I choose to start this blog with. You learned how to back up, and next I'm going to teach you how to point your feet where they are supposed to be pointed. After we go through stance, then we'll talk about simple stretches that we can do that will help lengthen our walking muscles so that, you guessed it.... we can walk more AND get more benefit out of the walking that we do (See what I did there? Yep, I'm all about the most benefit from one single thing. That's the "mama aint got time" way!!).
5. If there is a Restorative Exercise Specialist in your area, check them out!!
*think of the photo of someone checking someone out that I am not actually going to post*
Not like in a creepy way, but in a call them and sign up for a session kinda way. You do not KNOW how much goes into getting certified. Katy is NO JOKE and she doesn't want those people she certifies to be either. So we have to learn a LOT. If there is not a REx if your area, there are many that offer Skype sessions!! Here is a list of graduates or those in training.
Now... get up, stand up go out on a walk (sung to the tune of Bob Marley if you so desire)
Stand up for your rights. Love me some good Bob Marley. Did you know that I sing that song to floppy toddlers when they are puddles on the floor? Playful parenting at it's finest, folks.
This post is about standing up. REALLY standing up. There are many different alignment markers. But for this post, in honor of the winter olympics, we're going to talk about one item in particular... BACKING UP.
And not being a ski racer all the time. Because, really, we shouldn't be standing like this:
unless we are actually in a ski race. In that case… lean down that hill baby. But otherwise…. back that thang UP.
Get something weighted. It doesn't matter what. A rock tied to a string (well that doesn't sound safe… beware, toes!), or a random kids toy tied to a string. Whatever. Next, find the midpoint of your hip. Hold the string on the midpoint of your hip and see where the weight falls on the ground. Note how I am pulling a "ski racer" and leaning forward. Also note that I just took a shower after being up all night at a birth. And that the photo is taken by a preschooler.
Now. Shift your weight back into your heels. Watch the weight move back over your heels. Note that you can lift up and wiggle your toes. Now… can you lift and lower you knee cap? If you can't, it could be that your quadricep is used to always be "on" and so it's trying desperately to be the one to hold you up all the time. So, lifting and lowering the knee cap is a way of seeing if the quad can stay in the relaxed (knee down) position. It's also a way of seeing if you're standing with your knees bent. You will not be able to lift and lower your knee cap if your knee is bent. So straight that leg, baby. Note how when I shifted my weight back into my heels, my knees bend and my feet came up. My quads were trying to say "hey wait a minute here, what do you think you're doing? I wanna WORK!" And then I told them to simmer down, that they get enough use and I'm trying to be a fair parent and give Hamstring and Glute a job too. And besides standing is really a job for Glute and Hammy anyway. Quad is like that big overachiever who does all your work for you before you actually get a chance to try. I'm sure my shortened psoas from sitting all the time and from stress didn't help matters either. But more on that another time. Psoas deserves her own post.
Here is another pictures of me backing my weight up onto my heels, from today's series of photos/videos compliments of the 4 year old:
You are now on your way to standing up/BACK better! And yes, my 4 year old took the video and the baby was very intent on being held. And what I really meant to say was that to hold our babies we tend to create a "shelf" on our bodies and thrust our weight forward. Or our weight simply gets pulled forward during pregnancy because of the weight of the belly. Or because it's just our "normal" or what we're used to doing all the time and pregnancy or baby carrying just exasperates it.
SO… THIS WEEK (and always) when you are standing… in line at the bank, while cooking, or WHATEVER…. check in with yourself. It's so easy to go back to our normal way of standing. It takes a lot of times of checking in with yourself and making conscious changes. Eventually you will start to just go to the backed up weight in the heels position without even thinking about it! But, in the meantime. Just consciously adjust yourself.
Keep a look out for Restorative Exercise group and private classes coming up at the space!! I am getting full length mirrors installed at the space TOMORROW which helps SO much so that we can SEE what our bodies are doing and help our brain figure out where we are in space and where we need to be in space. Pretty nifty.
Mama Aligned is Lindsay McCoy.