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Pregnancy: Musculoskeletal System
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Congratulations!
Congratulations—you’re pregnant! Your team of prenatal care providers is no doubt giving you all sorts of information about eating well and exercising safely. You’re getting advice from family and friends, and you may be reading a lot about fetal development and what to expect. The new person growing inside you is changing every day; his or her organ systems are developing every week. But your body and organ systems are also changing as they adapt to hormonal changes, weight gain, and other adjustment that your pregnant body makes. Your heart starts pumping harder, you need to consume more calories, and your body needs more oxygen. The physical and physiological changes of pregnancy will affect not only your cardiovascular and respiratory systems, but also your musculoskeletal system. During this period, remember to focus on you. It is important that you stay pain-free, comfortable, and healthy during the next nine months and beyond. When the baby arrives you’ll need to maintain optimal joint health to manage your new responsibilities—and to lift your new weights!
Pregnancy and Your Musculoskeletal System
Pregnancy is accompanied by many changes to your musculoskeletal system. An average weight gain of 28 to 40 pounds, as well many hormonal changes, cause a range of musculoskeletal changes to occur. These changes include the loosening of ligaments throughout your body, weakness and separation of the abdominal muscles, and widening and increased mobility of joints. Each of these changes is a potential cause of discomfort. For example, pregnant women experience increased looseness in the ligaments of the lumbar spine. While this loosening happens for a good reason—to facilitate the baby’s passage through the birth canal—it can cause muscle strain.
Your posture will change in several ways due to your growing belly. To compensate for an enlarged uterus and a shift in center of gravity, pregnant women experience increased bending of the cervical spine (a hunchback effect), forward bending of the neck, and rounding of the shoulders. They also widen their stance to maintain balance and make moving their expanding bellies easier.
Gait changes also occur during pregnancy. As a pregnant woman walks, her pelvis tilts forward more than usual, and she makes increased use of her hip extensor, abductor, and ankle plantar flexor muscles.
Due to these changes, a variety of problems may develop. Pregnant women report joint pain (associated with extra force on the joints and increased levels of the hormones estradiol and progesterone), separation of the pelvic bones, transient (temporary) osteoporosis, tendonitis, and perhaps the most common musculoskeletal consequence of pregnancy: back pain. Lower-back pain affects about half of all pregnant women. It is especially troublesome in the later stages of pregnancy, when the pelvic region expands to accommodate the enlarging uterus. This expansion—along with the resulting pain—is even more pronounced in women who have had multiple pregnancies. Lower-back pain can continue for up to six months after pregnancy.
To treat back pain, doctors prescribe acetaminophen, application of ice or heat to the area, ergonomic modifications, abdomen supports, and a good lower-back exercise program. All of these treatments help decrease stress on the lower back. Providers also emphasize that women should become fit and resolve any existing back problems before becoming pregnant, or before their pregnancies advance. Back pain is particularly destructive when it disrupts sleep. You will certainly need your sleep when the baby comes!
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