You had a baby! The months that follow giving birth are typically a time of love, happiness and lots of baby giggles. Something that you do not want to deal with postpartum is low back pain. About 50% of women have low back pain during pregnancy and 25% in the postpartum period. Low back pain is the last thing you want to deal with after giving birth, so let’s look at a few things that could help.
After giving birth, the female body goes through a lot of changes. Not only has your pelvic floor been through a lot, but so has your low back. The joints and ligaments of your low back and pelvic region were softened in preparation for your baby. Your body weight was also redistributed while carrying baby around and your overall posture was adjusted. Now that baby is no longer hanging out on your front side 24/7, your body is slowly returning to its original position. Due to this change in the positioning of your spine and pelvis, you may be feeling some instability. This is a very important time to begin some gentle core strengthening, so that the feeling of instability does not result in pain.
So core and hip strengthening means I need to get back to my crunches and sit ups right? Not quite yet. While these are good core strengthening exercises; these are not the core muscles we need to be working at this time. We all have a deep layer of abdominal muscles called our transverse abdominis. This abdominal wall sits directly under those 6 pack abs and attaches to our pelvis. Due to the positioning of this muscle, it is very important in stabilizing our lumbar spine and pelvis. This muscle tends to be forgotten during the later months of pregnancy, so re-training it can make a big difference with low back pain.
Before you get back to your crunches and sit ups; let’s get started on a few more gentle core retraining exercises.
- Pelvic tilt: While lying on your back with your knees bent, flatten your low back into the floor for a 3-5 second hold then relax. 
- Pelvic tilt with march: Perform a pelvic tilt (flatten low back); and while maintaining this contraction, slowly march your legs in an alternating motion.
- Bridge: While lying on your back with your knees bent; lift your bottom up off the ground while avoiding any arch in your low back.
- Quadruped arm/leg lift: While on your hands and knees; begin by slowly kicking one leg back, return to its original position, and then alternate legs. Once this is accomplished, perform the leg kick while lifting the opposite arm at the same time as your leg (lift left leg at the same time as right arm, ect.)
There are a number of other exercises and treatment techniques that can help reduce postpartum low back pain, but this is just a start. It has been found in a number of different studies, that performing these exercises can significantly reduce low back pain. If your pain persists more than a few weeks once trying these exercises, make sure to see your trusty physical therapist. Your physical therapist can perform a number of modalities and manual techniques, that in combination with exercise, can reduce your low back pain. All in all, I hope that these exercises will help you to get back to caring for your new bundle of joy with less pain.
Emily Whiting, PT, DPT
 Teymuri, Z., Hosseinifar, M., & Sirousi, M. (2018) The effect of stabilization exercises on pain, disability, and pelvic floor muscle function in postpartum lumbopelvic pain. American Journal of Physical Medicine and Rehabilitation, 97(12), 885. doi: 10.1097/PHM.0000000000000993
 Wick, M. (2018). Mayo clinic guide to a healthy pregnancy. Rochester, MN: Mayo Foundation for Medical Education and Research.
 All photos from WebPT HEP website