Few women manage to escape some sort of backache during their pregnancy or in the first years as a mother.---- The reasons for these pains are easily explained and often easy to treat with Physiotherapy or Osteopathy and some simple exercises! During pregnancy certain things that happen to the body can contribute to the aches and pains experienced. At around 10 weeks, a hormone called relaxin is produced which has the effect of softening and loosening the ligaments (which hold the joints together). The role of this is to allow the joints of the pelvis to expand to allow for the growing baby. Weight gain and the expanding abdomen inevitably cause changes in posture, increasing the curve of the lower back and thereby putting stress on the joints. The stability of the lower back and pelvis depends greatly on the lower stomach muscles which are stretched during pregnancy. The Pelvic floor muscles are also weaker due to the increase in pressure on them and, to the hormonal changes. These muscles also have a role in the stability around the pelvis. The sacro-iliac joints are located at the back of the pelvis on each side. These joints frequently become out of line which can cause pain in the lower back, buttocks and into the leg (sciatica). This is a common complaint which can be simply rectified with a technique which both physios and osteopaths use to realign the pelvis. The mid (thoracic) spine often becomes more hunched, (not helped by the increasing size of the breasts!) resulting in stiffness and aching around this area. This can also affect the breathing pattern. Mobilisation of the joints, massage and stretches of the tight muscles can be highly effective in helping reduce the aches and pains. However, despite these changes, there really are ways you can help yourself... Stretches for the muscles that become tight due to the changing posture: Hamstrings Lie on your back with both knees bent up. Bend one hip to 90° and hold the thigh in this position. Slowly, straighten the knee until a stretch is felt at the back of the thigh. Sustain this stretch for 30 seconds. Buttocks Lie on your back with both knees bent up. Put one heel on the opposite knee and pull your thighs up towards you. You should feel a stretch in the buttock. Hold for 20 seconds and repeat on the other side. Front of thigh Stand holding onto a table and bend one knee up behind you, holding onto the foot. Push your hips forward so you feel a stretch down the front of the thigh. Hold for 20 seconds and repeat on the other side. Maintain the mobility of the lower back Lie on your back with both knees bent, feet on the floor. Pull your lower stomach in, then push the small of your back into the floor, hold for a few seconds then gently arch your back (rocking the pelvis). This exercise can be performed in the cat position (on all fours) when the pelvis can also be rotated around. Rocking the pelvis in sitting, is good for loosening the back before you stand up. Think about your posture and the way you move. Stand tall!! Pull up your pelvic floor; pull in your lower stomach and tuck your bottom under. Do this before you get up from a chair, going up the stairs, lifting and geting out of bed or the bath. (Knees together, roll on to your side and then get up.) This all helps to maintain the tone of the muscles, the stability of the trunk and puts less pressure on the joints. Going to ante natal exercise classes can be helpful, but the classes must be taught by a specialised teacher. All the same principles apply postnatally when the pelvic floor muscles and lower abdominal muscles need to be worked on to regain their tone. It should be remembered that the ligaments can still be loose for some months after giving birth especially if breast feeding.