Pregnancy and post-partum pain March 14, 2011

Surveys show that most women have back pain and/or hip pain during pregnancy.  And, in many cases, the pain persists even after Baby arrives.  Many women are told this is a natural part of pregnancy and there is nothing they can do about it.  Well, I have a different opinion.

Back and hip pain in pregnancy are due to a few things.  Some we can’t change, and some we can.  First, the things we can’t change:

1.  Weight gain – not much we can do here.  Let’s hope it happens.

2. Mechanical strain on lower back – the stress of carrying extra weight in the front pulls the back into “lordosis,” which causes soreness.

3. Relaxin, a hormone released in later stages of pregnancy, loosens up the connective tissue of joints to allow the pelvis to expand during the birthing process.  Since it circulates in the blood, all joints are affected.

We can’t do much to change those factors.  But the good news is that those things listed above are NOT the primary source of pain in pregnancy.

The main cause of pain in pregnancy can be summarized like this:

1. When weight is gained rapidly (like during pregnancy), muscles of the calf become overworked.  Their response is to tighten.

2. The tight calf muscles cause muscles of the lower back and hip to become weak through a series of inhibited reflexes (called heteronymous stretch reflexes).

3. The inhibited muscles of the hips and lower back tighten and become painful.  Sometimes the pain radiates into the legs.  (This is usually NOT due to the baby resting on the sciatic nerve.)

In most cases, this cycle can be prevented by maintaining the flexibility of the calf and hip muscles as the body gains weight.  And, if the pain is already present, the problem can be treated at its source by restoring flexibility to the affected muscles.

It’s not a lost cause.  Pregnancy doesn’t have to be painful!


Kathy Dykstra April 26th, 2011

Thank you for your understanding after a “lifetime” of lack of awareness of the long term effect of pregnancy – especially with triplets! I wish I had known then what I have learned – that pt could have been helpful back 34/35 years ago. No doctor knew? or didn’t tell me, maybe. I recently have been introduced to NMT and just met a GR PT, Dave Asselin at pt360 due to my continued appreciation and interest in my five finger barefoot shoes. They helped with pain tremendously a year ago when I began wearing them for walking. They decreased my hip pain greatly-before my hip replacement and during the recovery. My hip was “terrible” according to my surgeon due to all the bone growth. My pt, yoga instructors and Russian trained massage therapist were confounded that my right hip torqued out to the right and was not to be trained to straighten. The massage therapist was convinced it had to do with the pregnancy. I was to since prior to pregnancy, I was highly flexible doing the butterfly, able to bring the knees down to the floor with little effort. After delivery, the knees were elevated about a foot, doing the butterfly. So, now I am working out the details of learning how to walk again because my left knee has meniscus and MCL pain after increasing my stride and speed walking following experiencing ‘walkers’ (runners) high! I hadn’t taken a class in how to walk in my barefoot shoes. But now I am beginning to re-learn. I am looking forward to learning more about NMT from Dave at 360. And I was glad to find your website. It took some looking after googling NMT. THANK YOU! Kathy

hadleyclinic April 27th, 2011

I used to own PT360 with Dave, taught NMT to him, and licensed him to use my method. I’m very glad that you have found the help you have needed all these years!

No doctor knew… it baffles me too. I think it comes down to the training received in medical school. Having taught Gross Anatomy and Neuroscience in a medical school, I know a bit about what is taught and what is not taught – and very little is ever mentioned about mechanisms of musculoskeletal pain.

Glad to hear you like your Vibrams! I am a barefoot runner as well. It’s always nice to connect with other barefoot and minimalist runners. I encourage you to continue learning about minimalist running when you are finished with PT. I moderate a facebook page called “the barefoot running group of grand rapids.” I will be holding regular teaching/practice sessions this summer.

For regular updates on when and where the training runs will be held, you can select RSS feed on the top of this site’s home page or find the Hadley Clinic on facebook. You might also learn something from my blog,

As far as your knee goes, who told you it was your meniscus/MCL? Are you getting that treated?

Thanks for the comment, Kathy. Best Wishes.

Scott Hadley

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