Hello again! I'm back with the second installment in our series of most common muscle imbalances I see in my pregnant patients, and the stretches that I prescribe for home use between office visits. As always, make sure to talk to your healthcare provider before beginning any exercise regimen during pregnancy (and if I'm not your healthcare provider yet, give me a call!)
Let's talk about the psoas muscle. The iliopsoas muscle is a hip flexor (helps pull your leg up when you're walking) that attaches all the way up at the top of the lumbar spine, runs down through the pelvis, and ends by attaching to the back of the femur. Again, this muscle is easy to "anger" and can become tight and painful in many people, not just pregnant women. The most common symptoms of psoas muscle imbalance are low back, bottock, hip, or groin pain, and pain when moving from sitting to standing (or standing to sitting, or any other movement that requires flexing the hip).
As the curve in the lumbar spine increases (that is, as your belly grows during pregnancy), the stress on the psoas increases as well. This is the reason why psoas imbalance is so common in pregnant women. It is often missed when assessing reasons for low back pain in pregnant women, as there are many contributing factors to this pain. But I have found in my practice that I can alleviate most low back pain in my pregnant patients when I perform muscle releases on both the piriformis and the psoas muscles. (See last week's blog post about pirformis stretches for that information.)
Between office visits, most pregnant women will find that they need a little extra stretching. Here's an easy home psoas stretch. I usually recommend that you perform this stretch lying on your back on your bed or on the couch. The side that is causing you pain will be the leg that hangs off of the edge of the bed or couch. So lets say your right side is hurting. Let your right leg hang off of the couch or bed. You should feel a nice stretch down your entire right side. If your foot touches the floor, you can "walk" it out to the side to increase the stretch. For even more stretch, you can pull your left knee in to your chest (as in the picture above). Obviously that part gets harder as your belly size increases. To take a little stress off of your back or if the stretch is too much, bend your left knee and place your foot on the bed.
One other thing to consider - as your belly size increases, so does the stress on your lumbar spine (low back) which is part of the reason the psoas gets tight and painful. So something else you can do to decrease this pain is use a "belly band" to help hold up the weight of the belly and take some stress off of the low back. This, in turn, decreases the stress on the psoas, so it doesn't get as "angry".
I hope you've found this helpful. Leave a comment or send me a message if you have questions or suggestions for other stretches you'd like to see. Next time - the quadratus lumborum or QL as I like to call it!