October 1, 2019

Pregnancy Back Pain: Physical Therapist Recommended Exercises

Good posture is always important, but during pregnancy it is essential.

Pregnant woman smiling

Good posture is always important, but during pregnancy it is essential. As your belly and breasts expand during pregnancy, your center of gravity shifts. The natural tendency is to allow your pelvis to tilt forward, causing your lower back to have an increased curve called lordosis. As this happens, your head and shoulders protrude forward as well. This change in your posture increases strain through the muscles of the back and can cause discomfort. Additionally, the hormone relaxin is working to lengthen and soften your ligaments to prepare for delivery. Relaxin does its job well, but it can worsen low back pain due to increased instability. Pregnancy is already uncomfortable with morning sickness, swollen ankles and stretching skin, so read on to take back pain off the list! 

First, Check Your Posture

Stand upright looking in a mirror. What do you see? Do your neck and shoulders slump forward? Is there a large curve in your low back? Does your pelvis tilt forward? Are your knees locked? These are all signs of poor pregnancy posture. Follow these steps to improve your posture:

  • Stand with your feet and legs straight with your knees and toes pointing forward.
  • Now, imagine there is a string on the top of your head. Think about someone pulling gently on the string. See yourself tucking your chin and dropping your shoulders back and down. Feel your belly pulling in gently and reducing the curve in your low back. Think about your pelvis tilting back to neutral and feel the slight bend in your knees. 
  • Anytime you notice yourself slumping back into that poor position, imagine that string is giving you a little tug.

How to Sit Properly During Pregnancy

Sitting at a Desk

  • Try to sit up straight with your chin in a neutral position and your shoulders down and back. Your elbows should be resting at 90 degrees so that you don’t have to lift your shoulders while using the keyboard. 
  • Adjust your monitor so that you don’t have to tip your head up or or down to see the screen. You can use a small pillow behind your back if that feels comfortable to you. 
  • You’ll want to keep both feet on the floor with your knees and hips at 90 degrees. If your feet don’t reach, use a short stool.

Sitting on a Couch

  • Sitting upright with both feet on the ground is the ideal position, but admittedly is not always the most comfortable. 
  • Try the semi-reclined or side-lying positions (explained below) for relaxing.

How to Lay Down Properly During Pregnancy

  • You can lay on your back in a semi-reclined position by stacking pillows behind your head and back. You can also place some pillows under your knees.
  • Laying on your side is a great position during pregnancy. Put a pillow between your knees to support your top leg and place a very thin pillow or folded towel under your belly to support the weight of the baby. You can also put a pillow behind your back for added support. We love this pregnancy pillow!

How to Lift and Bend Properly During Pregnancy

  • If you’re carrying bags, divide them up so you’re carrying an even amount in each hand.
  • When moving an object, push it instead of pulling it. Use your legs, not your back and arms.
  • Try squatting, kneeling or standing with one leg slightly in front of the other and bending the knees (think lunge position) rather than bending at the waist when picking things up.
  • When getting out of bed, first roll to your side, bring your legs off and then use your arms to push up from the bed.

Best Exercises for Improved Pregnancy Posture


Begin this exercise on your hands and knees. You can be on the floor or on your bed. Position yourself so that your knees are directly under your hips and your hands are directly under your shoulders.

  • Upward (Cat) Motion: Gently exhale and pull in your abdominal muscles, pushing your spine upwards towards the ceiling and hold this position for 10 – 15 seconds. Allow your head to fall to your chest.
  • Downward (Cow) Motion: Slowly relax and let your stomach fall towards the floor (increasing the curve in your low back) and allow your shoulder blades to come together (move towards the spine). Hold this position for 10 – 15 seconds before returning to your starting position.

Repeat each motion 5-10 times, 1-2 times per day.

Chin Tucks

  • Sit up in your chair and with your index finger gently pull your chin straight back, as if you are sliding it backwards. 
  • Avoid tilting the chin up or down. Hold for 5 seconds and relax. 
  • Repeat 10-15 times, 2-3 times per day.

Shoulder Blade Squeezes

  • Sit up in your chair and gently bring your shoulder blades together while keeping your shoulders lowered. 
  • Avoid hiking your shoulders up towards your ears.
  • Hold for 5 seconds and relax. 
  • Repeat 10-15 times, 2-3 times per day.

Transverse Abdominis Contractions

  • Lie down on your back with your knees bent. Gently pull in your lower belly like you are buttoning a pair of pants that are a little bit too tight. 
  • Make sure you aren’t holding your breath!
  • Hold for 5 seconds and relax completely. 
  • Repeat 10-20 times per day.

Seated Thoracic Extension

  • Sit up in your chair and clasp your hands together. 
  • Bring your hands up over your head until you feel a gentle stretching in your shoulders and upper back. 
  • Hold for 5 seconds then return your arms to the starting position. 
  • Repeat 10-15 times, 2-3 times per day. 

If you have more questions or these tips aren’t working for you, consider scheduling an appointment with us below!



Are you currently pregnant or planning to conceive? If so, make sure to download my FREE resource — 5 Myths We’ve Been Told About Pregnant Bodies!  I correct common pregnancy myths and give you tons of tips to help you feel strong and healthy for 40 weeks and beyond.

Janelle Trippany PT, DPT, PRPC, CLT is a pelvic floor physical therapist in Seattle, WA where she lives and works with her husband and little boy. She is passionate about providing personalized care through every stage of a woman’s life, whether that’s during pregnancy or the postpartum period and beyond. She aims to make every treatment session friendly and comfortable and works to empower women in their healthcare journey. When not working, she loves hiking, camping and exploring the beautiful beaches of the PNW.


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