Role of Exercise Treatment of Low Back Pain in Pregnancy
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SPORTS MEDICINE REHABILITATION (BJ LIEM AND B KRABAK, SECTION EDITORS)
Role of Exercise Treatment of Low Back Pain in Pregnancy Heidi Chen 1 & Gerard D’Onofrio 1 & Farah Hameed 2 Accepted: 3 September 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review This review identified exercise therapies for specific diagnoses underlying pregnancy-related low back (PLBP) and pelvic girdle pain (PPGP). We describe the biomechanical changes that may lead to sacroiliac dysfunction during pregnancy, pubic symphysis dysfunction, diastasis recti in the peripartum period, and pregnancy-related low back pain. Our focus was to examine the impact of exercise on each condition. Recent Findings We consolidated updated guidelines for physical activity throughout pregnancy, explored whether exercise is effective for stabilizing the low back and pelvic girdle in pregnant and postpartum patients as well as reviewed the absolute and relative contraindications to physical activity during pregnancy. Summary PLBP and PPGP stem from multiple etiologies and can affect women during their pregnancy and in the postpartum period. Exercise during pregnancy is recommended for the cardiorespiratory fitness of pregnant women, appears to reduce disability and sick leave from work, and is considered to be relatively safe except for noted contraindications. Keywords Pregnancy pelvic girdle pain . Pregnancy low back pain . Exercise in pregnancy and postpartum . Diastasis recti abdominis . Pubic symphysis dysfunction . Sacroiliac dysfunction in pregnancy and postpartum
Introduction Pregnancy related lumbo-pelvic pain (PLPP) is a common ailment during pregnancy with physical, psychosocial, and even economic consequences. Overall prevalence of PLPP is variable with reports as high as 75% and as low as 20% when excluding mild cases; most studies have reported a prevalence of approximately 50% during pregnancy [1–4, 5••]. This discrepancy in prevalence is thought to be due to heterogeneity in defining PLPP. For the purposes of this review, PLPP is an umbrella term encompassing the area between the twelfth rib This article is part of the Topical Collection on Sports Medicine Rehabilitation * Farah Hameed [email protected] 1
NewYork-Presbyterian, Rehabilitation and Regenerative Medicine, Columbia University Medical Center, Weill Cornell Medical Center, New York, NY, USA
2
Rehabilitation and Regenerative Medicinen, Columbia University Medical Center, 180 Fort Washington Avenue, New York, NY 10032, USA
and the gluteal fold that can be delineated into two patterns of pain: pregnancy-related lower back pain (PLBP) and pregnancy-related pelvic girdle pain (PPGP) [1]. PLBP is considered to be pain located between the twelfth rib and iliac crest. PPGP is considered pain between the posterior iliac crest and gluteal fold encompassing the pelvis; this is further subcategorized into 4 classes depending on localization of pain: anterior in the pubic symphysis, posterior in either sacroiliac joint, both sacroil
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