Improving Back Pain Through Alignment

When you have aches and pains that you just can’t quite get rid of, it can be really frustrating, especially when you are a busy mama rockin’ all the things motherhood entails.  All you want to do is to enjoy your days pain-free, but back pain is a common complaint for many of us so what are some simple yet effective ways to improve back pain through alignment?

Belle About Town spoke to Wendy Powell, the founder of MUTU System – a medically recommended digital antenatal and postpartum support platform.

Assessed and approved by the NHS Apps Library, MUTU System is referred to by NHS and private specialist Pelvic Health Physical Therapists, Surgeons, NHS GP surgeries in the UK, Midwives and Hospital Women’s Health Physiotherapists. Wendy answered all of our questions and more, so read on for new insight to better support your body and end postpartum back pain for good…

Alignment and back pain – the connection

Let’s start with the ‘what even is alignment?’ question. To put it simply alignment is the way we are structurally ‘stacked’ internally, from head to toe. The terms posture and alignment are often used interchangeably and while they are related they are not quite the same thing. Posture is how we look from the outside but alignment is how we are from within. A great example of how these differ is what many of us were taught is ‘good posture’, with our shoulders back and chest out. While this looks good, for many the ‘chest out’ cue causes us to lift our rib cage out of alignment, which places strain and pressure on the rest of our kinetic chain (a fancy term used to describe how parts of the body act as a system of chain links during movement). Yes, good posture matters, but good alignment matters more! 

Improving back pain is a multi-layered issue and one of those layers is alignment. Such as how you are standing, sitting, and moving. Our way of modern living does us few favours when it comes to naturally encouraging good alignment. We drive everywhere, sit in chairs way too much, and when we do move, the way we move isn’t truly ‘natural’. We even sit down and strain rather than squat and let it happen when we go to the bathroom!

We wear shoes (including sports shoes) that pitch our bodies forward and force our muscles and joints to compensate unnaturally. We suck in our stomach and clench our butt. As a result, our alignment has shifted from what is natural and optimal and often results in increased aches and pains, back pain being one of them. 

Alignment Check Points

As already mentioned, alignment matters from the end of your toes to the top of your gorgeous head. Our body is a connected, complex, and amazing system and looking into how you currently carry and hold your body throughout your day is a really important step to improving back pain. It can get overwhelming thinking that you have to focus on every point from your head to your toes – so we are going to just focus on two alignment points that really matter, for mamas especially, and also in relation to back pain. These are: rib cage alignment and pelvis alignment. 

Rib Cage Alignment 

Your rib cage houses some pretty important organs and has various connection points through cartilage and ligaments. One of those connection points is to the thoracic vertebrae in your back. When you constantly have your rib cage thrusted upwards (think of that ‘chest out’ cue) it places an unnatural strain on not only the entire core structure (which can also impact diastasis recti) but also on the back – especially the lower back. This strain will cause increasing back pain that lingers. Also, when you constantly thrust your rib cage forward this often becomes your point of movement instead of your shoulders  – this constant moving of the ribcage and inactivity of the shoulders leads to shoulder mobility issues particularly rounded, more tight, shoulders. Your shoulders were meant to be moved and used, make sure your rib cage is not compensating and taking over for them. To give you an example of what this looks like in daily living – next time when you have to reach up to get something out of a shelf that is a little bit higher, check in with what you are using to move and stretch to reach that shelf – are you lifting and thrusting the rib cage forward to help propel your arms up, or are you keeping your ribs down and using your shoulders to reach up? Take note of what you find!  

Improving back pain also means improving your rib cage alignment. Click the link to find out how to do a simple ‘at home’ test to understand your rib cage alignment:  https://youtu.be/EpLAvHFK0pw

Pelvis Alignment 

Your pelvis also houses important organs and alignment of your pelvis really matters when it comes to pelvic floor, core, and back health. Too many of us are guilty of being ‘butt tuckers’, If you tuck your butt under all the time the muscles of the pelvic floor eventually shortens to compensate. Becoming tight and weak, just like the shoulders in relation to rib cage alignment. This tucking affects the spine as well, leading to aches and pains. The opposite issue arises when you tilt and arch your pelvis too far forward (when you stick your butt out) – affecting both the pelvic floor and the back as well. You want your pelvis to ‘live’ in neutral.

To find out how to find your neutral pelvis, we have put together this video, especially for you: https://youtu.be/3O4oft2F0M4

Simple at-home changes you can make

Now that you have a better understanding of why alignment matters when it comes to improving back pain and what more optimal rib and pelvis alignment looks like, let’s talk about a few changes you can make today, because you are an action taking woman! The below video link, may also be of some use: https://youtu.be/lFfkw80dimc

The shoes you wear

What you wear on your feet matters! One of the most important things you can do to start putting your body in the right place is to get out of heeled shoes. Positive heeled shoes (yes, high heels but also most running or sports shoes as well) pitch your body forward. If your body were a vertical column, which mechanically speaking, it’s trying really hard to be – adding a mere inch of heel has you falling forward and of course you can’t walk with your nose to the ground, so your body tries to compensate and straighten you up. Your butt has to tuck under and squeeze, and your stomach has to suck in. Meanwhile huge pressure is placed on your knees as your body is trying to resist the forward fall.

The result is a flat butt, sticky-out tummy, pelvic floor and core not working, and pressure placed on the back that results in unwanted back pain. 

How you move 

The way you move can make or break you (not really, but it does greatly impact the back pain you have). The following will provide some great help:

Add in some mobility work

Mobility work has many overall benefits. As you work on improving back pain through alignment, increasing your range of motion and working on being able to control how you recruit during movement, is going to help. Here are 3 mobility exercises you can do to target different areas of your body:

Shoulder Mobility: Wall slides

• Sit comfortably with your back against a wall
• Lift your arms, elbows bent to 90 degrees, out to both sides 
• Exhale as you slowly start to glide your arms up on the wall 
• Only extend your arms as far as you can without your rib cage lifting. 
• As soon as you reach the end of your range of motion, inhale and slowly lower back down
• Repeat for 5 reps 

Upper Back Mobility: Windmills  

• Lie on the floor on your side with both arms extended straight out, stacked with palms together at shoulder height.
• Straighten your bottom leg and keep your top leg bent at a 90 degree angle (if needed place a block or pillow under bent knee)
• Exhale and slowly lift your top arm and rotate it away from you, opening up your chest to the ceiling and rotating until you can rest that lifted arm to the other side if possible (if not just rotate and extend as far as you can comfortably) 
• Inhale and hold for 3 seconds
• Exhale as you slowly rotate to bring your arm back to the starting position 
• Repeat on one side for 5 reps. Switch and to other side for another 5 reps

Hip Mobility: Knee Opener 

• Stand comfortably with feet about shoulder width apart
• If needed hold a chair or place hand on wall for balance support 
• Inhale as you slowly lift one knee up towards the chest 
• Exhale as you open that knee out to the side and circle it around and lower back to the starting position. 
• Repeat on one side for 5 reps. Switch and to other side for another 5 reps

To Sum it All Up

Improving back pain is going to take improving your alignment as well, they go hand in hand! Alignment is something that can feel overwhelming, especially as you look to make changes to positively improve it. Don’t feel that you need (or should!) make all the changes at once. Muscle memory is powerful, and you may have been carrying yourself the same way for years, it may take some time to improve your alignment. But implement changes slowly and know that those small changes will have a big impact!