Is Postural Control the Key to Preventing Low Back and Pelvic Girdle Pain in Pregnancy?
- Julian Simpson
- 3 days ago
- 3 min read
Is Postural Control the Key to Preventing Low Back and Pelvic Girdle Pain in Pregnancy?
Falls are a prevalent concern during pregnancy, with research indicating that approximately 27 % of pregnant individuals will experience at least one fall, while around 10 % report experiencing two or more falls throughout their pregnancy journey. This statistic highlights the significant risk that falls pose to expectant mothers, who may be navigating physical changes that affect their balance and coordination.
Moreover, falls during pregnancy are recognised as the most frequent cause of emergency department visits among this population. The implications of such falls can be serious, not only for the health of the mother but also for the developing fetus, making it crucial to understand the underlying factors contributing to these incidents.
How do we know pregnancy can lead to postural instability?
Extensive research has been conducted to explore the relationship between pregnancy and altered postural control. Previous studies have consistently identified that pregnant individuals exhibit changes in their postural stability. For instance, during tasks such as bilateral standing with their eyes open, pregnant females tend to adopt a wider stance for balance and stability. This adjustment is a compensatory mechanism to counteract the physiological changes that occur during pregnancy, including shifts in the centre of gravity as the abdomen expands.
Additionally, these individuals demonstrate increased total sway, which refers to the overall motion of the centre of pressure (COP).
When compared to non-pregnant individuals, this increased sway indicates a higher level of instability and suggests that pregnant individuals may have a compromised ability to maintain balance. This phenomenon is particularly important to consider, as greater total sway has been linked to a heightened risk of falls.
Research has also indicated that a smaller sway during challenging balance tasks may correlate with an increased fall risk. This is particularly relevant for individuals experiencing knee pain, where it has been proposed that elevated fall rates could be attributed to various factors, including muscle inhibition, neuromuscular effects, or central changes such as cognitive or executive function interference caused by pain.
Considering that up to 70 % of pregnant individuals report experiencing low back and/or pelvic girdle pain (LB/PGP), it becomes essential for healthcare providers, particularly chiropractors, to assess these patients comprehensively. Our role is to evaluate spinal alignment and muscle function to mitigate the risks associated with falls and alleviate low back pain.
Recent research conducted in 2024 has provided further insights into this issue, revealing several critical findings:
During the third trimester, pregnant mothers are at the highest risk of falling, primarily due to a significant loss of postural control as their bodies undergo substantial changes in preparation for childbirth.
Increased lower back pain correlates with a noticeable rise in sway and a further loss of postural control, indicating that pain management is a crucial factor in maintaining stability.
Moreover, diminished visual input has been associated with greater loss of body control, suggesting that factors such as lighting conditions, visual acuity, and environmental awareness play vital roles in maintaining balance during pregnancy.
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Reference
Bagwell JJ, Reynolds N, Katsavelis D, Kyvelidou A. Investigating postural control as a predictor of low back and pelvic girdle pain during and after pregnancy. Clin Biomech (Bristol). 2024 Oct 29;120:106370. doi: 10.1016/j.clinbiomech.2024.106370. Epub ahead of print. PMID: 39488145.
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