This article is excerpted from the handbook 'Active Spine', which will be released soon by the Publishing House:


Pregnancy is a new challenge for woman’s body. Loads of biomechanical changes occur: a growing midriff shifts the centre of gravity and greater weight causes stress on joints and intervertebral discs. These are physiological changes and a healthy active back handles them well. If you did not have back problems before pregnancy, it is likely you would avoid them while pregnant, provided that your spine is properly “serviced” (taken care of).


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Namely, how should you take care of your spine? If you are physically active, the first two trimesters of pregnancy are absolutely not a contraindication to continue this activity, you should just exclude jogging and sports which require a lot of jumping. An active spine is the one controlled by muscles, and they are also worth looking after. Exercise and physical activity are the best remedy for pain relief and well-being. They increase blood circulation and improve the supply of oxygen, which is also very important for your unborn child.

If your physical activity before pregnancy was limited to driving and sitting behind your office desk, then you should sign up for training carried out by a specialist, to prepare for the birth and the last trimester of pregnancy. Exercises should be properly tailored to your capabilities. The role of well-functioning muscles turns out to be very important in later pregnancy, when the body produces natural hormones that relax and loosen ligaments. The easiest and most effective exercise proves to be walking. Alternate loading of the pelvis while walking acts as a massage on your muscles and causes the natural alignment of joints. The fluctuating pressure nourishes cartilage and intervertebral discs.  For maximum effectiveness you should walk for the minimal distance of at least 3 kilometres of continuous marching.  If you use Nordic walking sticks, your knees will be relieved and upper body – activated. This simple but effective exercise is highly recommended, which should be performed at least 3 times a week. Exercises using Swiss balls, yoga and swimming pool have also a very positive influence on your body.

Keeping a proper body posture can prevent ailment. Growing breasts cause impulsive slouching – you have to control it because such a position increases the risk of thoracic spine pain and most likely headaches. Remember to stand up straight! You may exercise muscles of shoulder blades using an elastic tape.

Do not overload! You have to control your body mass, you will certainly gain weight, but make sure this


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happens within the normal range for your height and build. Consult your doctor. Each extra kilogram is a burden on your joints.

When sitting, avoid armchair position, when your spine is curved as a letter C. Do not cross your legs, relaxation of the pelvic joints may cause their blockage and unpleasant pain.

Greater weight means greater strain on feet. Increasing diagonal flat foot during pregnancy may lead to hallux valgus in the future. If you have a tendency to diagonal flat feet you should get tailor-made orthopaedic insoles for the time of your pregnancy.

High heels completely change walking biomechanics, turning you into a “toe-walker”. This additionally overloads the lumbar spine. Do not exaggerate with wearing such shoes.

Examples of exercises

Exercises during pregnancy should always be approved by your doctor. Exercises recommended below may be performed all the way through pregnancy, as long as there are no medical contraindications to physical activity.

Except for exercise No 9, they should be performed according to the following rules:

–      after each exercise the position should be endured for 20 seconds

–      back to the initial position

–      5 seconds break

–      number of repetitions – it is recommended that you exercise until you become tired or unable to maintain the correct position.

1, 2, 3stabilization and sensorimotor exercises using sensorimotor pillow or Togu® (supporting pillow).

Active sitting

1.     Alternate straightening of lower limbs. It is important to keep your back straight!

1a 1b              1b 1                 


2.     Lifting hips to the straight line of the body

2a 2a        2b 2b


3.     Alternate lifting limbs. It is important to keep your back straight!

3a               3b

3a Alternate lifting upper limbs                       3b Alternate lifting lower limbs



3c Alternate lifting upper and lower limbs together

4, 5 – stabilization and sensorimotor exercises using stool, sensorimotor pillow and ball

4.     Sitting on a sensorimotor pillow on a stool.It is important to keep your back straight!

4a                 4b

4a Alternate straightening of knees                   4b Lifting both legs up.

5.     Bending forward with the ball. It is important to keep your back straight!

5a              5b                 

5a                                                                  5b

6, 7, 8, 9 – stabilization exercises using a big rehabilitation ball.

6.     Lifting hips to the straight line of the body.

6a              6b

6a                                                                  6b Pulling the ball towards you with your hips lifted


7.     Bending forward. This movement is only performed within range and movement of knee joints. The range of movement depends on the ability of keeping the correct position (straight back).

7a                   7b 

7a                                                                     7b

8.     Lifting the big ball up.

8a                    8b

8a                                                                       8b

  9.     Moving from sitting position to lying on your back. We perform 3 sets of 20 repetitions with a 2 minute  break after each set.

9a                    9b

9a                                                                      9b




Dariusz Straszewski, MA in Physiotherapy, Physiotherapy Department Manager at the orthopaedics and sports medicine clinic Carolina Medical Center in Warsaw, Poland; experienced lecturer and teacher of practical therapy techniques within orthopaedic rehabilitation and sports medicine; author of articles and guidebooks in this area; frequent guest of radio and TV programs; as a physiotherapist he works with leading Polish athletes and Olympians.

Inspiration and cooperation for this and other projects has been with Daria Mejnartowicz (2012 Fortune/US State Department Global Women’s Mentoring Partnership Alumna) who along with Darek cooperate with Polish Professional Women Network and Vital Voices Poland.