Oh, Baby, My Back Hurts
Rehabilitation
Written by Dr. Joe Ventura   
Monday, 21 February 2011 00:00 Read : 2381 times

As if the prospect of morning sickness, constipation, rashes and changes in hormone and wardrobe weren’t daunting enough, 80% of pregnant women will develop back pain and almost 100% will develop poor posture. The pain can last up to three months past the delivery date. Typically pain is experienced in the following areas:pregnantbelly

  • Hip Joints
  • Low Back
  • Mid-back
  • Neck
  • Shoulders
  • TMJ or Jaw joint

Unfortunately, the poor posture can become permanent.

It’s easy to see why. First there are the hormone changes that help relax ligaments and joints throughout the body. Next is the extra weight. Here is a breakdown of weight gain for a woman of normal weight.pregnancychart

The Body’s Balance System

The human body has a magnificent system of adapting to keep us upright under many different conditions. This “Balance Control System” is comprised of two parts; Sensory (Where am I) and Motor (What am I going to do). But this adaptation comes at a price. As the extra 25 or so pounds are added to the woman’s general mid-line area, the initial reaction is for the Center of Gravity and Center of Mass to shift forward. However, the body’s Balance Control System kicks in and begins a slow but steady realignment of the pelvis, spine, head and shoulders to act as a counter-balance for the extra weight of pregnancy. Eventually the Center of Gravity shifts backward. This short term solution can have long lasting consequences.

The spinal changes are very predictable.

  1. Pelvis tilts forward
  2. Mid back drifts backward
  3. Head/Neck assume a position in front of the shoulders (know as Forward Head Posture)

How This Affects the Spinepregnancyskeleton

The natural “S” shape curve of the spine is created from the attachment of muscles and ligaments. Any changes in the curves of the spine will cause some muscles to stretch
and some muscles to shorten, both situations contributing to instability in the spine. This instability leads to chronic tension in certain muscle groups and increased strain on joints.

The study of Physiology tells us that a muscle kept in a stretched position will eventually elongate its fibers and become weak (Stretch Weakness). Conversely, a muscle held in an over-relaxed position will shorten its fibers and also become weak (Short Weakness). Because the postural changes are so predictable, it is clearly understood which muscle groups are involved and whether they have become stretched or shortened. Unfortunately  after delivery and the loss of the extra weight normally gained during pregnancy, the mother’s posture does not “snap” back into place. The stretched and shortened muscles stay that way until there is an intervention. That Intervention is known as Posture Reprogramming™.

The Shear Truth

pregnancyspineAs if all this wasn’t enough, other forces come into play to create a low back that is less stable and more prone to create chronic pain and discomfort. Shear forces to be exact. In a person with normal posture, downward Gravitational and directional shear forces work with the body to “lock” joints into position under load, thereby providing strength and stability to the spine. In a pregnancy posture, the Gravitational forces remain essentially the same, but the shear forces change direction in such a way as to open the low back joints, providing less stability in the spine. The body’s exquisite feedback system senses this and the muscles in the low back become tighter in an effort to take up the slack.

First the bad news: Poor posture is NOT self-correcting.

Now the good news: Poor posture can be corrected in as little as four weeks!

Identifying Poor Posture Through the Use of the Posture Numberpregnancytop

Correcting posture begins with a simple non-invasive digital analysis to establish the patient’s Posture Numbertm. This number is used to identify and quantify the extent of the poor posture, and provide guidelines for the cost of posture reprogramming.

Next a series of gentle spinal mobilization sessions will be started and a set of custom stretches and exercises will be assigned. A special therapeutic cushion may be prescribed. These protocols are designed to reverse spinal muscle changes and reprogram muscles back to their original positions. This process takes about four weeks. 

About the Posture Reprogramming Stretches and Exercises

Because the pelvic and spinal changes are so predictable, it is possible to map which muscles will undergo “Stretch Weakness” and pregnancymiddlewhich will exhibit “Short Weakness”. With that knowledge, a Posture Reprogramming professional can create an exercise program to strengthen the muscles that have become stretched, and a stretching program for the muscles that have become shotened.

In addition to these maneuvers, a new therapeutic cushion that helps reduce  the effects of Forward Head Posture may be recommended. It’s called Posture Blocks™ (Patent Pending).

Gravity Works Against You All Day Long. Now, Make It Work For You!

The special contours and foam density of the Posture Blocks cushion causes the person’s body weight, along with the pull of Gravity, to stretch muscles that need to be stretched and relax muscles that need to be relaxed. Imagine an exercise program that works simply by doing no more than lying on the floor!

Here are some of the innovative features:pregnancybottom

  • Adjustable Headrest allows the head to assume a neutral or slightly backward position simultaneously stretching the muscles in the front of the neck and relaxing the muscles in back.
  • The soft neck bridge encourages a normal curve in the neck.
  • Special cut-out encourages external rotation of the shoulders.
  • The upper back bridge exerts a gentle forward force that relaxes the back and expands the chest area.
  • The upper back bridge has a gentle decline to the low back area.

The special features of the Posture Blocks cushion are so unique the company was awarded a Patent Pending designation by the USPTO. 

Reimbursement for Posture Reprogramming

Although there is an ICD-10 code for Abnormal Posture  (R29.3), third-party reimbursement for abnormal posture is rare and is generally considered an out of network service, Most insurance companies will allow its use as a compound or complicating code. This essentially means that Posture Reprogramming is a cash based service. The fee is based on the results of the posture exam. The Posture Pro software will generate a Posture Number™, which is the accumulation of deviations from normal. The general fee guideline is $50 for every Posture Number unit of deviation. For the average patient that would be in the $500-$1,000 range for the Posture Reprogramming.

Using the Posture Reprogramming System a doctor of chiropractic can market this service directly to pregnant patients or to local OB/GYN clinics.

Conclusion

Back pain and postural changes from pregnancy are both inevitable and manageable. If started early, a prescribed exercise and stretching program can help reverse muscle changes and improve posture during and after the pregnancy. A new therapeutic cushion, the Posture Blocks, shows great promise in helping with this universal problem.

 

Joseph Ventura D.C. is owner of VenturaDesigns, a 32 year company that develops software and marketing strategies for the chiropractic profession. Dr. Ventura can be reached at (888) 713-2093 or at This e-mail address is being protected from spambots. You need JavaScript enabled to view it



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