PSA: Moving around in bed during pregnancy does not need to hurt
You wake up in the middle of the night. Your hip hurts because you're 6 months pregnant and you've been laying on one side for the past 4 hours. You go to roll over and bang! Out of nowhere you feel a sudden, sharp pull in your pelvis.
Sound familiar?
Pelvic, abdominal and low back pain while moving around in bed is common, specifically during pregnancy. These pains can roll over into postpartum times as well.
The most common places people feel pain while rolling in bed include their:
pubic symphysis joint (at the front of the pelvis)
sacroiliac joint (typically on one side of the low back, near the back dimple)
low back
linea alba (along the center of the belly)
belly button
Sleep is already hard to come by during the end of pregnancy and with little ones at home, and there's nothing worse than getting a sharp jolt of pain in the middle of the night waking you up even further. In today's piece we're going to be jumping in to two simple ways you can reduce pain with bed mobility, but first, let's discuss why this happens.
Why is pain while rolling around in bed so common during and following pregnancy? While there's no single reason this happens, there are a number of contributing factors. These factors include:
fatigue in the muscles surrounding your pelvis including your pelvic floor, glutes and abdominals
changes to your sleeping and waking postures due to a growing belly
changes to activity level during waking hours
extra weight and stress on muscles and ligaments surrounding and supporting the pelvis
Notice something missing? Relaxin. While relaxin, the infamous pregnancy hormone we all love to hate, MAY play a role in pelvic pain during pregnancy, all too often it gets pinned with all the blame. Research has repeatedly shown that relaxin peaks in the first trimester - interestingly removed from when most begin to experience pelvic pain - and is unlikely to be the primary cause of pelvic pain in pregnancy. Dr. Jill Krapf did an excellent talk on pregnancy hormones for My PFM on this topic
Nonetheless, moving around in bed can be a huge pain during and following pregnancy, but there are ways we can blunt that pain. While we can't influence the relaxin or the weight stressing the muscles and ligaments, we can influence how our posture and muscle activation impacts our pain.
These are two tricks I teach my patients experiencing pain to help better engage the muscles supporting the pelvis and reduce the stress on the pelvis:
1. Log roll instead of sitting up
Log rolling is one simple way to reduce discomfort while moving around in bed. By using the log roll technique, we reduce intra-abdominal pressure and strain on our pelvis. We do this by keeping the body parallel while moving rather than introducing rotation and asymmetrical movement.
While I'll describe the log roll below, I also filmed a short 3-minute video demonstrating both of the recommended techniques that you can watch here.
If you prefer to read instead of watch, follow along with me step by step to learn how to log roll:
Start on your back with your knees bent and feet flat on the bed.
Your goal is to keep your knees, hips and shoulders parallel to one another as you move.
If you're rolling to the right, use your left foot and elbow to push yourself onto your right side. Reverse the sides if rolling the opposite direction.
Once you're laying on your right side, your knees should still be bent with knees and ankles together.
Now you're going to push yourself up using your right elbow and left hand, while swinging your legs off the bed. Use the momentum from swinging your legs off the bed to help lift yourself into a sitting position.
And voila! You did a log roll!
Repeat these steps backwards to come back onto your side.
2. Activate your transverse abdominis before moving
Another, catchier way of saying this is "blow before you go." Intentionally engaging your deep abdominal muscles provides some additional support to the muscles surrounding your pelvis. This technique is also demonstrated in the video above.
The coordination here is a little simpler than the log roll. This tip is also demonstrated in the video above, here’s how you want to coordinate this movement:
While laying on your back, before you begin to move, take a big belly breath in.
Exhale and pull your navel to your spine as you begin to move.
That’s it!
Making sure you are correctly engaging your transverse abdominis is key for optimal support during this movement. For my visual people out there, click here to see how a TA contraction should look. For the rest of you, here are some cues you can try to see which one makes the most sense to your body. Each of these should be performed after a big deep breath in.
Exhale navel to spine
Exhale navel to spine and scoop up towards your head
Exhale and imagine hugging your hips towards each other
Exhale and imagine a zipper running from pubic bone to rib cage, zipping your core
Exhale and make the sound "shhh" as you do
As always, if you continue to experience pain during or following pregnancy, consider seeing a pelvic floor PT. We offer 1:1 appointments both in person, here in our pelvic floor PT clinic in Austin, TX and virtually for those all across the globe. Learn more by shooting us a message here.
This post was written by Dr. Rebecca Maidansky, PT, DPT, owner and founder of Lady Bird Physical Therapy. Rebecca is a pelvic floor physical therapist in Austin, TX and founded Lady Bird Physical Therapy in 2019. She is the creator of Birth Preparation and Postpartum Planning, Baby Steps Fitness and the head writer and editor of The Pelvic Press.
Rebecca is a passionate writer and vocal advocate for pelvic health and the importance of improving access to perinatal care. She believes strongly that many common pregnancy pains and postpartum symptoms can be eased or even prevented with basic education and care.
She created this blog to help all birthing people manage common pregnancy pains, prepare for birth and recover postpartum.