懷孕媽媽體態大解析 Pregnancy and posture alterations
The body changes drastically at different pregnancy trimesters. Postural changes can be affected by the gravid uterus, hormones, increased body weight and lifestyle changes. This article focuses on what posture malalignment can be a potential harm to your body.
頸部前傾 烏龜脖子 頭向後仰 Neck forward tilting, elevated chin
Progesterone and estrogen levels elevate during the second pregnancy trimester, which increase breast size. The cervical shifts forward and the head compensates in an elevated (chin up) position due to the changes of the center of gravity. Palpate the back of the neck, approximately around the collar (6 or 7 segments of the cervical spine), there is a great chance that the head and neck is malaligned if there is an evident bone protrusion.
Neck forward tilting and elevated chin may cause pain around the neck and upper back, headache and even upper limb numbness.
駝背 胸椎過度前彎 Back slouching, thoracic kyphosis
Increased size and weight of the breasts directly influences the position of the thoracic spine. The displacement of the thoracic spine would worsen during pregnancy if slouching is a habit before pregnant. According to a previous study, there is an increase of trunk extensor muscle activity in pregnant women compared to the nulliparous. This adaptive response is to compensate the increase of anterior loads during pregnancy. In addition, the back extensor muscles would be in a more active state in those who have thoracic kyphosis.
Pregnant moms may have problems with upper back muscle tightness and pain in the middle of the scapula.
肋骨向上翻 Ribs out flare
In order to ‘correct’ thoracic kyphosis or slouched spine, some might have doubts about the right way of posture adjustment. Some often find themselves flaring the ribs instead of straightening the thoracic spine. This is due to the decreased mobility of the ribs which is related to wearing bra since puberty and poor postures. Malalignment of the ribs may change the placement of the diaphragm, which is crucial to normal breathing patterns and spinal stability.
Moms may experience chest tightness, hypoxia, drowsy, core muscle weakness and difficulty in maintaining your body in an upright position for a long time.
腰椎前凸 Accentuated low back curvature, lumbar lordosis
Most women still work during pregnant, prolonged sitting, standing and carry weights are necessary in certain situations. Those who have small ones to care at home, holding children and carrying their necessities are needed. The increased anterior loads and external weight accentuate the low back curvature (lumbar lordosis), which place pressure on the lumbar spine. Core muscle, a trunk stabilizer, is weak in those with exaggerated lumbar lordosis. Without the help of core muscle providing support to the spine, ligaments and joints on the spine is compensated to act as stabilizers.
Low back pain is highly related to excessive lumbar lordosis. In worse conditions, some might suffer from lower limb numbness and heat due to nerve compression.
骨盆前旋（傾）Pelvis forward tilting
The gravid uterus rotates the pelvis sagittally which puts the pelvic floor muscles, gluteal muscles and muscles around the thighs in a stretched position. The muscles may decrease in function and normal muscle tone. Urinary incontinence is highly associated with pelvic muscle weakness, while decreased gluteal muscles and thigh muscles is related to low back injuries. A previous study indicated that the trunk was more bent and knee flexion was significantly less for pregnant women during lifting objects up from a stool. This is possibly due to the weakened gluteal muscles and thigh muscles that do not provide proper function during activities.
Prolonged pelvic forward tilting result in problems such as incontinence, low back pain and thigh muscle weakness.
膝蓋向後頂 Back knee, genu recurvatum
Ligaments in the knees become loose during pregnancy, which induce hyperextended knees. In anatomy, it is thought as malalignment of the femur and the tibia. The knee joint, ligaments and cartilages are put under stress in this situation, while the muscles that support the knee joint decrease in function. This induces knee pain during increased physical activity or exercise.
Patellofemoral pain, patella tendon pain, medial/ lateral knee pain are the most common problems in those with back knee. Especially during squatting down and going up and down the stairs.
足部外翻 Flat feet, pronated feet
Flat feet during pregnancy is caused when the arch of the foot flattens out upon weight bearing or walking. Thus causing stress on the plantar fascia, ligaments and foot muscles leading to significant pain. When flat feet appears, there is a greater chance of altering knee alignment — knock knees. When standing up straight, the knees are close together but the foot stay apart. This adds stress to the knees, calf and ankle causing unwanted pain.
Pregnant moms may have symptoms such as medial calf pain, medial knee pain, patellofemoral pain, uneven foot pressure and plantar fasciitis.
如果您因為有這些現象而導致疼痛或痠痛，建議尋求醫師或物理治療師的幫忙。Please seek medical help if you have pain or problems related to the faulty postures mentioned above.
Other articles you might be interested in…
Danna A, Magalhães AT, Silva BS, Duarte BS, Barros GL, Silva M, et al. Upright Balance Control Strategies During Pregnancy. Gait Posture. 2018 Oct;66:7–12.
Pardo F, Amo A, Rios MP, Gijon-Nogueron G, Yuste CC. Changes in Foot Posture During Pregnancy and Their Relation With Musculoskeletal Pain: A Longitudinal Cohort Study. Women Birth. 2018 Apr;31(2):e84-8.
Biviá-Roig G, Lisón JF, Sánchez-Zuriaga D. Changes in Trunk Posture and Muscle Responses in Standing During Pregnancy and Postpartum. PLoS One. 2018 Mar 27;13(3):e0194853.