Pregnancy-Specific Stabilization

Every woman’s body goes through an amazing transformation as she proceeds through her pregnancy. Unfortunately, some of these changes can be the source of considerable discomfort and may even cause unrelenting pain during a time that should be joyous. A recent Cochrane review of the scientific literature reported that “more than two-thirds of pregnant women experience low-back pain and almost one-fifth experience pelvic pain.1A survey of pregnant women in Connecticut found that 68.6% had experienced substantial pain in their lower back region, and this had interfered significantly with important activities of daily living in at least a third.2 Women who report having low-back pain during pregnancy are also much more likely to experience future episodes of back pain, either during another pregnancy or during unrelated activities.3

Lumbopelvic pain can also persist after delivery, resulting in chronic, sometimes debilitating, physical and psychological stress for at least a third of new mothers.4 There are several factors that often combine to create a “perfect storm” of biomechanical malfunctions that cause this misery - weight gain, posture and gait changes, and joint laxity.

Physics of body alterations during pregnancy

The normal weight gain during pregnancy ranges from 1.5 to 2 pounds at 10 weeks, then increases to 25 to 35 pounds at delivery. This wide range is due to many factors, including genetics, ethnicity, and personal variation in health and wellness activities before and during pregnancy. Around 48% of U.S. women gain more than this normal amount of weight, according to recent research reported by the Centers for Disease Control and Prevention.5

The biomechanical effects of these increases in weight vary by body region based on the changes to the mass distribution around the trunk. Postural alignment is altered by large gains in weight localized to the abdomen and breasts, which shifts the center of gravity forward and causes a tendency to increased thoracic extension with lumbar lordosis and anterior pelvic tilt during walking.6 An increase in EMG activity of the trunk extensors (primarily the lumbar extensor and biceps femoris muscle groups) when standing is an adaptive response to the greater anterior loads during pregnancy.7 Large systemic buildups in blood volume, fluid retention, and fat deposits contribute to a more generalized loading of the musculoskeletal system, affecting the weightbearing structures in particular.

A pregnant woman’s gait alterations include a lateral shifting of the torso and pelvis accompanied by a greater step width.4 Researchers have also identified increased ankle stiffness and a shorter step length; all of these are felt to be attempts to enhance postural control and gait stability. A forward shift in plantar loading onto the forefoot and a drop of the longitudinal arch from increased body weight also occur as the pregnancy progresses.8

Physiological changes during pregnancy

Many bodily functions and most hormones undergo significant fluctuations throughout this exciting period. Surging levels of the hormone relaxin, which elevate 10-fold during pregnancy, greatly increase the flexibility of all joints in the body.9 While this is a good thing for the pubic symphysis and sacroiliac joints that will require additional mobility during delivery, laxity in weight-bearing joints can be detrimental to their stability. When the additional weight being gained combines with the altered postural alignment and gait changes, the spine and pelvis joints may be stressed to their limits or beyond, resulting in chronic discomfort and even disabling pain.

Post-partum considerations

Persistent low-back and pelvic dysfunctions are commonly seen after delivery, since the postural and hormonal changes require 3-5 months to return to normal.2 3 Additionally, the new physical stresses of baby carrying (and “baby-wearing”) are introduced soon after delivery. These recurrent physical strains are often the source of the continuing low-back and pelvic girdle pain that affects new mothers.

Providing care for pregnant patients and new mothers

Chiropractors frequently provide care for women during their pregnancy and postpartum phases. Various manual treatments and specific adjustments are often very helpful in easing the physical distress of pregnancy.10 Recent systematic reviews have found moderate-level evidence and overall favorable conclusions in the scientific literature regarding the positive effects of chiropractic care for pregnancy-related back pain.1112

Foundational support (from the ground, and up the entire Kinetic Chain)

One treatment objective that is frequently overlooked is the weightbearing joint instability and the postural/gait stresses, as described above. Orthotic stabilizers should be considered an important part of the treatment and disability prevention programs for most pregnant patients.

The Mother Nurture™ Custom Orthotics System by Foot Levelers - body stabilization just for pregnant women

With the addition of the revolutionary NEW Mother Nurture Custom Orthotics System during pregnancy and after delivery, mothers-to-be can benefit from having balanced proprioceptive alignment from their feet into their spine when under chiropractic care. This groundbreaking solution to pregnancy-related low back and pelvic girdle pain is unique; the Mother Nurture system is the first and only custom orthotic available for pregnant women. It’s only available from healthcare professionals, who will provide their recommendations and adjustments during the various stages of pregnancy, while monitoring the patient to ensure optimum results.

About the Mother Nurture Support System

With just a single scan obtained early in a woman’s pregnancy,

Foot Levelers will develop a custom stabilization program for each mother-to-be. The Mother Nurture System consists of three pairs of spinal pelvic stabilizers designed to assist her through the many changes that occur during trimester two, then through trimester three, plus after delivery into the postpartum recovery phase.

These carefully hand-crafted custom orthotics can help improve balance, maintain proprioception, and reduce low back and pelvic girdle pain. The Mother Nurture System includes a bonus foot roller, which is useful for reducing tension and soreness in her overburdened feet.

Mother Nurture custom orthotics support balanced alignment for healthy gestation and a safer and easier pregnancy. The system enhances the benefits of adjustments and massage treatments, and lax, hypermobile joints will have customized stabilization whenever they are weightbearing. This is especially important as increasing weight gain puts greater stress on the sensitive lumbo-pelvic and lower extremity joints and loads many large muscles with unrelenting strain. The third pair of the set, the postpartum orthotics, are very important for maintaining spinal-pelvic balance as the new mother cares for and continues to transport a growing newborn using various methods of baby “wearing” and asymmetrical infant carrying.

The foundational alignment these three pairs of custom orthotics provides will support the mother’s entire body as it undergoes the many physiological and biomechanical alterations of pregnancy and postpartum. The baby will benefit from a greater chance for a smooth and easy delivery, as well as a happier mother with greater pain-free mobility and energy!

Why is the Mother Nurture Custom Orthotics System needed?

Details of the Mother Nurture Support System

Since each pregnancy is unique, Mother Nurture orthotics are individually fitted and then monitored throughout pregnancy to help each woman’s body adapt to the changes she is facing. As her body and her needs change, her weightbearing support system should be customized for her. Therefore, a system of three separate orthotics (for trimester two, trimester three, and then postpartum) is necessary.

The Trimester Two Orthotics include the StanceGuard™ support system, which extends all the way to the heel to counteract the effects of plastic deformation. They also contain a firmer level of corrections for greater support to all three arches of each foot.

The Trimester Three Orthotics also include the StanceGuard™ support system, as well as a more aggressive level of corrections to address the forward-shifted center of gravity. Like the other orthotics in the system, they are lightweight, thin, and flexible to accommodate swollen feet.

The Postpartum Orthotics are designed to support the physical challenges of being a mother/caregiver, returning to work, and other activities. They include additional heel cushioning, enhanced shock absorption at foot strike and the DRSX™ support system, with more accommodative corrections for enhanced comfort.

The Mother Nurture Custom Orthotics System also includes a Foot Roller, which can be used by the patient as needed throughout pregnancy, as well as after delivery. Edema and muscle cramping in the feet, as well as plantar fasciitis are often reported by pregnant patients, especially in their third trimester. Using the foot roller for 10 to 15 minutes a day is an easy and effective way to decrease pain and soreness in aching, swollen feet and to provide relief from plantar fasciitis and other foot issues. Regular use of the roller also aids in the success of the break-in period.

It is very important to obtain an updated scan of each new mother at the time of her baby’s first birthday, as the previous scan image is no longer appropriate for ongoing stabilization needs. The Mother Nurture System is a very targeted approach - it’s crucial that each stage of the system is used only at the designated time, and not for long-term spinal stabilization.

Here are some typical comments from recent patients who’ve used the Mother Nurture System: “The additional support has been wonderful and helped with my low back pain.” “The orthotics have definitely helped to increase my productivity so that I am less tired. The support is an amazing feeling.” “When I am not struggling with low back pain, it makes it easier to stay active and fight fatigue.” “I feel like my whole body is being supported, not just my feet.”

Jamie Greenawalt, Senior Vice President of Foot Levelers, describes the development of the Mother Nurture Custom Orthotics System, “As a mother of two, I understand the evolving physical changes a woman experiences when she’s carrying a baby. I first had the idea to create a custom orthotic for the unique stabilization needs of mothers-to-be when I was pregnant with my oldest daughter. My goal was to make their pregnancy and post-pregnancy experience as healthy and comfortable as possible. My second pregnancy coincided with the development of the NEW Mother Nurture Custom Orthotics System, and my feedback and first-hand experiences went into the formulas for the three sets of orthotics. Our development team included mothers and mothers-to-be. We are proud and excited to offer a solution that we know wifi help offset the destabilizing effects of pregnancy during three unique stages: Trimester Two, Trimester Three, and the first year of Postpartum, so that the mother can feel her most comfortable, vibrant, and active. By using the system, doctors wifi be able to help their pregnant patients and their babies stay as healthy as possible.”

Foot Levelers Chairman and CEO Kent S. Greenawalt adds that, “Foot Levelers has always been an innovator for chiropractic. We believe that we’re the only company that could provide this type of chiropractic stabilization for pregnant women and do it correctly. The Mother Nurture Custom Orthotics System has been long in development, incorporating our seventy years of proprietary knowledge and experience. We understand that as pregnancy advances it can be difficult for women, with 68.6% having back pain, and we want to help. As their bodies are evolving, Mother Nurture can help them maintain consistent customized support.”

Dr. Maggie Colucci is a graduate of Palmer College of Chiropractic in Davenport, IA. She is the owner of Red Rock Chiropractic & Wellness Center in Las Vegas, NV. In addition to practicing full-time, Dr. Colucci is the current president of the Chiropractic Physician Board of Nevada and a board member of the Foundation for Chiropractic Progress. She has served on the National Board of Chiropractic Examiners and was the first female president of FCLB (Federation of Chiropractic Licensing Boards).

For references please see Page 46.

References from " Pregnancy-Specific Stabilization" article on pages 22 to 26.

1. Liddle SD, Pennick V Interventions for preventing and treating low-back pain and pelvic pain during pregnancy. Cochrane Database of Systematic Reviews, 2015; Issue 9. Art. No.: CD001139.

2. Wang SM, et al. Low back pain during pregnancy: prevalence, risk factors, and outcomes. Obstet Gynecol, 2004;104:65-70.

3. Ostgaard HC, Zetherstrom G, Roose-Hansson E. Back pain in relation to pregnancy: a 6-year follow-up. Spine, 1997;22:2945-50.

4. Gutke A, et al. Impact of postpartum lumbopelvic pain on disability, pain intensity, health-related quality of life, activity level, kinesiophobia, and depressive symptoms. Eur Spine J, 2011;20:440-8.

5. Weight gain during pregnancy - https://www.cdc.gov/reproducti... pregnancy-weight-gain, htm weight

6. McCrory JL, et al. The pregnant “waddle ”: An evaluation of torso kinematics in pregnancy. JBiomech, 2014;47:2964-8.

7. Bivia-Roig G, et al. Changes in trunk posture and muscle responses in standing during pregnancy and postpartum. PLoS ONE, 2018; 13:1-10.

8. Mei OC, Gu YD, Fernandez J. Alterations of gait during pregnancy and post-partum. Nature-Scientific Reports, 2018;8:2217.

9. Calguneri M, Bird HA, Wright V. Changes in joint laxity occurring during pregnancy. Annals Rheum Dis, 1982;41:126-8.

10. Oswald C, Higgins CC, Assimakopoulos D. Optimizing pain relief during pregnancy using manual therapy. Can Fam Phys, 2013;59:841-2.

11. Stuber KJ, Smith Chiropractic treatment of pregnancy-related low back pain: a systematic review of the evidence. J Manip Physiol Ther, 2008;31:447-54.

12. Weis (A, et al. Chiropractic care for adults with pregnancy-related low back, pelvic girdle or combination pain: a systematic review. J Manip Physiol Ther, 2020;43:714-31.