Answers to questions regarding common aches and pains of 2nd and 3rd trimester proviced by: Dr. Andrew Weiss, OB/GYN, Ministry Medical Group, Stevens Point. 

Answers to questions provided by Ministry Medical Group clinicians are general in nature and should not take the place of a physician visit. If you have specific questions regarding your pregnancy please see your physician.

Aches and Pains (2nd and 3rd trimester):
Aches and pains are common, but should not be considered “normal” or inevitable. Some specifically relate to the growing uterus, like the well- known “round ligament strain” of the second trimester, most common between 14 and 20 weeks. The round ligaments are normally lax, and connect the right and left upper portions of the uterus to the inguinal ligaments in the groin. A woman may first become aware that she has these when she sneezes or turns quickly and feels a knifelike pain, often on one side or the other. (Jump shots in basketball should be avoided at this stage.) Round ligament strain is harmless, and typically improves when the uterus is large enough that it doesn’t wobble from side to side, but fills the space in the upper pelvis. Placing a hand over the lower abdomen before sneezing, sitting down, and taking care to avoid quick twisting movements (exiting a vehicle for example), may reduce or eliminate this.

Low back pain
Low back pain is also common, and is often attributed to the changes in body shape and tissue changes including softening of collagen and cartilage in tendons and joints. The fused bones of the pelvis form a bowl shape attached to the spine, and this point of connection, the sacroiliac (S I) joint often becomes more mobile, instead of firmly fused. This may produce discomfort, and even a sense of motion, like grinding or popping.

More often, significant low back pain is a result of exaggerated lumbar lordosis, the forward curve of the small of the back. This MUST be corrected by using abdominal and hip muscles to correct posture

Stretching of the abdominal wall also causes discomfort, and often we provide a wide elastic belt, or “abdominal binder” to provide counter pressure and support.

Ankles and knees bear extra weight during pregnancy, and tissue swelling (edema) causes soreness. Periodic elevation and stretching, plus good footwear help.

Stretching
With regard to stretching, which also relates to exercise in pregnancy, the goal is not to experience pain while stretching, but to improve flexibility and relieve tightness from overuse of muscles, often related to unaccustomed weight and changes in posture. Stretching involves safe techniques, holding the desired degree of stretch for at least 30 seconds without increasing the stretch or changing position. After 30 seconds of holding the position and breathing, the muscle should relax, and it should actually feel better, not worse, near the end of the stretching. Bouncing or stretching too hard (all too common in some sports training situations) can actually injure and strain the tendons. It is well worth learning to stretch safely and effectively, and it’s good to get advice and feedback.

Mention to your doctor/ provider if something hurts. Pains of these kinds are common, but can be avoided or improved with the right do’s and don’ts. Most causes of pain are not a sign of anything threatening to the baby, but all deserve careful evaluation. Kidney stones, bladder infections and intestinal causes also feel like uterine cramps or contractions, and need to be differentiated from the “musculoskeletal” categories discussed above.