7 Prenatal Exercises to Ease Lower Backaches

Prenatal Cat Cow

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If you're pregnant and experiencing twinges or chronic aches in the lower back, know that you are not alone. Back pain, in general, is one of the most reported issues among pregnant women and is more prominent in the later stages of gestation. And it's not surprising, given your body is undergoing tremendous physical changes week by week.

According to Dr. Kasia Gondek, PT, DPT, CSCS, a physical therapist specializing in women’s health, pelvic floor rehabilitation, and orthopedics at Femina Physical Therapy in Los Angeles, there are a few common causes of lower back pain when you're expecting. "Women with a previous history of lower back injuries or aches are at an increased risk of having back pain during pregnancy, in addition to anyone with underlying muscle weakness that can cause hypermobility," meaning overly flexible joints.

In addition, the hormone relaxin, a pregnancy-related hormone produced by both the ovaries and placenta, helps to (as the name suggests) relax ligaments of the pelvis and soften the cervix. "Relaxin, which peaks during the first trimester, allows your hips to widen in preparation for birth, mainly affecting the ligaments and connective tissues of the pelvis," says Dr. Gondek. "Other areas commonly impacted by relaxin are the shoulders, spine, hips, ankles, and feet." The loosening of the spine, in particular, can affect your stability, leading to ongoing bouts of back pain.

Dr. Gondek also points out that as your uterus and baby grow, your weight will change and so will your center of gravity, often contributing to postural compensations and the onset of back pain.

Exercising While Pregnant

Exercising may help reduce the back pain you might be experiencing. And, not only is exercise safe while pregnant, it has a ton of benefits for you and the baby. Safe exercise while pregnant may help to manage gestational diabetes and promote healthy weight gain. "Once cleared by your medical provider, aim for 20-30 minutes of moderate-intensity physical activity per day, such as walking, swimming, prenatal fitness, and prenatal yoga," suggests Dr. Gondek.

While exercise is safe and beneficial, you do want to be mindful of the intensity and type of exercise, duration, and temperature, as well as your baseline exercise habits prior to becoming pregnant.

What to Avoid During Prenatal Exercise

Introducing new types of workouts: If the weight rack is your normal go-to at the gym, or likewise, you love to work up a sweat on the treadmill, in most cases it's safe to continue unless indicated otherwise by a health care provider. Although as a caution, it's not advisable to introduce anything new into your fitness routine at this stage which may lead to unwanted injuries or added strain on the body.

Certain positions: As a general rule, after the first trimester, avoid any exercises that require you to lie flat out on your back (supine), as this can add pressure to your uterus and the vein that flows blood back to the heart.

Overheating: Another consideration is to avoid working out for prolonged periods in the heat and make sure to hydrate accordingly.

As a reminder, whether you are new to exercise or an expert on the gym floor, it's best to discuss a workout plan of action with an obstetrician prior to starting.

Exercises For Lower Back Pain

Bird Dog

The Bird Dog directly targets the muscles running the posterior chain (the back of the body), safely promotes core stability in enlisting abdominal and lower back muscles, and introduces gentle movement into the shoulder and hip joints.

Bird dog

Verywell / Ben Goldstein

  1. Start on all fours on a yoga mat with your wrists aligned under your shoulders and knees in line with your hips.
  2. Reach the left arm out in front before extending the leg behind you, creating a straight line along the arm, spine, leg, and foot.
  3. Check your hips are square to the floor and make sure not to dip at your lower back.
  4. Extend both arm and leg out for two seconds before bending them back into the starting position. Keep the core braced to minimize any 'rocking' of the body.
  5. Repeat 10 repetitions on each side for three rounds.

Pelvic Tilts

Pelvic tilts are small, yet effective isometric holds that help to alleviate lower back pain as well as strengthen and support the core-stabilizing muscles. Although changes to your pelvic alignment occur throughout pregnancy, this exercise can help you to counterbalance the shift in the degree of your pelvic tilt.

Pelvic tilt

Verywell / Ben Goldstein

  1. Lay down on your back on a yoga mat and bend at your knees, placing your feet flat on the floor. Rest in a neutral position so that your lower back forms the natural curve of your lower spine.
  2. Exhale as you gently tuck your hips toward your head. Note how your lower back presses into the floor.
  3. Hold this position for two full breaths, and then inhale as you return back to the starting position.
  4. Repeat for 10 reps for a total of three sets.

Good Mornings

Good Mornings are superb at targeting not only the muscles of your back, but also the hamstrings and glutes. Although they are safe to perform while pregnant, you may want to opt for adding a lighter weight, or no weight at all! Also, keep in mind, as the baby grows, and therefore your bump, you'll need to take a slightly wider stance to allow for added space.

Good Morning Exercise

Verywell / Ben Goldstein

  1. Select an appropriate weight of the barbell or perform with just your body weight.
  2. Stand with your feet shoulder-width apart and keep a small bend in both knees.
  3. Place the barbell over your shoulders on the upper back, or simply interlock the hands behind the head (keeping your elbows wide).
  4. Stabilize through your core as you breathe in, and on the outward breath, hinge at the hips to push them back as your upper body comes forward, keeping your spine in a straight line.
  5. Pause when you are parallel to the floor and take an inward breath as you slowly raise back up to the starting position.
  6. Perform 8 to 10 reps for three sets.

Squats With an Exercise Ball

Aside from the strength element and core building benefits of squats, the exercise is an example of a 'primal' movement that brings more mobility to the hips to better prepare your body for childbirth. After all, squatting is a common birthing position.

For anyone suffering from lower back pain, exercise ball squats cushion this region and allow you to move through the motion with extra support.

  1. Standing either hip-width or slightly wider apart (to accommodate for your growing belly), place a large exercise ball behind your lower back and press against a solid wall.
  2. Bend at your knees and lower down into a squat, walking the feet forward until they are aligned with the toes.
  3. Brace your core and continue lowering until you reach a 90-degree angle at the knees, then push through the heels to bring yourself back to the starting position.
  4. Perform 8 to 12 reps for three sets.

If you are familiar with this exercise and want to add a strength-building element, you can hold a weighted dumbbell in either hand. Practice the movement first before piling on the weights.

Lateral Band Walk

A dynamic variation on a squat, the lateral band walk is exemplary at honing in on the glutes and improving the mechanics which stabilize the hips, pelvis, knees, ankles, and feet. This movement pattern builds strength in the lower body to better support the lower back.

Lateral band walk

Verywell / Ben Goldstein

  1. Loop a small resistance band around your ankles, making sure the band is not twisted.
  2. Standing hip-width, or slightly wider apart (depending on your stage of pregnancy), keep the band lightly taught against both ankles.
  3. Bend your knees and push your hips back into a half-squat position, keeping your back straight, toes aligned with your knees, and balancing your weight evenly across both feet.
  4. In the half-squat, balance your weight onto your right leg as your step the left leg sideways and then back in, before switching to the other leg. Keep checking that your hips remain level for the duration of the exercise.
  5. Perform the exercise for 30 to 45 seconds for three rounds.

Glute Kickback

Glute-centric exercises build up supporting muscles which can promote improved balance in the body, and therefore the potential to reduce strain in the lower back. The quadruped hip extension, commonly referred to as the 'glute kickback' is a beginner-friendly exercise that does just that!

Quadruped Hip Extension

Verywell / Ben Goldstein

  1. Lower down onto a yoga mat on all fours, making sure your wrists are aligned with your shoulders and knees with your hips. Maintain a flat, straight back, running from the tip of your head and along the entirety of your spine.
  2. Gently shift more of your weight to the right side, keeping the body stable without a rotation at the shoulders and hips.
  3. Extend your left foot (with the knee still bent at 90-degrees) upwards, before exhaling and extending the leg fully. Keep your foot in line with the glue and check that your left hip is not rotating up or out.
  4. Flex the knee back to 90-degrees and lower the leg back down with control to the mat as you inhale.
  5. Perform 10 reps on each leg, for two-three sets.

Wall Roll-Down

The wall roll-down is a Pilates exercise that encourages gentle flexion of the spine and gives your hamstrings a good stretch. The movement can help improve your overall posture, and therefore how you stand, sit, and carry yourself, alleviating strain across the body including your lower back.

This exercise can slot into both a warm-up and a cool-down.

Full Body Roll Down

Verywell / Ben Goldstein

  1. Stand long against a solid wall and walk your feet forward a full step.
  2. Tuck your pelvis under to protect your lower back and drop your shoulders down away from your ears, letting your arms dangle freely at the sides.
  3. Take a deep breath in and as you breathe out, start to tuck your chin toward your chest and roll down, feeling your spine peel away from the wall one vertebra at a time.
  4. Your spine will lengthen as you continue to roll down as far as you can go (keep a soft bend in the knees if needed) as you deepen into the stretch of your hamstrings.
  5. Exhale and reverse the movement, rolling slowly back up and connecting the spine with the wall once again.
  6. Roll your head up last and drop the shoulders back down away from your ears.
  7. Repeat for 6 to 10 repetitions.

Other Tips to Reduce Lower Back Pain

Aside from these exercises, the following tips may help you find added relief when your lower back pain is acting up during pregnancy.

Strengthen, Stabilize & Rehabilitate

The body will naturally do its thing in releasing relaxin during pregnancy—that you can't stop, but you can work on strengthening and stabilizing the body to better support your joints.

As an example, research has found that stabilization of the lower spine, coupled with stretching, has a positive effect on pain reduction. "Working with a physical therapist with special training in women’s health, prenatal physical therapy or pelvic rehabilitation can make a big difference when managing back pain," Dr. Gondek suggests.

Avoid Over-Stretching

Although a good stretch session can help restore and recover muscles, vigorous adductor muscle (inner thigh) strengthening and over-stretching can place too much strain on this area during pregnancy. "That's because the pubic symphysis is one of the major joints of the pelvis affected by relaxin, and so you want to avoid adductor muscle workouts where your legs are positioned wide apart," explains Dr. Gondek.

Instead, opt for gentle stretches such as the Cat-Cow to encourage the optimal movement of the spine, and Child's Pose to loosen off a tight lower back and hip flexors.

Sit and Stand With Good Posture

Standing or sitting for extended bouts can often lead to chronic low back pain, given the increased musculoskeletal strain. "If you're standing in one place for longer than 15 to 20 minutes, try placing one foot on a low step stool to offload the back, and make sure to alternate sides," says Dr. Gondeck. "When sitting, make sure your seat has a solid low back support, a firm seat cushion, and that your feet can touch the floor."

Misaligned postures often stem from habit. In fact, the root cause of neck, shoulder, and back pain for many can be triggered by a forward head posture, rounded shoulders, and an anterior pelvic tilt, according to Dr. Gondek. This creates excessive strain on the spine, shoulders, and hips, only worsened by weakness or a lack of muscle flexibility.

Her recommendation? Set an alarm periodically to remind you to take a posture break and change up your position to reduce unwanted strain.

Wear Supportive Clothing and Shoes

"A belly support band or S.I. (sacroiliac) belt can be helpful in reducing back pain or pelvic pain by giving your abdominal muscles and pelvic joints a little extra support when you are on your feet and physically active," outlines Dr. Gondek, who also stresses the importance of wearing shoes that have good arch support.

A recent systematic review of maternity support garments confirmed the benefits of such belts in alleviating pain during pregnancy, not to mention, their ability to improve balance, functionality, and mobility.

A Word From Verywell

Exercise is generally a safe activity while pregnant, but it's best to discuss your workout plan with your healthcare provider before getting started. Many forms of exercise, such as swimming, walking, prenatal Pilates, resistance training, and cardio are excellent forms of physical activity to do while pregnant. However, during this time, and also in the early postpartum period, it's important to avoid attempting anything new that your body is not yet acquired to.

The goal of exercise during pregnancy is to move, strengthen, and better prepare the body for labor. Make sure to check in with yourself during each workout and stop if something doesn't feel quite right.

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9 Sources
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