Rolling over in bed takes more effort now. Getting up from the couch catches at the front of one hip, and by evening your low back or groin aches.
The three standing stretches below target the front of the hip, the deep buttock muscles and the low back. They may help with muscular stiffness, but pain during pregnancy has several possible causes. Check the safety guidance first; a painful stretch is a reason to stop.
Before You Try These Stretches
Talk with your obstetric care provider before trying these exercises. ACOG’s back-pain guidance says exercise should not cause pain: stop if it does. All three positions use support, but pregnancy can affect your balance.
Seek medical care immediately for a headache that will not go away or gets worse, fainting or ongoing dizziness, trouble breathing, chest pain or a fast-beating heart, severe shoulder or back pain, or severe belly pain that is sudden, worsening or does not go away. These are among the CDC’s urgent maternal warning signs, which apply during pregnancy and in the year after delivery. Do not wait for a routine appointment.
Seek immediate care for these nerve warning signs with back pain: not being able to tell when you need to pass urine, leaking without feeling it, loss of bowel control, numbness around your genitals or buttocks, or new or worsening leg weakness. The American Association of Neurological Surgeons identifies these as warning signs of a potentially serious nerve problem. Do not try these stretches if any apply.
Stop and call your obstetric care provider for vaginal bleeding, fluid leaking from the vagina, dizziness or faintness, shortness of breath before exercise, chest pain, headache, muscle weakness, calf pain or swelling, or regular painful contractions (ACOG, Exercise During Pregnancy). Also call about back pain that is severe, lasts more than two weeks, or comes with fever or burning during urination; ACOG notes that back pain can signal preterm labor or a urinary tract infection. The immediate-care guidance above takes priority if symptoms overlap.
For the Front of the Hip: Hip Flexor Stretch
The iliopsoas is the iliacus and psoas major together; it helps lift your thigh toward you. This stretch targets the front of the hip. Groin or low-back pain alone cannot tell you whether this muscle is involved.
Skip it if the split stance brings on pain over the pubic bone or elsewhere in the pelvis, makes your groin pain worse, or if you cannot balance comfortably with support.
Sit your left buttock on a stability ball with your left leg in front of you and your right leg behind you. Your left foot should be planted on the ground and your right heel should be off the ground. Make sure your hips are pointed straight forward and your pelvis is tucked under. You can stabilize yourself by holding on to a stable surface with your left hand. Move forward toward your front leg to feel the stretch at the front of the right hip.
To get a better stretch, you can reach your right arm up straight in the air, then side bend your body to the left. ACOG’s balance caution applies to both positions; use the support and skip the stretch if you feel unsteady.
Hold for 30 seconds and repeat two times on each side.
For Deep Buttock Pain: Standing Piriformis Stretch
This stretch targets the piriformis, a muscle deep in your buttock. Buttock pain has several possible causes, so the location alone does not tell you whether this stretch will help.
Skip it if moving your legs apart is one of the things that hurts, or if lifting the leg onto the surface brings on pelvic or groin pain. Pain traveling down your leg, especially with altered sensation or weakness, deserves assessment rather than repeated attempts to stretch it away.
To perform this stretch, stand and place one leg on a surface that is about waist height. Make sure your knee is at a 90 degree angle and your hips are pointed straight forward. You can bend forward and slightly angle your upper torso over your knee to get a better stretch. Hold for 30 seconds and repeat two times on each side.
For a Low Back That Aches by Evening: Standing Lumbar Opening
This lumbar opening maneuver lets your low back round while your hands hold a fixed support. It is the third standing option; none of these stretches requires getting down on the floor.
Skip it if sitting back into your hips brings on pain at the front of the pelvis, or if you cannot hold the support comfortably; we would rather you stop than push through.
Start with holding on to a stable surface that is about waist height. A kitchen or bathroom sink usually works pretty well. Keeping your feet fairly close to the sink, tuck your pelvis under and sit back into your hips, letting your back round.
If you want to feel it more on the left side of the low back, keep your left leg straight, bend your right knee, and look underneath your left armpit.
You can hold the stretch 20 to 30 seconds and repeat the stretch two times on each side.
Is back, hip or pelvic pain changing how you walk, dress or sleep? At Victory Performance and Physical Therapy in Mar Vista, Los Angeles, you can contact us about an assessment for back or hip pain. Keep your obstetric care provider in the loop either way.
Call today: 424-543-4336
When Stretching May Not Be the Right Approach
Pain over the pubic bone, across either side of the low back, between the vagina and anus, or spreading into the thighs can occur with pelvic girdle pain. Walking, stairs, standing on one leg, rolling in bed or moving your legs apart may make it worse. The NHS advises calling your midwife or doctor when pelvic pain makes these everyday movements difficult. When pelvic girdle pain is the cause, it is not harmful to your baby.
Pain location alone does not determine whether stretching is appropriate. RCOG describes an assessment that looks at back and hip movement and rules out other causes. Clinical guidelines recommend individualized exercise for pregnant women with pelvic girdle pain (Vleeming et al., 2008, Eur Spine J. View on PubMed).
A deep buttock ache does not identify a tight piriformis pressing on the sciatic nerve. A review of the available studies could not establish how accurately the proposed symptoms and tests identify piriformis syndrome (Hopayian & Danielyan, 2018, Eur J Orthop Surg Traumatol. View on PubMed). Pain on the outside of the hip, especially when lying on that side, is another pattern; our lateral hip pain article explains one possible cause. Its exercise program needs individual clearance during pregnancy.
A brief sharp catch low on one side of your bump may be ligament pain. The NHS describes this as a possible explanation when mild pain settles with rest or a change of position. Do not use these stretches to test that explanation; persistent or severe pain needs medical advice.
For pelvic pain, the NHS advises staying active while avoiding activities that worsen symptoms, and resting when you can. Its pelvic-pain guide and ACOG’s back-pain guidance describe options for making everyday activities and sleep more comfortable.
Back pain often eases after birth, but ACOG notes that it can linger for months. If pain continues to limit you, arrange an assessment; the urgent signs above still apply after delivery.
Why Your Back Can Ache by Evening
ACOG explains that your expanding uterus shifts your center of gravity and stretches and weakens your abdominal muscles, leaving other muscles with more work to do. In a study of standing posture, women in their third trimester had greater back and hamstring muscle activity than women who had not given birth. The researchers found no significant difference in lumbar or pelvic position between the groups (Biviá-Roig et al., 2018, PLoS One. View on PubMed).
Hormones are part of the picture, but the evidence linking measured relaxin levels with pelvic girdle pain is low quality (Aldabe et al., 2012, Eur Spine J. View on PubMed). Feeling tight does not establish that stretching farther is what you need.
What Does the Research Say About Stretching?
A single-center, open-label trial of 60 women with low-risk pregnancies and back, lumbar or sacroiliac pain found less pain after an 8-week stretching-based program than after advice alone, with no adverse effects recorded. It tested standardized postures, not these three stretches (Barbier et al., 2023, Am J Obstet Gynecol MFM. View on PubMed).
A larger review found lower low-back and pelvic-pain severity in 15 randomized trials of prenatal exercise, with evidence rated very low to moderate (Davenport et al., 2019, Br J Sports Med. View on PubMed). Exercise can be useful, but the findings do not make every stretch suitable for every pregnancy.
How to Get Assessed
An assessment establishes what you can do without provoking your pain, what to change first, and whether you need to see a physician before physical therapy. ACOG says that once other causes are ruled out, your obstetric care provider may recommend a physical therapist, and the NHS says that getting diagnosed as early as possible can help keep pelvic pain to a minimum.
In California you do not need a physician's referral to be assessed by a physical therapist; our post on direct access sets out the limits. ACOG still advises you to talk with your obstetric care provider before doing any exercises.
Our post on what to expect at a first visit explains what happens at the appointment. Our free initial consult is a 30-minute appointment where you can sit down with a doctor of physical therapy and ask us questions. Neither replaces your obstetric care.
Get Help With Back and Hip Pain in Mar Vista
Victory Performance and Physical Therapy is at 3865 Grand View Blvd, Los Angeles, CA 90066, in Mar Vista, serving Culver City and the Westside. We treat back pain and hip pain, and you can read what physical therapy with us involves before you book.
Book your evaluation today.
Call: 424-543-4336