Should I wear a back brace during pregnancy or afterwards?
Generally I am an advocate for wearing a back brace during pregnancy and for the first few weeks afterwards (if you are having pain), but certainly believes the topic warrants a further discussion as there are a few considerations to consider.
First is the research. Generally speaking, studies show support for usage of back brace during the pregnancy and the initial post-partum period, however there is not good data support the use of back braces for long term pain management. Generally we are seeing people with worsening low back pain, when they use back braces long term.
As a physical therapist I think its important to note that whenever you use a back brace, or any kind of brace/or slings, you will discourage the muscles from being used, which can cause them to get weaker over long periods of time, and loose their inherent ability to provide stability to the joints.
With this being said pregnancy is a unique condition where you loose some abdominal muscle function due to the significant anatomical changes that occur to accommodate a pregnancy. Particularly speaking we are seeing a significant stretching of the Transverse Abdominus and Rectus Abdominis. The role of the transverse abdominus is to provide stabilization to the pelvis and spine, regulate abdominal pressure, and facilitate respiration. The role of the Rectus Abdminus is assist with trunk flexion and allow your body to bend for actions such as sitting up out of bed, or bending to pick up an item.
It is expected that during the pregnancy and the early postpartum periods, these muscles tend to not function appropriately, causing back and pelvic pain. A brace would be a wonderful alternative to help you regain stability through your trunk, regulate your abdominal pressure to lower chances of hernias, prolapse, and diastasis recti, and to make moving easier and less painful.
At about the 4-6 week period, the muscles should be close to their resting position/size and back to performing their specific function.
In summary, my thoughts are, wearing a back brace in the beginning (during pregnancy, and first 4-6 weeks postpartum) is fine, and probably going to be helpful for most women. If you are not having any symptoms, I do not recommend wearing a brace as a preventative measure. If you continue to find yourself dependent on the back brace after 6 weeks, I would suggest seeking professional assistance to improve your symptoms. I would also emphasize that if you find your self using a back brace, I would make it a point to do some light strengthening of the abdominal muscles, so they do not weaken from their time spent in the brace. Be on the lookout for a future blog post, for my recommended abdominal exercises to support back and pelvic stability for pregnancy and early postpartum.
Lastly, the discussion of back brace, is not to be confused with postpartum belly binding, or waist shapers. That is another discussion for another time.
As always, love to hear your thoughts and comments,