From headaches to swollen feet and everything in between, pregnancy aches and pains can be a full-body affair. And the back can become ground zero: As your belly grows, that extra weight in the front of your body makes it harder for your spine—the body’s main support system—to keep you upright. Which is why many parents-to-be start practicing exercises for back pain in pregnancy.

“When you have a huge load in front of you, your back is having to work much, much more,” says Vijay Yanamadala, MD, a spinal neurosurgeon and chief medical officer at Sword Health. “That fulcrum effect of our body wanting to lean forward because of the pregnancy and the weight in front of us, and the back having to support it and hold us upright is real.” That extra work can lead to low back pain as the spinal joints come under pressure and the muscles supporting the spine start to fatigue.

Dr. Yanamadala explains that the position of that extra load matters: “If I carried a 20-pound baby plus 20 pounds of water on my head, it would be much less work than carrying it in front of you in a growing belly,” he says. That’s because you’d have the whole spine to disperse the extra load—your back wouldn’t have to do anything additional other than maintain its posture. But when your belly pulls your weight forward, the spine is constantly working to try to realign itself and keep your torso in a vertical position.

You’d think evolution would have come up with a better place to put a growing baby if it would be so much work on our lower backs, right? Unfortunately, the bump is what we’ve got, and back pain is the lot of many a pregnant person.

There are two main ways to combat or prevent low back pain in pregnancy. The first is posture. Prenatal certified trainer Azul Corajoria says checking in with your posture more often than you normally would is key. You’ll want to keep a soft bend in your knees, your pelvis tucked slightly more than neutral (to counter the belly’s pull to sway your back forward), with your core engaged and shoulders pulled back and down.

But maintaining good posture is easier said than done, and requires actually having the muscles to sustain that position, as well as mobility and flexibility, in a pregnant body undergoing myriad fluctuations.

“So much is going on [in pregnancy] from changes in muscle tension, decreased joint mobility, or lack of strength in crucial muscles,” Lindsay Arnold, a professional dancer, prenatal certified personal trainer, and founder of The Movement Club, previously told Well+Good about how to combat low back pain during pregnancy. “It is important to work on strengthening the supporting muscles as well as stretching to improve joint mobility and release muscle tension.”

That includes your upper back as well as lower back muscles that are a part of your core and provide crucial support for the spine. Dr. Yanamadala recommends doing core strengthening exercises with the help of a Bosu ball, since the ball can give some extra support and pain relief to an already-taxed spine. Arnold recommends exercises that combine core work with spine mobilization. Here are some of her favorites.

6 exercises for back pain in pregnancy

1. Bird dog

“This move targets the posterior-chain muscles and improves core stability by utilizing the abdominal and low-back muscles,” Arnold explains. 

1. 1.
   Start on all fours. Make sure that your wrists are directly aligned beneath your shoulders and that your knees are beneath your hips. 
2. 2.
   Lift the opposing arm and leg. “Slowly lift and reach your right arm forward while you simultaneously lift and reach your left leg back straight behind you,” Arnold says. Make sure not to rotate your torso or arch your back.  
3. 3.
   Return to all fours.
4. 4.
   Repeat. Alternate slowly between each side, performing 10 reps per side. 

2. Pelvic tilts

“This movement alleviates low-back pain through isometric holds that strengthen and support the core stabilizing muscles,” Arnold explains. 

1. 1.
   Lay on your back. Bend your knees and place your feet flat on the floor with your knees roughly hip-distance apart. 
2. 2.
   Tilt your hips. Focusing on pressing your lower back into the ground and engaging your abs, tuck and tilt your hips up to the ceiling, while maintaining contact with the floor. (Note: This is not a glute bridge; you should not lift your bum off the floor.) Hold the tilt for three seconds, breathing as you do.
3. 3.
   Return to neutral. 
4. 4.
   Repeat 10 times. 

3. Side-lying leg lifts

According to Arnold, side-lying leg lifts activate the glutes, core, hip flexors, hamstrings, and lower back muscles. She says the old-school movement improves mobility in your hips and increases your core strength. “They help prepare your body for labor,” she says.

1. 1.
   Lay on your side. Stack your legs on top of each other, with your arm closest to the mat extended straight above you so that you can comfortably lay your head on it.
2. 2.
   Lift your top leg up to a 45-degree angle on an inhale, hold for a second, and release back down. Keep your torso as still as possible, with your hips stacked directly on top of each other. 
3. 3.
   Repeat. Perform three rounds of 10 reps per side. 

4. Seated piriformis stretch

Arnold says that stretching is just as (if not more) important as performing strengthening exercises while pregnant. She recommends the seated piriformis stretch, which targets a key hip muscle that can make a major impact on how tight the low back feels. 

1. 1.
   Sit on a chair with feet flat on the ground.
2. 2.
   Place your right ankle over your left knee to create a figure four. 
3. 3.
   Bend forward. Exhale and slowly lean your torso forward, keeping your spine straight, until you feel a slight stretch in your glutes and low back. “Do not round shoulders,” she emphasizes. Hold for 30 seconds.
4. 4.
   Repeat on the other side.  

5. Child’s pose

One of yoga’s most recognizable poses proves beneficial for low back pain.  

1. 1.
   Begin on all fours. Let your big toes touch while keeping your knees shoulder-width apart.  
2. 2.
   Shift your butt back toward your heels on an exhale while tucking your chin to your chest. If you feel flexible enough to do so, rest your forehead on the ground.
3. 3.
   Rest for six breaths. Slowly inhale and exhale before returning to neutral. 

6. Cat stretch

Surely you’ve heard of the cat-cow stretch by now. When focusing on your low back, Arnold says to prioritize the convex cat stretch.  

1. 1.
   Begin on all fours. Again, keep your shoulders stacked over your wrists and knees directly under your hips, all while maintaining a neutral spine. 
2. 2.
   Inhale, then while exhaling, slowly pull your stomach up and round your spine to curve your back like a cat. 
3. 3.
   Hold the shape for three seconds before inhaling and releasing back to neutral.
4. 4.
   Repeat. Perform eight to 10 reps. 

For other workouts that can help to mitigate back pain, Arnold recommends these four The Movement Club classes: 

• Upper Body Cool Down
• Lower Body Cool Down 
• Toning Mat Session
• Upper and Lower Body Tone