May is Women’s National Health Month and is a time to focus on many aspects of health, from women’s fitness to mental and emotional well-being. Women are a powerful force of influence and change in their communities and families. For this reason, a women’s modeling of her own health can have a profound impact on all those around her, including her children and possibly even generations to come.
As health and exercise professionals, we can help the women in our communities have a better understanding of how their bodies change over their lifetimes and then train them appropriately. One area of change is within a woman’s lumbo-pelvic complex, which is the area of the low back and pelvis. While both men and women contain the same musculoskeletal anatomy, a woman’s body experiences significantly more change throughout her lifetime.
Simply put, the muscular system is the “armor” that either holds the skeletal structure in or out of alignment. If the muscular system becomes compromised (e.g., if the tension/length ratio gets skewed), the body’s skeletal structures can be pulled out of alignment, causing muscle fatigue and pain. This prolonged malalignment can also cause compensations elsewhere in the body, which can lead to issues over time. Understanding the times of life when change can occur in a woman’s body is the first step to training her effectively. Here are three life stages during which the most profound changes occur: pregnancy, postpartum and perimenopause.
Pregnancy: As pregnancy progresses, a woman’s body continues to shift, potentially causing her skeletal structure to be pulled out of neutral alignment. With the presence of the hormone relaxin, which causes ligamentous laxity, the skeletal shifts become even more profound as the weight redistribution pulls her pelvis and low back anteriorly.
Postpartum: The body that changed and shifted during her pregnancy remains after the baby is born. Additionally, she also has the challenge of caring for another human being. The increasing asymmetrical load (i.e., her baby) that she carries almost all day will pull her even more out of alignment. She is still adjusting or responding to relaxin postpartum, as it can stay in the body up to 12 months after delivery.
Perimenopause: This phase in life brings a drop in estrogen, among other things, which can affect muscle tone. The potential malalignment of her pelvis at her low back, coupled with a reduction in muscle tone, means that issues like low-back pain and stress urinary incontinence are more likely to occur.
While the issues described here only begin to describe the changes a woman’s body is likely to experience over her lifetime, it is critical for health and exercise professionals to gain a deep understanding of the female lumbo-pelvic complex. As a woman progresses through life, this understanding will be needed for her to gain the best benefits of thoughtful exercise programming.