A hip hinge (deadlift) is one of THE most performed exercises in mom life, and also a tricky movement to coach. As a parent I’m bending over to pick up items ALL the time, and the last thing I want to worry about (besides tripping over legos), is low back pain.

I’ve spoken about hip hinges quite a bit, but I’m back to breakdown why a hip hinge/deadlift may feel challenging after baby.

Read more here: 5 Tips for your Hip Hinge (learn more about what a hip hinge is here)

Pelvis Changes during Pregnancy

Why does a deadlift feel so tricky postpartum?

Let’s take a closer look at the pelvis, and shifts during pregnancy.

Growing a human is hard work, and during this nine month period, the pelvis changes shape to accommodate a growing baby, and increased pressure/weight in the abdominal cavity. The hip bones externally rotate to create space in the pelvic inlet, where baby will pass through. Think hip bones widen and feet slightly turn out.

As this shift happens, the pelvic outlet (where baby exits) will narrow. The top and bottom of the pelvis work in opposition, almost like a seesaw. As the top opens, the bottom narrows, and visa versa. Additionally, the pelvis often tilts forward (anterior tilt) or backward (posterior tilt) to help counterbalance the body’s shifting center of mass.

During pregnancy/birth our bodies need external rotation AND internal rotation.

• External rotation = baby enters the pelvis

• Internal rotation = baby exits the pelvis

Postpartum our bodies don’t just “snap back,” and this new pelvis position biased towards external rotation is compounded by baby holding postures, like holding out in front with hip shoved forward. Moms also do a lot of sitting, which often leads to the pelvic rocked under, tailbone tucked, and chest down while feeding or rocking baby.

The video below describes pelvis position, and how it impacts the pelvic floor (keep scrolling for more on this.)

Why does this pelvis position matter?

While this shift in the pelvis is an amazing pregnancy adaptation, it also often brings a lost of hip internal rotation. We need both hip external and internal rotation for happy hips, back, knees, and pelvic floor.

1. Limits movement options: While there is nothing inherently “wrong” with this position, it’s important that we are able to find other positions and not get “stuck” here. We need movement variability, and the ability to move in all the ways. Movements like a squat, lunge, hinge, lateral lunge, walking, etc. all require that we’re able to access internal rotation AND external rotation.

2. Pelvic Floor symptoms: When the hip bones are in more external rotation, it shortens the glutes and can make your posterior pelvic floor tight. When we have a tight backside it makes it really difficult to hinge well, and can bring about other things like piriformis pain, painful sex, leaking, etc. If you’ve been told you have a tight pelvic floor, working on glute lengthening exercises, hip internal rotation, tuning in to glute clenching throughout your day, and posterior pelvic floor release can do wonders for managing pelvic floor symptoms.

   Note: If you’ve been told to perform kegels, I highly recommend consulting with a Pelvic Floor Physical Therapist to see if that is truly what your body needs, OR if perhaps you need to lengthen and relax those muscles instead.

   3. Difficult to grow a booty: For years I did all the hip thrusts, glute bridges, and deadlifts, but I had no booty. I did, however, have pelvic floor symptoms and low back and glute pain. When the pelvis is in a more externally rotated position, the backside is tighter - aka flatter too. In order to grow the backside and address pelvic floor symptoms, we need to incorporate exercises that create length through the backside, and take the glutes through their full range of motion. Read more here.

   Below are some advanced single leg hinge variations to load internal rotation in a single leg hinge.

4. Athletic Movement Limitations: In human movement/walking, internal rotation is necessary for mid-stance when we have our bodyweight on one leg and we need to propel it forward to the next.

Internal rotation is needed to produce force and “drive out” effectively without compensation.

• Internal rotation: load into one side, to then drive out effectively to the other side

• External rotation: propel you forward to the opposite side

If you have tight glutes and limited internal rotation, your ability to master side to side cutting, running, and more athletic based movements will be limited.

Many postpartum programs prescribe exercises that drive external rotation (clamshells, lateral band walks, etc.), but forget internal rotation. You need internal rotation to effectively externally rotate, and visa versa.

If you’re only doing external rotation on an externally rotated pelvis, there’s a key piece missing! Not only are you continuing to shorten the muscles on the backside, but you’re not effectively able to LOAD. If you cannot load, you cannot propel forward, and your body struggles to handle ground reactive forces overall. Leaking with impact? This might be something to consider.

The video below demos how you can manipulate an athletic exercise to drive internal or external rotation side to side.

What does this have to do with a deadlift?

When you hinge/deadlift your sacrum tilts forward (nutation), allowing for a hinge to come from the hips. If the sacrum isn’t able to tilt forward and gets stuck, the movement likely comes from the low back instead. A lot of moms struggle with a hinge, and a big piece of this is the ability to open the backside, find length in the booty, and therefore free up the sacrum to move and tip and forward (nutate).

Nutate what?!

With nutation vs counter-nutation I’m referencing the relative motion of the sacrum within the pelvis. Our sacrum has its own motion moving into a tipped forward or back position.

• Tip forward: nutation

• Tips back: counter-nutation: tucking the tail under with relative external rotation

This is different from the entire pelvis going forward into an anterior tilt or backwards as a unit into a posterior tilt. That is a shift in overall orientation.

Summary: How can we improve the hinge postpartum?

In an externally rotated pelvis position, our movement options are limited. In order to hinge effectively we need to:

• Release posterior pelvic floor tension

• Find length through the glutes

• Learn how to anteriorly and posteriorly tilt your pelvis with breath (I often joke about a mini twerk)

• Learn to hip ship, access internal rotation, and load that position

• Chest expansion too! One often forgotten piece. The sternum must stay lifted (open heart), but without flaring the ribcage to make it happen. When our chest is super compressed and we stare at a computer all day or hold babies, this is hard. Working on gaining some expansion of the chest wall can be helpful too. Open heart for an open a$$.

All of these pieces should be included in your postpartum fitness program. Essentially we are freeing things up so the sacrum can move and we can hinge from the hips, AND find length in the glutes, NOT the low back. Check out this post for a visual.

If you’re struggling to hinge/deadlift postpartum, I’d love to help! Addressing pelvis position through exercise selection can be a key piece in your pelvic floor recovery, and rebuilding strength postpartum.

I offer postpartum personal training in San Diego + virtually, online programming, and DIY programs <3 Let’s get back to hinging without pesky low back pain and pelvic floor symptoms, together.

Feel good mama,

Erica