Category: Postpartum

5 Ways to Help Your Postpartum Recovery

5 Ways to Help Your Postpartum Recovery

Posted on by Monica

The body undergoes a significant amount of change during pregnancy and childbirth. Our bodies and bellies are stretched to the max and then often put through either a major surgery or a physically exhausting labor to bring our beautiful babies into the world. It can take weeks to months to fully heal and every woman’s recovery is different. But do not fear, there are several things you can do to help your immediate postpartum recovery. 

Without a doubt Baby #3 has been my best recovery. Between this being my third go around, plus my additional education on the postpartum body, I have discovered several things that have helped me feel better sooner. There are a number of things I have done differently but here are the five main things that have helped my body heal after baby.

1. Hydrate

postpartum recovery

Your body needs water! Depending on your specific labor and delivery experience your body likely lost some amount of blood and fluids. Water helps your body heal and function properly. It can aid in decreasing fatigue levels, improving muscle function, decreasing swelling, increasing milk production, and so much more. You should aim to have at least 64 oz of water a day. But an even better goal is to consume half your body weight in ounces of water daily. For example if you weigh 160lbs you should try to drink 80 oz of water a day. 

After Baby #3 was born I couldn’t get enough water. I brought my favorite water bottle to the hospital and went through a 32oz water bottle every few hours. Drinking a lot of water definitely helped reduce my swelling and my body fatigue. 

2. Eat Nutritious Foods

nutritious foods

Fruit, vegetables, and other high fiber foods can help quiet a bit with postpartum recovery. Eating nutritious foods can help with bowel function and offer important vitamins and minerals to aid in our bodies recovery. High protein foods can also be extremely helpful in healing postpartum. Foods high in collagen such as bone broth, chicken, fish, egg whites, and citrus fruits helps promote healing of the connective tissue in your body. Additionally, eating a healthy diet also helps with milk production if you’re a nursing mother.

During my hospital stay and the next couple weeks to follow I made sure to eat a good amount of fruit, vegetables, and protein. I know it can be really difficult to eat a healthy meal with a newborn, especially if there are older kids on the scene. My trick was to make sure my fridge was stocked with my favorite fruit, easy to eat vegetables, hummus, yogurt, and other grab and go items. Additionally, I had meal prepped several crockpot meals that were high in protein and other nutrient dense foods. Stay tuned for my Baby Meal Prep blog post. 

3. Breath Work 

postpartum breath work

To start your postpartum recovery, proper breathing is essential in retraining the activation of your deep core (abdominal) muscles. Breathing properly is very important for proper function of your core muscles, bladder, rectum, and pelvic floor. You can start with a simple diaphragmatic breathing exercise explained below. 

Diaphragmatic Breathing Exercise: 

  • Step 1: Lay on your back with knees flexed with one hand on  your stomach, and one on your chest. 
  • Step 2: Take a deep breath in through your nose. Chest should minimally move while your belly and lower ribs should expand out into your hand. 
  • Step 3: Slowly let the breath out through pursed lips (like you are blowing out a candle). As you blow out, feel your deep abdominal muscles activate and your belly tighten. 

Repeat for 5-10 breaths. Laying down is the best way to stay relaxed and tune into your breath and muscle activation. As you progress, perform this breathing exercise in sitting or standing

You also want to be sure to avoid the valsalva maneuver (or holding your breath) with bearing down or exerting yourself including bowel movements, sitting up, picking your baby up, or any other strenuous activities. This places excessive pressure on the pelvic floor and can cause hemorrhoids, prolapse, or other incontinence issues. 

Check out my blog post Are You Breathing The Right Way to learn more about how breath impacts our body. 

4. Tend To Your Pelvic Floor

physical therapy postpartum

After delivery, the tissues of your pelvic floor may be swollen and painful. Ice is your best friend! Place ice packs between your thighs as needed to help reduce pain and swelling. Twenty minute increments are recommended. 

Strengthening: After delivery, it is recommended to strengthen your pelvic floor muscles. This will help decrease incontinence (leakage of urine) and help return support to the organs that sit closest to your pelvic floor. Start pelvic floor contractions (Kegels) once pain and swelling have gone away. To do this, lay on your back, bend your hips and knees up with your feet supported and contract your pelvic floor by imagining bringing the tissues between your upper thighs up and in towards your abdomen. To feel the muscles activate, place a hand over your perineum and you should feel the tissues pull away from your hand. Do not hold your breath while performing these contractions.

I started doing kegels day three after delivery. I started with performing them in a seated position. Aim for 10 sec holds and doing a set of 10. I then moved on to performing them throughout the day in standing and during dynamic activity such as walking or squatting. Being able to contract and relax your pelvic floor muscles properly is imperative to your postpartum recovery. Check out more about the pelvic floor in “Is It Normal To Pee When You Sneeze?”.

5. Sleep & Rest 

Sleep Positions

Did you know your body heals itself while you are sleeping? Our bodies need sleep to recover. I know in those first couple weeks postpartum sleep and rest can be very hard to come by. What I have learned is to accept help and prioritize sleep. Let your partner take care of the baby, say no to visitors so you can nap when the baby naps, and let that pile of laundry sit another day. Sleep and rest is so important to our physical and emotional health. Try to get as much sleep and rest as possible those first couple weeks to allow your body to recover. 

Final Thoughts About Postpartum Recovery

This post is for informational purposes only. Talk to your doctor or medical professional if you have any questions about your postpartum recovery. I believe that all moms should have more education and help in their postpartum recovery. Please check out my post Bouncing Back After Baby (Why All Moms Should Have Physical Therapy After Pregnancy)

Your body went through many changes during pregnancy and delivery. Some of these changes may resolve on their own, but some may not. It is NOT normal to experience the following conditions after 6 weeks postpartum. Please let your doctor know at your follow up visit (or later) if you have:

  • Back pain
  • Pelvic pain
  • Pain with sex
  • Incontinence/ urinary leakage
  • Abdominal separation
  • Discomfort with C-section scar
  • Questions about safe return to exercise 

Pregnancy and childbirth is amazing but definitely hard on our bodies. The best thing you can do is be educated and proactive in your health, wellness, and recovery. Feel free to reach out if you have any questions about pregnancy or postpartum health and wellness.  You got this mama! 

–Monica 

Postpartum recovery

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Bouncing Back After Baby (Why All New Moms Should Have Physical Therapy After Pregnancy)

Bouncing Back After Baby (Why All New Moms Should Have Physical Therapy After Pregnancy)

Posted on by Monica

Hi ya’ll. Some of you may know that I recently began seeking further education in the area of women’s health. I especially have a strong interest in the pregnancy and postpartum population. Since having my two babies I have realized how much change women undergo physically. It’s actually quite amazing what our bodies are capable of. But unfortunately, our postpartum bodies are not perfect. Muscle weaknesses, posture changes, and healing tissues can lead to aches, pains, and impaired function. Luckily physical therapy is available to help women after pregnancy with many of these new and unanticipated challenges.

The need for physical therapy after pregnancy

physical therapy after pregnancy

In my recent postpartum course I discovered some staggering statistics on the number of women struggling with postpartum pain or issues who are not receiving any treatment. Some of the particularly noteworthy statistics include:

Pregnancy related lumbopelvic pain persists in 25-50% of women at 3 months postpartum. And if the pain is there at 3 months postpartum, then it will most likely still be there at one year postpartum. 

Sometimes this back pain can become chronic. So what exactly does this mean? This tells us that postpartum women suffering from low back pain need therapeutic intervention. Unfortunately the pain will not just magically go away. 

What’s more, only 32% of women who have PLBP (pregnancy low back pain)  or PGP (pelvic girdle pain)  report it to their care providers. And then of those who report pain to their providers only 25% of these women get a treatment recommendation. This means a huge number of women are not getting any treatment or professional help for their physical problems after having a baby.  

Postpartum Care in Other Countries

physical therapy postpartum

So why aren’t more women in the U.S. getting physical therapy after pregnancy? I mean their body just went through a huge change, they potentially had surgery, and their physical demands just grew exponentially with a new tiny human on the scene. 

Many other countries are leaps and bounds ahead of us in their postpartum care of mothers. In France, the Netherlands, and Australia every woman is automatically given several visits with a pelvic floor physical therapist to address healing issues,  muscle imbalances, or any other concerns.  Fox News published an article addressing the vast difference between France and the U.S in their care of the postpartum women. In fact, U.S. women are the least likely to get physical therapy treatment after pregnancy (only 24%) compared to Europeans.  

Yet, of these women who do get treatment in the U.S. up to 87% reported positive effect, meaning that therapy works. Obviously. Therapy can help your body heal effectively in order to prevent chronic pain symptoms, incontinence, pain with future pregnancies, and safe return to exercise and regular activities. 

postpartum care

Common Problems Postpartum 

Below are some of the common problems women might experience postpartum.

Abdominal Separation/ Diastasis Recti 

When we are pregnant our uterus and stomachs grow as the baby grows. This new growth can place extra pressure on the linea alba which is the tissue that runs down the middle of your 6 pack abs (also known as your rectus abdominis). The added pressure on your linea alba can lead to a separation of your abdominal muscles known as a diastasis recti. A diastasis recti is diagnosed postpartum if the distance between the abs is 2 finger widths or more when measured slightly above and below the belly button, or there is insufficient muscle tension.  Around 4 weeks postpartum this separation naturally starts to come back together.

However, about 60% of women still have a diastasis recti 6 weeks after childbirth. In fact, if a diastasis recti is present at 8 weeks postpartum it will likely still be present at 1 year (Coldron, 2008) An untreated diastasis recti can contribute to low back pain, pelvic pain, urinary incontinence, and other pressure system issues in our body. 

A physical therapist would be able to assess and provide proper treatment to help heal a diastasis recti. We do not have any specific exercise program supported in the scientific literature to heal a diastasis. What matters is the quality of your exercises and movement which would be assessed by a specially trained PT.

Incontinence

For many women pregnancy and postpartum is the starting point for urinary leakage and other bladder problems. There is no “normal” amount of leakage or pee with activity. A systematic review shows that 33% of women have urinary incontinence at 3 months postpartum. At 4 years postpartum about 29% women reported incontinence. Postpartum incontinence could be from weakness, poor coordination, pelvic floor muscle endurance or from overactivity and muscle trigger points. Again a pelvic floor therapist would be able to evaluate and determine to the best specific and individualized treatment for you. 

Therapy after having a baby

Cesarean Section Scar Healing  

One in three women have a cesarean section according to an article written by The Bump in 2017. A cesarean section is a major surgery in which several layers of the abdomen are cut open. Caesarean sections vary in the layers sutured or not suture as well as the depth and amount of scarring. There are several techniques for scar mobility and massage to help the healing process. A physical therapist can perform and educate a woman on these techniques to aid in optimal recovery. 

Perineal Tearing 

Tearing is the tissue damage that happens during labor and delivery. Greater than 85% of women have perineal trauma with vaginal birth (about 50% of women have episiotomy). Tissue healing of the pelvic floor is important for proper function and remaining pain free.

Low Back or Pelvic Pain

Pregnancy related low back pain or pelvic girdle pain is common during and after pregnancy. Due to changes in the body’s composition and posture during pregnancy many muscles and ligaments can become stressed out and irritable. And as previously mentioned, the core muscles are often quiet weak so there is a lack of stability which can further contribute to pain in the back and pelvis.

Upper Back and Neck Pain

Similarly upper back and neck pain is often present postpartum. Upper back pain is reported in about 43% of postpartum women. This again is due to muscle imbalances and forward posture preferences when holding baby, feeding baby, and more.

There are numerous other things a physical therapist can assist a new mom with after having a baby. Other impairments that often need to be addressed are posture, gait, breathing patterns, body mechanics, and potentially nerve pain. 

How Can Physical Therapy Help New Moms After Pregnancy

Physical Therapy after having a baby

No two women, pregnancies, or birth stories are the exact same so there is no one size fits all treatment for new moms. An individualized treatment session with a PT would allow a therapist to look at your specific impairments. There are numerous ways physical therapy could help a woman after pregnancy.

Examples include:

  • Help aid appropriate healing of perineal or C-section scars/incisions
  • Education on body mechanics and positioning techniques to improve function and prevent pain
  • Provide specific techniques and exercises to heal and strengthen the abdominal muscles (often through use of biofeedback, palpation, observation). They can help postpartum moms retrain the deep core muscles to work effectively and appropriately 
  • Provide specific exercises to heal and strengthen the pelvic floor muscles
  • Assess posture, breathing patterns, and gait mechanics for correctness and efficiency
  • Evaluate and treat low back pain and pelvic pain. Possible techniques include massage, taping, manipulations, and appropriate exercises.
  • Provide an individualized treatment plan for safe return to exercise

physical therapy after pregnancy

What’s Next?

Ok, ok I’ll get off my soap box now. I just recently realized how little education is available to American women regarding their postpartum bodies. To be honest with you there is so much I have learned already that I was not aware of when I had my children. Luckily, I was able to use some of my prior knowledge of the human body to heal and get rid of the little pain and discomfort I did experience after having my babies. But most women do not have a background or education base on body biomechanics and exercise science.

So what can you do? I would love love love if you could share this info with all the mamas or mamas to be out there. I do believe there is a movement happening in the U.S. for postpartum care to be more common place. Do not be afraid to ask your doctor for a referral to a pelvic floor therapist or woman’s health specialist. I think there is a bit of a stigma around woman needing therapy after pregnancy. But you wouldn’t be embarrassed if someone told you your leg muscles were weak. Weakness of the core and pelvic floor shouldn’t be any different.

Keep following along as I embark on this journey of education regarding health and wellness for the pregnancy and postpartum woman. And I do believe the saying, once postpartum, always postpartum. Our bodies are fricken amazing. Let’s give them the love and respect they deserve.

–Monica

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Top Reasons for Back Pain During Childcare

Top Reasons for Back Pain During Childcare

Posted on by Monica

Between all the lifting, carrying, pushing, pulling, running, squatting, grabbing, and maybe even rolling, taking care of kids is extremely physical. And all of these childcare activities can cause back pain as well as other annoying aches. I consider myself fairly fit and healthy and I have experienced back pain on and off as a result of caring for my children. 

And I am not alone. A study of childcare workers found that pain in the lower back was reported by 40% of workers, followed by pain of the neck (35%), and shoulder (16%). You want to know something? My mom (aka Nana) experiences occasional back pain too. She helps us out regularly with childcare and she does her fair share of wrangling a toddler and a baby. So this post is dedicated to my mom who helps us out with babysitting every other week.

Back Pain and Childcare

 

Grandparents as our Childcare Providers

I don’t know what we would do without my mom. My kids love Nana. She plans crafts, reads stories, and chases them around the house. But, (without sharing any specific numbers) Nana is over half a century old (sorry Nana).  And let’s be real, the body just doesn’t work the same the older we get.

Also, I know my mom isn’t the only grandparent doing us all a solid and helping out with childcare. In fact, according to Popsugar Family, the latest AARP data shows that 38 percent of grandparents play the role of babysitter or daycare provider. So actually this post is for all the Grandmas, G-mas, Grammys, Nanas, and GGs completely killing it as childcare providers. And I think every single mom could learn a helpful tip or two. 

We love you, our kids love you, and most importantly we love that you watch our kids for free…so please don’t get hurt. Keep reading to find out about the impact age has on our bodies and common activities that can trigger back pain during childcare. Also, make sure to follow my simple tips to avoid back pain and what do if all else fails.

The Impact of Age on The Body

Toddler and Back Pain

Let us quick address the elephant in the room and acknowledge that as we age our bodies change. These changes can place the body at an increased risk of injury during the challenging demands of childcare.

Decreased Muscle Mass:

With age there are changes in the nervous system and muscle connective tissue impacting the function of the muscles. Also people often become less active resulting in a decrease in muscle mass.  This impacts the stability of the joints during movement. Decreased strength also places your body at an increased risk of muscle injury.

Arthritis and Stiff Joints:

Arthritis is a natural side effect of aging. We all develop some degree of arthritis as we age due to decreased muscle mass (see above), decreased cartilage, and increased wear and tear. Arthritis can cause stiffness in the joints of the hips, knees, back, and neck decreasing your ease of mobility. 

Common Back Pain Triggers During Childcare

holding baby and back pain

Lifting From Crib

When picking up a child from the crib first pull the baby as close to you as possible. Then try to stagger your legs and bend your knees while trying to keep your back straight. Avoid bending or rounding your back.

Putting In/Out of Highchair

Remove the tray to allow the child to easily slide in or out of the highchair. When picking baby up brace your core and lift with two arms.

Lifting From Floor

Assume a wide stance and bend at the knees in order to lift with your legs. Alternatively you can stagger your feet and lift via a 1/2 kneeling position. Always brace your core and avoid bending and lifting with your back.

How to pick up a toddler to prevent back pain

Holding Baby or Toddler

When holding a child avoid putting them on your hip. This places stress and strain on your low back muscles. Instead hold the baby close to your body center with two arms. Keep your core braced and stagger your feet to reduce low back pressure. When holding a toddler encourage them to wrap their legs around your torso for even less pressure on your arms and back. 

Placing in Lap

Never sit and reach out to pick up and place a toddler in your lap. Instead stagger your feet, assume a lunge position grab child and slowly lower yourself down into the seat. Better yet, encourage the toddler to climb into your lap.

 

picking up a toddler to avoid back pain

Getting Off the Floor

Avoid sitting on the floor for prolonged periods of time. It is also best to avoid positions in which your knees are bent. This can cause joint stiffness and pain which will make rising to stand more difficult. When getting off the floor try to get near a support surface you can use to push/pull up on with your arms. Assume a 1/2 kneeling position, push through your planted foot and pull with your arms.

Tips for Preventing Back Pain During Childcare

Childcare and back pain

Maintain Good Posture

Keeping good posture with your shoulders down and back, spine erect, and hips under trunk will help you avoid injury. Bad posture sets your muscles up for failure. You can read more on the importance of good posture in my post Why Good Posture Matters. 

Strengthen Your Core

One of the best ways to prevent injury to the low back is to have a strong and stable core. Your core muscles protect your spine and decreases the risk of overuse injuries of the low back. You can find some great core exercises in my post 5 Core Exercises for a Better Belly

Practice Good Body Mechanics

Bending, lifting, and carrying the proper way is very important in the prevention of low back pain during childcare. You always want to make sure you are picking up and holding your baby or toddler the proper way. Be sure to follow the tips above and you can read more about everyday childcare body mechanics in my post Basic Baby Body Mechanics and Break Yo Mama’s Back (Body Mechanics Part II). 

Stretch and Stay Active

When you regularly exercise your muscles stay stronger and more flexible. This will aid in the prevention of injury to your low back muscles when caring for babies, toddlers, and older children.

Treating Back Pain

childcare and back pain

Rest

If you unfortunately hurt your back muscles you want to give yourself a day or two of rest. Try to avoid strenuous movements and lifting or carrying anything heavy. Your muscles need a bit of rest and time to heal.

Ice

Ice is a great way to reduce inflammation in the muscles. Applying ice is best for a new (or acute) injury and should be used in the first 24-36 hours after an injury. After 36 hours it is ok to try heat which will bring blood flow and help to loosen tight muscles.

Stretch

After an injury to your back you want to be sure to stretch and move the muscles. This will aid in the healing process and reduce pain and tightness. You can find some great stretches for your low back in my post Motherhood and Low Back Pain. 

Resume Activity

After a day or two of rest it is good to gradually ease back into activity. Of course you want to go slowly and start with activities that do not place excessive strain or pressure on your back. You should always check with your doctor if you continue to experience bad or unrelenting pain in your back.

Other Physical Side Effects of Childcare

 

Unfortunately, back pain is not the only complaint people have during childcare. Childcare is very physical and you may be experiencing pain in your:

Click on any of the above to read the associated post related to each of these body parts. Each post will include more detailed information on causes of the pain, pain prevention strategies, and possible treatment options.

Holding Babies and Toddlers and Back pain

Sharing is Caring

Thank you Grandparents for helping take care of our kids! We know it’s not always easy. Our children are busy, heavy, little balls of joy. So take a little extra time to protect your back with these helpful tips. Be sure to share this post with any loved ones, friends, or family who help take care of children. I believe we all could benefit from one or two of these tips to prevent back pain, no matter your age.

–Monica

Back pain when caring for babies and toddlers

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Break Yo Mama's Back (Body Mechanics Part II)

Break Yo Mama’s Back (Body Mechanics Part II)

Posted on by Monica
Body mechanics
basic body mechanics
Body mechanics to avoid back pain

I know what you might be thinking; “body mechanics again?…boringggg, not reading this post.” But stop! Don’t go! My number one goal is to try and help moms (or anyone who cares for children) avoid or treat their everyday aches and pains. And changing the way in which we perform our everyday movements is one of the easiest ways to avoid pain and injury. 

One of my first ever blog posts (Basic Baby Body Mechanics) was about simple tips to avoid back pain as a new mom with a new baby. But unfortunately the opportunities for body mechanic errors doesn’t end after the newborn or baby phase. Motherhood in its entirety is a high risk job where potential for body aches, pains, and strains lurks around every corner.

After I had my son I had terrible low back pain from constantly bending over too low to change his diaper, or pick him up out the crib, and carrying the car seat. And gosh darn it, I’m a physical therapist!… I should know better!

So I quickly righted my wrongs and changed how taking care of my baby and my back pain went away. Thank the lord! But if I knew what I should be doing and wasn’t even doing it I imagine there are a lot of other moms or child caregivers out there making the same body mechanic mistakes.

So I thought it was time for a mom body mechanics part II post. Between holding your kids, bath time, laundry, and groceries moms need to be extra careful about how they are performing these everyday tasks. Please don’t break your back mama! Forget about cracks, check your mechanics and make sure your are doing these activities correctly.

Holding Your Child

How to hold your child

Don’t Do This:

Avoid holding your child on one hip or with one arm. Avoid holding your child for prolonged periods of time if possible. This can lead to neck and back aches and strains.

Do This:

Hold baby, or toddler, (or 9 year old…no judgement) with two arms near your body center. If possible wear your baby using a baby carrier or wrap. Stagger your feet to reduce the pressure placed on your low back. I have these two below and they are life savers (well actually back savers) 

Grocery Shopping

how to avoid back pain

Don’t Do This:

While shopping don’t load up a basket at the store with more than four light items. If your basket will weigh more than 5-10lbs just grab a cart. Avoid leaning over far into your car to reach and pull out groceries. Avoid loading up one arm with several heavy grocery bags.

Do This:

Always use a shopping cart (instead of a basket) at the store if you are picking up more than four light items. Before taking heavy grocery bags out of your car pull the bags as close as possible to you and then pick them up. Try holding the bags as close to your body center as possible. Avoid over loading your body with heavy bags.

Giving a Bath

Giving baby a bath

Don’t Do This:

Avoid standing and bending over at the waist to reach your children. Avoid lifting kids up out the bathtub using your low back. Avoid being in a prolonged position being bent over reaching or bathing your kids.

Do This:

Use a folded up towel or a knee pad product to kneel down as close to the tub as possible. Keep your back straight and core tight while kneeling. Quickly wash, rinse, etc and then return to tall kneeling or take a seat while watching your kids (assuming your kids are old enough to sit and play in the tub safely independently). Lift kids up out of the bath by bending your legs.

If bathing a small baby place the baby bathtub on the counter or bath the baby in a sink so you can stand with the baby at waist height. (Obviously NEVER leave the baby unattended)

Doing Laundry

how to avoid back pain

Don’t Do This:

Depending on the set up of your washer and dryer this can be a tricky one. Try to always bend at the knees and not the waist. Avoid picking up too much laundry at one time and avoid twisting your back while keeping your feet planted. Try not to carry a laundry basket on the hip or with one arm.

Do This:

Bend down to grab or put in clothes using your legs, not your back. Always keep nose over toes and turn your whole body or take a small step to put clothes from the washing machine into the dryer or into a laundry basket. Carry laundry basket with two hands close to your body center.

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Final Thoughts About Body Mechanics:

Ok listen. I’m a realist and I know that some things are unavoidable or out of our control. Parenting is busy, messy, craziness and sometimes you just need to get sh*t done. I get it. But help me help you and try to remember these tips to protect your low back; especially if you already suffer from low back pain.

You can find some easy stretches for low back pain here. And the besides practicing good body mechanics the best way to prevent low back pain is to have a strong and stable core. Learn some great core stabilization exercises. here.

Good luck!

–Monic

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