Tag: pregnancy

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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Exercise & Pregnancy (Plus a Total Body Routine)

Exercise & Pregnancy (Plus a Total Body Routine)

Posted on by Monica

There is a common misunderstanding about exercise and pregnancy. Years ago it was believed that pregnant women should rest and take it easy. And while I am all for having a pregnant woman kick her feet up so her baby daddy can give her a world class foot massage, baby mama should also be participating in regular exercise.

Women with noncomplicated pregnancies can (and should) safely participate in exercise throughout their pregnancy. According to The American College of Obstetricians and Gynecologists “If you are healthy and your pregnancy is normal, it is safe to continue or start regular physical activity. Physical activity does not increase your risk of miscarriage, low birth weight, or early delivery.”

In fact there are numerous health benefits of regular exercise to both mom and baby that you can read about next. See what are the general exercise recommendations during an uncomplicated pregnancy. And finally, when one of my preggo besties asked for an at-home core, butt, hip, and leg strengthening exercise she could do during her second trimester I was more than happy to oblige. You can try it out below (even if you aren’t expecting!).

Benefits of Exercise During Pregnancy

Exercise and Pregnancy

There are numerous benefits to exercise during pregnancy. Exercise when expecting can aid in decreasing musculoskeletal aches and pains, helps decrease stress, aides in healthy weight gain, improves your self image, and helps decrease the recovery time after your baby is born.

Additional (likely lesser known) benefits include:

  • Decreases constipation
  • Decreases swelling
  • May decrease your risk of preeclampsia and gestational diabetes
  • Strengthens your heart and your blood vessels for you and baby
  • May help prepare your body for labor and/or birthing your baby (it can be a marathon)

Physical Changes During Pregnancy

Pregnancy and Exercise

Hormonal changes

The hormone relaxin is released during pregnancy which increases laxity in the joints allowing the pelvis to widen. However, this increase in laxity can lead to joint instability and pain.

Extra pressure on joints

With a growing baby in utero there typically comes a growing number on the scale. This increased weight gain is healthy and part of a typical pregnancy but it can lead to a sudden increase of pressure on the low back, hips, knees, and feet.

A growing stomach

As the baby grows the uterus and abdomen also expands at an exponential rate. The places stress on the muscles and tissues of the abdominal wall. Sometimes this increased pressure and growth can lead to a separation of the abdominal wall known as a diastasis recti. You can read more about diastasis recti in my “Mommy Pooch” post.

Pelvic pain and pressure

Not only does the growing baby place increased pressure on the joints but it also places extra pressure on the pelvic floor muscles. This can lead to pain in the pelvic floor region, sciatic nerve compression, and incontinence. You can read more about pregnancy and it’s effects on pelvic floor function in my post Is It Normal To Pee When You Sneeze.

To learn more about how the total core body functions be sure to check out my post about The “Pop Can” Core.

How To Exercise When Pregnant

How To Exercise When Pregnant

So you may be wondering how much exercise you need when pregnant. The general recommendation is to participate in 30 minutes of moderate-intensity exercise on most days of the week. This will help you achieve many of the aforementioned benefits.

Key elements for limiting excess maternal weight gain during pregnancy include exercising 5 times a week, exercising at a moderate to somewhat hard intensity, and continuing to exercise until the end of pregnancy (if medically able).

If you never exercised pre-pregnancy you should ease into an exercise routine. Do not go crazy and decide that pregnancy is the perfect time to start training for a 5K when you haven’t run since you were 9 years old. Let’s be realistic now.

Exercise when expecting

Choose something you enjoy doing when deciding on what type of exercise to do while expecting. Avoid any activities that may place you at risk of falling such as skiing, horse back riding, or mountain biking. (Cause I know that’s exactly what most women with an ever growing watermelon belly want to do.) Pick something that is fun and convenient such as walking, jogging, exercise machines, swimming, resistance training, yoga, or dancing.

Strengthening or stabilization exercises can be very helpful in avoiding musculoskeletal aches and pains throughout pregnancy. Additionally, strengthening your core, hips, pelvis and legs can help prepare you for the physical demands of labor, childbirth, and motherhood. Strengthening can be done through using resistance bands, isometric holds, or repetitions.

Important muscle groups to strengthen include:

  • Core/abdomen muscles – can help decrease development of a diastasis recti
  • Hips/buttock muscles– aids in prevention of hip and low back pain
  • Pelvic floor muscles– can decrease low back pain and incontinence
  • Leg muscles – improves function during pregnancy, childbirth, and postpartum
  • Upper body muscles – helpful during labor and when holding/carrying baby postpartum

Exercise Routine

There are certain conditions in pregnancy in which exercise may be contraindicated. You should always speak with your OB or health care provider before beginning an exercise program.

If you are just starting an exercise program aim to exercise three days a week and progress up to six if your body is tolerating it well. You should always start an exercise routine with a brief warm up and a cool down period. Check out this total body strengthening routine for core, butt, hips, legs, and even a dash of pelvic floor.

Core & Hip Strengthening Routine (1st and 2nd Trimester Friendly)

  1. Bridges: 10-12 reps
  2. Sumo Squats: 10-12 reps (add 5-10lb dumbbell for extra resistance)
  3. Hip Circles: 10 reps clockwise 10 reps counter clockwise
  4. Plank Toe Taps: 10 taps to each side
  5. Wood Chops: 10 to each side (add 5-10 lb dumbbell for extra resistance)
  6. Modified Hip Dips: 10 each side

Repeat this circuit for 3 sets.

What’s Next?

Again, always be sure to speak with your OB or the appropriate medical professional prior to beginning an exercise program when pregnant or postpartum. Exercise is a great way to promote a healthy pregnancy and pave the way for an easier recovery postpartum. If you are looking for more exercise ideas just drop a comment and let me know what you would like to see. Enjoy and happy exercising!

–Monica

Reasons to exercise during pregnancy

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Hi and welcome

Hi and welcome

Posted on by Monica

I know what you’re thinking.

“Greeeeeat, another fitness blog”. Nope. I’ll never have the six pack abs or bootylicious hindquarters to compete with those ladies. Mad props to them. And while I do my fair share of dabbling in Instagram workout routines I unfortunately like cake and beer too much.

“Another Mommy blog?” Not exactly. I’m often the one seeking advice and by no means have the experience or confidence to dish any out. Like a lot of moms I simply do my best to get by. Are my kids alive, mostly clean, and happy? If yes, it’s a good day.

My blog is about sharing what I know as a physical therapist or what worked for me as a mom to stay active and address any body pains during pregnancy, postpartum and beyond. Being a mom is hard A.F. and we are really hard on our bodies. I would bet 99.9% of you could think of an ache or pain you have experienced at some point in motherhood (or prior) that really just kinda ruined your day, or week, or year. Furthermore, sometimes these musculoskeletal issues prevent us from doing the things we enjoy or make us feel good.

I know from personal experience how much it sucks when you hurt your back or your neck and that is literally all you can think about because every little movement hurts so you lay on your family room floor and cry because all you want is for the pain to go away. Been there. Done that.

So why the blog? Because over the past few years I have had countless mom friends ask me questions about pelvic pain, back pain, neck pain, wrist pain, pain with running, incontinence, running during pregnancy, running after pregnancy, how to exercise safely and honestly I LOVE talking about it. LOVE. IT.

The number one question I get asked by patients is “Why did you become a physical therapist?” 

My answer. “Because I love the body.”

It’s fricken amazing. The things it can do are crazy. And if you strengthen or stretch the right muscles you can basically make it do whatever you want. So cool, right? But it’s also important to be aware of the everyday activities and positions we are putting our bodies in because if you are doing it wrong your body is gonna let you know. Cue persistent back pain.

Annnd, I like helping people. I like building relationships and helping others feel the best they can so they can do the things they want in life. Maybe you’re a mom-to-be, a new mama, an old mama, a grandma, a dad (stay tuned for future blog post about my husband’s wrist pain), or heck, maybe you just have pain (cuz who doesn’t) then I want to help you with some tips to help you take care your body and to just generally feel good. I mean it’s your body and you only get the one.

So here goes nothing. Me, doing my best to navigate the blogosphere, use appropriate punctuation (not gonna happen) and give you content you all find helpful or informative. I have a lot of post ideas but would love to hear what you would like to see. Feel free to send me an email with any questions or comments. 

Sincerely, Best wishes, Regards, Cheers,

(Working on coming up with something catchy)

–Monica

Working out with kids