Post Partum Back Pain Causes and Prevention
By Dave Van Zandt, CSCS, CEAS, Cert FCE
The physical stress of caring for infants and young children can place a tremendous biomechanical strain on your back. Daily repetitive stress from lifting the child or infant can lead to back injury or pain.
The post partum mother has a higher risk for potential injury as compared to a woman who has not been pregnant or is beyond the post partum stage. The hormones that are essential to pregnancy cause global relaxation to the ligaments and muscles. Several anatomical changes created by the global laxity in muscles and ligaments compromises the stability of the spine.
Spinal stabilizers, such as the abdominal muscles, lose their tone. As do the muscles and ligaments surrounding the spinal column. This reduces the body’s ability to stabilize the spine. Throughout pregnancy, instability of the spine gradually increases. Changes in posture due to pregnancy and the increased instability of the spine can lead to back pain in some women during and after pregnancy.
New mothers who are post-partum often resume the routine of child-care without obtaining full recovery. Laxity of the ligaments and muscles remains. Often mothers are lifting car seats, baby strollers, the child and/or other siblings into their arms and carrying the infant and other children. Many times this is done recklessly without proper back ergonomics. Mothers are often fatigued and hurried to get to their destination, often with self-neglect. These activities, concurrent with laxity of muscles and tissues, create a higher probability for injury to the tissues around the spine.
Many more women are having C-Sections today. The C-Section greatly increases the risk for injury in a post partum woman. The C-Section surgery involves cutting through the abdominal muscles. This results in a much longer recovery time to gain lumbar stabilization from the abdominal muscles. A women who has a C-Section needs to be particularly careful to use proper lifting mechanics when holding the child and lifting objects that can strain the back and abdominals. Consult your OB about beginning an abdominal strengthening program after your C-Section.
The best prevention for post partum back pain is to use proper body mechanics when lifting your baby or household objects. The proper technique is to use your legs instead of your back. See pictures below.
You should also avoid twisting your back when reaching or lifting something that is away from your body. Use your legs to turn toward the object and always keep the weight close to your body. The closer the weight is to your body the less torque placed on your back.
Post Partum exercise is very important to rebound quickly from your pregnancy. Vigorous exercise such as jogging or lifting weights should be avoided. It is generally recommended that exercise be avoided for 6 weeks following delivery.
The best way to get started is to engage in alternatives such as walking, isometric and gentle stretching exercises. These can help you to get back into shape, facilitate the weight loss process, help manage post-partum back pain and prepare you for returning to your normal activity level.
For a start, you can try out a walking program at a suitable pace. For instance, you can walk around your neighborhood or park at a comfortable pace for about twenty minutes each day. Then, you can increase your pace and distance gradually once you regained your endurance. Walking helps you tone your muscles, build endurance and burn some of the maternal fat stores that developed during pregnancy in order to help you lose excess weight. These combined effects will help combat post-partum back pain.
Besides this, you can also use isometric exercises to build muscle strength without putting stress on the joints. The major muscle groups to focus on are the abdominals, buttocks, inner thighs, front thighs and upper back. For instance, when performing the exercise on your upper back, you should squeeze your shoulder blades together and press your chest forward. You should hold each contraction for 5-7 seconds; repeat 5-10 repetitions, 3 times a day.
In addition, stretching exercises are recommended. If you try to stretch too quickly or too far, you may feel pain due to the instability of the pelvis and spine. Instead, you should slowly stretch to the point of a comfortable pulling sensation and hold the stretch for 15-20 seconds and repeat 3 times. It is important to regain normal flexibility in order to minimize stress on the joints of the spine and pelvis.
Consult your OB before beginning any post partum exercise program.
Performing the above exercise is definitely an effective and safe way to help you manage post-partum back pain and regain your body fitness as well.