American Baby

The Aches & Pains of Mommyhood

Advice and exercises to prevent problems. (2005)

 

By Charlotte Huff

By the time my son celebrated his first birthday, I'd shed my pregnancy weight and was playing racquetball twice a week. A little cocky, perhaps, but not for long. My body soon set me straight, my left hip collapsing into painful spasms seemingly out of the blue one night as I rose from the sofa.

I needed a round of steroids and physical therapy and still it took several months before I could even walk comfortably. Along the way, I learned to strengthen my abdominal muscles, watch my posture, and, above all, reluctantly accept that a 35-year-old mom can't cavalierly lift a 24-pound baby without some kind of boomerang effect.

It's no surprise that pregnancy poses a body mechanics nightmare. Your breasts swell almost immediately, straining the neck and shoulders. Hormones relax ligaments throughout your body, including the pelvis, which is vital to lower back support. And those abdominal muscles are stretched into near uselessness by your growing baby.

New moms, though, often don't realize that the first year after delivery can be just as back (or neck or hip) straining, if not more so. A battered body, fatigue, a demanding infant and a society perpetually on fast forward can stretch some new moms literally to the breaking point, says Hollis Herman, a Boston-based physical therapist and author of How

To Raise Children Without Breaking Your Back (Ibis, 1995). "Everything in your body has been shifted. You're carrying around this 10-pound baby every place you go."

After her daughter, Erica, was born in 2003, Lisa Vogt noticed some uncomfortable pressure in her lower back. But the first-time mom ignored the discomfort until, she believes, a combination of stress, poor lifting habits and badly designed baby furniture triggered excruciating back spasms three months later. "It felt like my whole spinal column was collapsing on me," says the Dallas mom. "I had to call my friend to come over and lift the baby, because I could not even pick her up. I couldn't pick her up for two months."

Two-thirds of American women report lower back pain during pregnancy and nearly 30 percent say its severity forced them to stop at least one daily activity, according to 2004 research published in the journal Obstetrics & Gynecology. Another study in the late 1990s, involving Swedish women, found that those reporting low back pain during pregnancy were more likely to miss work later on because of continued discomfort. But research about the causes and the extent of musculoskeletal problems after delivery-particularly if they don't involve the back-is scarce, experts say.

It's unclear, for example, how often muscle strains and spasms can be blamed on pregnancy-related body changes and how often they would have occurred anyway, given all of the repetitive lifting and twisting required to raise a rapidly growing infant, says Pamela Berens, MD, an associate professor of obstetrics and gynecology at The University of Texas Medical School at Houston. Still, body stresses can be reduced and maybe even prevented if you intervene early.

Before delivery

By the end of the first trimester, the body's framework is already shifting. Your breasts swell sometimes to two or three times their normal weight, encouraging you to round your shoulders and jut your neck forward in an unconscious effort to compensate. Your uterus begins to protrude out of the pelvis, pushing into the abdominal cavity and gradually throwing off your balance, Berens says. "Because of that, to keep your center of gravity over your hips, you have a little more tilt in your spine. That spinal tilt, she says, can throw off your balance and strain your lower back. To fight back, you can strengthen your abdominal muscles even if you don’t have the energy to embark on an exercise program, says Jessica Drummond, a physical therapist specializing in postpartum care at The Woman's Hospital of Texas, in Houston.

When you exit a car or stand up from a chair, focus on pulling your belly button toward your spine to strengthen the traverse abdominus, the muscle that supports your back by joining it to the stomach and other core muscles crucial for body stability. And when you shop for baby furniture, pay attention to more than price or how much you like the style.  Look for adjustable handles on strollers, adjustable sides on cribs. As for that SUV-style stroller, could you open it with one hand while jostling a fussy infant on the opposite hip?

As Your Baby Grows

Your body may feel the most banged up in the first few weeks after delivery. But you may notice more body strain later, once your feather-light newborn has doubled or

tripled her weight. How do you protect yourself? Here are some basics to help you stay healthy:

Watch Your Posture: Limit the amount of time you spend hunched forward-over the crib, the diaper changing table, reaching into the stroller. And pay attention to your posture at other times, such as at work.

Lift Carefully: Hold your baby close to your body as you stand. Don't bend from the spine; use your knees and hips. Tighten your lower belly and pelvis as you lift. Once standing, hold your baby in both arms, or cradled against your chest in a baby carrier, rather than loading all that weight on one hip. Vogt, who had a son earlier this year, no longer uses her hefty infant car seat as a baby carrier.

Reduce Fatigue: Sounds like a bad joke, right? With families and friends often scattered these days, too many responsibilities fall on a new mom's shoulders. If your body is already feeling strain, fatigue will only make things worse, especially for moms who already have a child. Don't become a martyr. When people offer to help, take them up on it! Let them pick up groceries or watch the baby.

Body Smarts For The Long Haul

As more women postpone motherhood into their 30s, they may face more physical challenges. Older mothers are more likely to have already suffered some back strain. Their tissue might not rebound as quickly. But ultimately, your level of physical conditioning trumps the number of candles on your birthday cake, says Susanne Bathgate, MD, assistant professor of obstetrics and gynecology at George Washington University Medical Center.

Losing the pregnancy weight will help you get back into shape faster. Nursing can help burn an extra 500 calories a day, Dr. Berens says. But nursing also prolongs your hormonal infusion, keeping ligaments looser than normal. That's why you should start strengthening your muscles as soon as your doctor issues the go ahead, Herman says. (See “Strengthening Exercises,” previous page.)

Aches and pains may emerge where you least expect them. Even your wrists and hands are vulnerable. Fluid accumulation during pregnancy can place pressure on crucial nerves. Add to that the repetitive lifting of your newborn and problems can snowball, Drummond says. If you experience early twinges of pain, wear a supportive wrist brace.

Wrist or hand pain also can be misdiagnosed as carpal tunnel syndrome when the culprit lies elsewhere, says Herman. Habitually bending the head, neck and shoulders can compress an artery in front of the shoulder, radiating pain as far away as the arm or the hand, she says. Working with a physical therapist or an exercise trainer at a gym can help build up the muscles in the shoulder region, relieving pain there, as well.

Another new-mom issue: a sore thumb from repeatedly picking up your baby under his shoulders, which can strain the tendons in the thumb, causing them to become inflamed. (See “Are You Lifting Baby the Right Way?” above, for technique pointers.)

And don't forget your feet—the building blocks that support the rest of your body. Relaxed ligaments can reshape or eliminate your arch. Without a good arch to provide support, your feet and calves muscles will have to work harder. One way to improve your odds of retaining your arch, Drummond says, is to avoid going barefoot and wear supportive shoes for the full nine months. Your feet may get bigger during pregnancy, and stay bigger after you’ve given birth, so be sure you’re wearing the right size shoes.

Just two months into her second pregnancy, Lisa Vogt was already doing abdominal and back exercises. “Those exercises, combined with prenatal yoga classes, make a dramatic difference,” she happily reports. She only wishes—and I can second this sentiment entirely—that somewhere in the numerous books she read during her first pregnancy there had been more discussion about the painful results of poor body mechanics. "I don't think I would have gotten so bad," Vogt says, "if someone could have helped me earlier."