Postpartum Health
Things to Consider After Having Your Baby The postpartum period comes with a lot of changes and challenges-- learning how to take care of your newborn, prolonged sitting for breastfeeding or bottle feeding, long periods of holding baby, sleep deprivation, adjusting to life with a new baby, stress, your body healing and recovering from labor/delivery, and so much more! You may feel pressure to “bounce back” after pregnancy and birth to your “pre-baby size” or “pre-baby body.” But, friend, this is not the case and this is not the time to focus on those things as tough as it may be. Your body went through so many changes during pregnancy and birth that it will take time to allow your body to heal and recover postpartum. I want to challenge you to turn your focus from “bouncing back” or “getting your body back” to a focus on reconnecting to the muscles of your deep core and gradually and specifically strengthening your entire body so you can be the best version of yourself and the best mom! Let’s talk about some of the things to expect postpartum and what is normal or not normal! WHAT IS NORMAL?? 0-8 Weeks After Delivery:
8+ Weeks After Delivery:
WHAT IS NOT NORMAL??
While these symptoms listed above are very common in the postpartum period, they are NOT normal and they are not just your “new normal” after having a baby! There is help for these symptoms! If reading through those symptoms above and 1 or more of them apply to you, see a physical therapist specializing in women’s health or postpartum rehab to assess you as these symptoms typically do not just go away on their own! I love helping postpartum women heal and recover so they can feel strong, take care of their kid(s) without worrying about these symptoms, and get back to doing exercise that they love! WHY YOU SHOULDN’T JUMP RIGHT BACK INTO PRE-PREGNANCY EXERCISE AFTER YOUR 6-WEEK CHECK-UP: So, you just went to your 6-week check-up and your OB-GYN or midwife gave you the “green light” to return to exercise and sex, etc. Their job is to make sure from a symptom and healing standpoint that there is no specific reason you should not begin these activities. However, what they don’t assess for you is:
This is where our job as physical therapists come in! This is why ALL women (no matter if you have symptoms or not) need to be assessed by a physical therapist after having a baby! These are some of the things that are assessed at an initial evaluation by a physical therapist postpartum. Jumping right into an exercise program after delivery isn’t ideal for everyone and just because you are cleared to exercise doesn’t mean you are ready for any and all exercise! It is crucial to learn how to reconnect with your deepest layers to facilitate healing and recovery physically and mentally postpartum. Whether you had a vaginal delivery or C-section, your abdominals and pelvic floor were stretched, weakened, and may have experienced some damage! You need to:
I offer in-person physical therapy consultations to local Columbus, OH women and online/video sessions as well for those in the state of Ohio! I love helping pregnant women and postpartum women (at any stage -- even years after having your last baby!) to restore their core and finally feel like themselves again! Let me know how I can help you!! Email me at: [email protected] or shoot me a message on my instagram @movewell.pt ! Kaitlin Hartley, PT, DPT, PPCES
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“Text neck” has become a true issue in today’s society as everywhere you look, people of all ages are spending more and more time glued to their smart phones. People not only use their smart phones as communication with family and friends, we are now using them for work, music, and endless amounts of games to choose from to occupy our time!
Neck pain can be very frustrating as it can affect many aspects of daily life including exercise, work, reading, hobbies, etc. The International Association for the Study of Pain (IASP) defines neck pain as “pain perceived anywhere in the posterior region of the cervical spine, from the superior nuchal line to the first thoracic spinous process.” Text neck is the term used for neck pain that occurs when using a handheld device such as a phone or tablet. This prolonged use of the devices causes our head and shoulders to move into a forward flexed position. Over time, this can increase the pressure on the intervertebral discs in the spine and often lead to neck pain. If you find that with increased time spent on your device, your neck becomes more painful, you may benefit from a course of physical therapy to help! What are the typical symptoms associated with text neck??
How can physical therapy help with text neck?? A physical therapist will do a thorough assessment of your neck, shoulders, and thoracic spine to look for any postural impairments, muscle imbalances, poor movement patterns, etc. Some common treatment techniques for neck pain include:
Next time you start feeling that aching, tightness in your neck give this exercise a try: Seated Chin Tucks/Cervical Retraction If you have dealt with persistent neck pain that has not improved, see a physical therapist to assess you and guide you in an individualized, specific treatment plan! Email me at [email protected] with questions or for scheduling purposes! If you want to stay up to date on my practice, receive physical therapy and fitness advice and tips, and find out about new blog posts → Subscribe to my newsletter so you don’t miss a thing! Do you feel a little leak of urine as you step off that curb unexpectedly? Do you notice a few drips as you run or feel that little dribble when you sneeze? What about when you squat and deadlift heavy weight?? All of these scenarios are very common in women who have had a baby or babies, however here is the good news: THEY DO NOT HAVE TO BE YOUR NORMAL! There is help and there are treatments and exercises that can give you your life, exercise routine, etc. back and even better, LEAK-FREE! Today, we are going to talk about pelvic floor tightness or ‘increased tone’ in the pelvic floor muscles and why kegels are not the answer in this case! Often times, us women talk about ‘doing our kegels’ or ‘I had a baby, I probably should do some kegels.’ Or maybe your healthcare provider prescribed kegels for you to do and yet, you notice your symptoms aren’t improving or maybe they even seem worse since you started doing kegels! Well, my friend, kegels may not be the answer for your symptoms! Let’s start with a quick, broad overview of what the pelvic floor muscles are and what they are supposed to do when functioning properly. The pelvic floor muscles sit at the base of the pelvis and you can think of them like a ‘sling’ or ‘hammock’ at the bottom of the pelvis surrounding the openings. There are superficial pelvic floor muscles and deep pelvic floor muscles. If you think of doing a proper kegel, there is a squeeze portion (superficial muscles) and a lift portion (deep muscles). Just as important, there should also be a full relaxation of the muscles after the squeeze and lift, where all the tension releases. The pelvic floor muscles have an important role in continence (urinary and fecal), breathing, support of the spine and pelvis, and postural stability. They also function to support your internal organs. A properly functioning pelvic floor is able to contract when we need it to in order to prevent leaking (ex: sneezing, coughing, running, lifting) and relax when we need it to (ex: breathing, at rest, to birth a baby). So, how do you know if your pelvic floor is tight??? Some common symptoms that may be indicative of a tight pelvic floor (aka increased tone) include:
Why is my pelvic floor tight??? Pelvic floor tightness can occur for various reasons -- just like we often carry tension in our neck/shoulders when we experience stress, the pelvic floor muscles are also a common place women carry tension. When these muscles are constantly tensed, then if you try to do kegels and contract these muscles more, they will have difficulty fully lengthening. For a muscle to function properly, it must be able to fully lengthen and fully contract. Or else it will not be very effective! Let’s look at your biceps muscle for an example. If you flex your biceps (bend your elbow) and hold it there for an hour or two, when you go to straighten your elbow it will be pretty difficult and will feel ‘tight’ and ‘stiff.’ You likely wouldn’t be able to contract it very well after that, it would feel very weak. The same thing happens with the pelvic floor when those muscles get tight and have increased tone. The muscles aren’t able to lengthen fully and thus, aren’t able to contract very well making them weak. This can lead to leaking urine when coughing, sneezing, jumping, running, etc. The pelvic floor muscles can also become tight as a compensation for weakness in other areas, such as glute weakness, adductor weakness, or abdominal weakness. Thus, it is very important to be assessed by a physical therapist if you are having pelvic floor dysfunction because a physical therapist will look at areas of muscle imbalances + a lot more to ensure we are not just treating your symptoms but getting to the root cause! Adding a lot of kegels to an already tight and tense pelvic floor may make your symptoms worse! So, if you’ve tried kegels and your symptoms have not changed or have worsened, I suggest you hold off on doing the kegels and see a pelvic floor or postpartum physical therapist! What can I do if my pelvic floor muscles are tight??? First, see a pelvic floor physical therapist or a physical therapist trained in working with prenatal/postpartum women. You don’t have to have had a baby to have pelvic floor dysfunction! It is very common in men and women! Here are a couple things to try:
Check out these videos on my YouTube page for more on diaphragmatic breathing & pelvic floor relaxation! You can reach me directly via email at [email protected] with questions or for scheduling purposes! I’d love to help you :) Leave me a comment below with questions or share your personal experience! 3 Tips to Improve Your Core Strength and Stability Postpartum Whether you gave birth 6 weeks ago or 6+ years ago, these tips and exercises will help restore functional strength to your core (diaphragm, deep abdominals, low back stabilizers, and pelvic floor)! Many women return to exercise when they are cleared by their physician without adequate guidance and often struggle longer than expected to “find” their abs. The physical changes that occur during pregnancy are abundant and include: lengthened/weak abdominals, tight/shortened back muscles, thinning/separating of the linea alba (diastasis recti), and pelvic floor weakness and/or tightness. Things don’t just snap back into place after the baby arrives. We have to allow our bodies time to physically and mentally recover and spend time focusing on reconnecting to our bodies, specifically our deepest layers. TIP #1: Improve your alignment and posture. What You Do All Day Matters → Improving your posture during daily activities can help improve back pain, facilitate healing of diastasis recti, and improve core stability. Plus, you can work on it while you walk around and carry your little one! Focus on these tips to improve your posture:
Your core does not only consist of your 6-pack ab muscles. Your core is made up of your diaphragm, deep abdominals, low back stabilizer muscles, and pelvic floor muscles. We need to reconnect to all of these layers. A good way to learn how to activate the deep abdominals is through diaphragmatic breathing. You can do this anywhere & in any position!
Check out this video to learn how to perform diaphragmatic breathing & begin to restore your core! TIP #3: Learn how to tell if an exercise is too difficult for you. Improving your core stability postpartum has a lot to do with how your entire core works together and manages pressure that occurs in the abdomen. With certain ‘core’ exercises, there is a lot of pressure that builds up in the abdomen. The pressure has to go somewhere and often ‘leaks’ out at the weakest links. As you gradually build up your core strength postpartum, it is important to avoid any exercises that cause the following things:
You CAN restore your core postpartum, whether it’s been 6 weeks, 6 months, or 6+ years! It’s never too late to be assessed by a physical therapist with training in working with postpartum women. You don’t have to live with back pain, pelvic pain, urinary incontinence (leaking with coughing, laughing, running, jumping), or diastasis recti! I would love to help you restore your core! Please reach out to me directly at [email protected] with any questions! Now that this lovely Ohio weather is starting to turn around, are you hitting the pavement running??
Nobody likes getting injured and you don’t want to have to push through pain to get through to the finish line of that upcoming race! Here are some helpful tips to prevent running injuries! I always recommend seeing a physical therapist to assess your movement patterns, running gait, strength, mobility, etc. to help you determine an effective exercise program for you specifically to prevent running injuries and address your running form if necessary! TIP #1: Avoid Training Errors I know this is vague, but let’s talk a little bit more about what I mean. Training errors could include excessive running distance (increasing distance too fast or too much over 1-2 weeks), sudden change of training routines, increasing intensity too quickly, etc. Evidence suggests that training errors are the cause of 60-70% of running injuries! Thus, overuse running injuries should be pretty preventable if the large majority of them are due to training errors! However, there is conflicting evidence in regards to training errors (including frequency, intensity, volume, etc.) and how they relate to relative risk of injury! TIP #2: Avoid Overstriding This is one of the most common things that we see in individuals that are dealing with various running injuries! Overstriding basically means when you are running, you land with your heel first and your foot is well ahead of your body’s center of gravity. This increases the ground reaction force and thus, impact up the kinetic chain (foot/ankle, knee, hip/pelvis), creating an increased risk of injury such as runner’s knee. A simple way to try and fix overstriding is to slightly tilt your body forward coming from the ankles as if you are going to fall forward. However, this is very slight, but it changes your center of gravity. In addition to this, you want to try and keep your feet directly underneath your head/center of gravity. This decreases the force and impact that goes up through the body! It’s not easy to make changes to your gait, but gradually over time you will see improvements if you make small changes and stay persistent! TIP #3: Strength Training Is A Must! It is no secret that in order to get better and stronger at running, you need to run! Seems obvious, right? However, I often find that runners don’t focus quite as much on strength training when in reality, this is a VERY necessary piece of their training to help make them run faster, more efficiently, and with less risk of injury! Let’s talk about an example to demonstrate the importance of training specific weaknesses or muscular imbalances with running injuries. Knee pain in runners has been linked to weakness or poor motor control of the hip abductor muscles (muscles that control your pelvis when you land on one leg during running and keep your pelvis from tilting laterally when you stand on one leg). So, knee pain may actually be coming from ABOVE the knee, at your hip! You may be surprised to find that these muscles or various other muscles are weaker on one side versus the other and thus, could be contributing to pain you are dealing with when running! It’s so important to perform proper corrective exercises for certain muscle imbalances as well as a general strength training program, including strengthening of the hips, thighs, calves, trunk, core, etc. Are you ready to get out there running this spring?! Make sure to keep these 3 tips in mind! If you are dealing with pain during or after running and need help determining what the problem is or how to keep running, Email me directly: [email protected] with questions or to schedule! I’d be happy to talk with you before scheduling to determine what would be best for you! Is Shoulder Pain Limiting Your Training??
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AuthorKaitlin Hartley, PT, DPT Archives
January 2020
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