The day a mother brings a child into the world, everything changes for her back — even if she doesn’t give birth to that baby. Our back is involved in nearly every move we make, and mothers begin to tax this body part in new ways once they have a child. In the blush of new parental love, and the early stages of a lifelong commitment to put our children first, we often don’t realize that the damage we do could be painfully debilitating down the road.
“All of a sudden your entire being is wrapped up in another being; it’s all consuming,” says Julie Rothschild, an Alexander Technique teacher located in Boulder, Colo. “We often sacrifice ourselves, overworking and depleting our resources.”
Bending, carrying, sitting
During the early years of parenting, we often move in new ways that compromise the back. “Parents of young children, babies and toddlers are forever bending forward, carrying their children and adapting their sleep or sitting positions to accommodate their little ones,” says Dr. April Bolding, a Seattle-area physical therapist and co-author of Pregnancy, Childbirth and the Newborn. “We see a lengthening of back muscles and rounding of our shoulders as we curl around our babies. Our chest muscles shorten. And when we try to stand up straight, we can’t.”
When a woman carries a baby inside of her and gives birth, vaginally or via cesarean section, the back goes through a whole other level of significant physical change. The litany of things that can happen sounds, well, depressing enough to make some women dream about a lifetime epidural.
“As Pregnancy progresses, the abdominals lengthen and are unable to generate sufficient tension to support the back as effectively,” says Bolding. “Women are at risk for a rectus abdominis diastasis, where the midline connective tissue that holds the abdominals together widens. If a diastasis is caused and not repaired postpartum, this further challenges the abdominals’ effectiveness at supporting the back.
Pregnancy and giving birth also often alter a woman’s pelvic alignment, putting more pressure on the lower back’s vertebrae and nerve roots, says Kelly Clancy, an occupational therapist, structural integrator and massage therapist based in Seattle. She believes every postpartum woman should receive bodywork that addresses this misalignment.
“We are starting to understand the fascia, or connective tissue, in our body is like a spider web. If one part of this web is out of alignment, the whole body will be affected,” Clancy says. “I believe it takes a practitioner who understands fascia and the relationship between body parts to ensure restoration of proper alignment to alleviate pain and reduce symptoms. The practitioner needs to look at the big picture.”
Gentle is key
Bodywork for moms can take many forms, including working with a physical therapist who specializes in postpartum women, massage therapy, Bowenwork, structural integration or acupuncture. Taking a gentle, postpartum yoga classes is another way to bring balance and stability back to the pelvic floor and ease corresponding pain in the low back. Yoga also includes core stabilization work, a key for both bringing the separated abdominals back together and alleviating back pain.
Gentle is an important word to keep in mind during those early baby years. Physical therapist Ellen Roth points out that the hormone relaxin is present during pregnancy and for as long as a woman breastfeeds her baby. “Relaxin relaxes all of your ligaments,” says Roth, owner of Smooth Moves Physical Therapy at Bodycenter Studios in Seattle’s Fremont neighborhood. “You have less stability within your joints, and your body relies more on muscles to control your joint position.”
What does this mean for a new mother and her aching back? First, ignore the trend that says women should “get their bodies back quickly,” says Dr. Loren Riccio, a naturopath and midwife who practices at Fern Valley Natural Health in Bellevue. “I’ve seen women wearing [postpartum support] bands immediately postpartum, but this seems too soon to me. Everything has been displaced, and we should give the body a moment to resituate itself before constricting it.”
Second, work on restoration on all levels, Jennifer Keeler, owner of Seattle’s Yoga Momma, says. “Physical restoration might be a gentle yoga class or doing pelvic tilts at home. Emotionally, do whatever brings you renewal.”
This emotional component — which affects the back by creating muscular tension — can be a big issue for parents of children of any age. “Your nervous system is often in a fight-or-flight mode, and it’s natural that your muscular tension will increase,” says Clancy. “If we are not getting enough sleep or taking care of our bodies by eating well and having enough down time, we have more musculoskeletal pain, including back pain.”
A stretch a day keeps the doc away
Beyond bodywork and taking care of your emotional needs, try to do simple posture checks during the day. “Stand with more weight on your heels and move your pelvis back,” Roth says. “You should be able to look down and see the fronts of your ankles.”
Clancy recommends adding simple core-engagement practices. When you are standing in line at the store or doing dishes, push your belly button toward your spine by engaging your core muscles.
Of course, if your back pain gets in the way of your daily functioning, visit your doctor and/or a physical therapist. Continuing to move is often the best way to alleviate pain. A 1997 public health campaign in Australia featured billboards and radio campaigns that announced, “Does your back hurt? Get up and take a walk.” During and right after this campaign, medical claims for back pain dropped by more than 15 percent. A daily walk might be the best medicine for your pain.
EASY HELP FOR YOUR BACK
Easing low-back pain is often about adding in a few relaxing exercises — yes, that sounds like a contradiction — to your daily schedule:
- Lay on the floor for five to 10 minutes every day, maybe even twice a day, says Rothschild. Elevate your head with a slender book or two so your neck is comfortable. Bend your arms and place your hands on your lower belly. Bend your knees so your feet (on the floor) are a little more than hip distance apart and your pelvis retains a relaxed, natural shape. Now just think about how your body feels. Where do you feel tension? Just breathe and try to let some of that tension go. Before you get up, let your arms open at your sides. With your palms facing up and starting with your fingertips, gradually peel your arms off the floor until you feel as though your arm bones are balancing on the edges of your shoulder blades. Stay soft in your wrists, elbows and shoulders. Then let them ease back down. Repeat this a few times.
- Use a birth ball to lie backward on, with arms outstretched in a “V” in a pleasurable way that supports the back as you stretch out your chest muscles.
- Do pelvic “clock” circles. Lie down on your back with your knees bent and rest your hands on your lower belly. Push your belly button toward the floor by engaging core muscles (this is 12 o’clock), then keep these muscles engaged while rotating your pelvis up to 6 o’clock. From here, with muscles still engaged, rotate your pelvis down the other side and back to the 12 o’clock position. Repeat a few times. Breathe rhythmically while doing pelvic circles.