The physical toll of motherhood is seldom discussed or expected. Still, without a doubt, motherhood is hard on the body. Think about it – when have you ever carried around an extra eight pounds, which then becomes ten pounds, and before you know it 15 pounds, and so on? Now, add in the weight of the car seat, the diaper bag, and all that laundry. This is a lot of weight to lift, and your body may not be ready for it.
Most moms use one arm to carry the baby, and do everything else with the other. If you are right-handed you will probably carry your baby on your left, leaving your right arm free. Using one arm to carry a newborn is not easy on your body. When possible, try to carry your baby on alternate sides or with both arms.
Since newborns have little muscle tone, you must provide it for them. That means you use many more muscles to safely carry a seven-pound baby than you would to carry a seven-pound bag of potatoes. Simple tasks, such as taking milk out of the fridge, instantly become challenging.
Mothers will tell you that it does not take much baby carrying to create imbalance and overload. While muscles and tendons do strengthen and adapt to the extra demand, the process takes time. If they repeatedly support a load that is too heavy, they may not be able to gain strength quickly enough. The muscles become overwhelmed, leading to symptoms of overuse called repetitive strain injury. The result is pain.
Repetitive strain injuries suffered by parents of infants follow a predictable pattern, starting at the neck and moving to involve other areas.
Neck: While nursing, mothers often tilt their heads slightly to look down at their infants. This classic pose appears often in art. However, it can cause neck pain.
Shoulder: Always carrying a baby with the same arm strains the rotator cuff, which stabilizes the shoulder, and trapezius muscle of the upper back and neck.
Chest wall: The muscles of the upper chest, the pectoralis major and minor, can tighten, making the shoulders roll forward and stooping the neck.
Upper back: As the shoulders roll forward, the back muscles stretch. Those muscles then do not work properly and become weak, leading to pain.
Elbow: Pain can occur in both elbows – in the dominant (usually right) arm that lifts everyday objects, and in the other side that supports the baby.
Wrist: As with the elbow, pain can occur in either wrist. Pain may become much worse when lifting the baby under the armpits, as with lifting the baby out of the bath.
Hands: Parents often lift their babies by spreading the space between their thumbs and their fingers, straining the thumb and leading to ongoing pain.
Lower back: Low back pain is very common and often due to poor core strength. (The core involves your abdominal, low back, and buttock muscles.) Mothers carrying babies may push their abdomen forward to support the baby, exaggerating the curve of the lower spine (called lumbar lordosis). This in turn strains low back muscles, creating a cascade of problems in the muscles of the rear end and back of the thigh (hamstrings).
Hip, buttock (glute): Pain in this area is also common and is associated with low back pain. Many causes exist, but a common one is using one hip to support the baby. To do this, the hip is pushed up and out. This creates muscle tension, muscle imbalance, and tightness in the area between the muscle and overlying connective tissue (called the myofascia), leading to pain.
Lateral (outside) thigh: The IT band (ilio-tibial band) can also be strained by the hip position described above.
Posterior thigh (hamstrings): If the lumbar lordosis is exaggerated, the buttocks tip upward, pulling on the hamstrings and causing tension.
Any or all of these ailments can affect a mother caring for a newborn or infant.
Prevention is key. Have a pre-conception and pregnancy exercise plan. A general weight-training program will hit all of the areas outlined above. You can continue to lift weights during pregnancy if you have no complications.
OK, but if you have the symptoms already, it is too late for prevention. What is your solution?
Good posture: Just like Grandma said, stand up straight. Think of your head being pulled upward to the sky by a string. Do not let your head tilt forward. Keep your ears over your shoulders. While keeping your pelvic floor and abdominal muscles turned on, lift your ribcage and lengthen your spine. Roll your shoulders backward and squeeze your shoulder blades together. Several times a day, remind yourself to ‘lift’ yourself skyward. Whenever you stop at a red light, check your posture. Lift your spine and chest, and squeeze your shoulder blades together for a count of three. Do this until the light turns green.
Safe lifting: Be aware of your body position when lifting. Use your legs by bending at the knees to lift. Bending at the waist strains your back. Always involve your core when you are lifting and carrying, and try to stay tall and straight while carrying your baby. Avoid twisting and lifting at the same time. If you carry your baby often, find an infant carrier that fits you well and use it daily. Using a carrier will free your arms without losing your physical connection to your baby.
Stretching: A daily stretching routine can lengthen muscles and reduce formation of muscle spasm (also known as trigger points). Stretching can be done anytime, anywhere. Before you get out of bed, lock your abdominal muscles, and then do ten leg lifts on either side. This warms up your hamstrings before your feet even hit the floor, and it only takes a few seconds. Do it even if the baby is crying. Yoga is a great way to keep your muscles relaxed and strong. Many yoga providers offer a post-partum class.
Muscle strengthening: A gentle weight program to improve strength in the rotator cuff, upper back, core, and arms will reduce symptoms. Most exercises can be done at home, using your own body weight. A set of stretchy bands is a good way to target small muscles like the rotator cuff. Stretchy bands are available at most medical supply shops and some physiotherapy clinics.
Symptom control: The general rule of using heat during a warm-up (before or early in the exercise routine) and ice afterwards, remains good advice. Depending on your situation, your doctor or physiotherapist may recommend a brace to help reduce tension at the elbow or wrist. Painkillers like ibuprofen and acetaminophen are safe and effective, even for breastfeeding moms. Massage therapy feels good, but usually does not correct the underlying problem, which is lack of strength. Cortisone injections and acupuncture do not usually help.
Unless you are in phenomenal shape prior to pregnancy, you will probably have some muscular discomfort as your body adjusts to its new reality. See your health care provider to fully evaluate your problem and come up with a treatment plan. With the correct approach, none of these aches and pains should become long-term problems.