13 Feb Post Delivery and C-Section: Fight back pain
Pregnancy is not without its aches and pains, but that can be nothing compared to post-labor and post-cesarean section pain. Add to that holding a newborn for what feels like hours on end and you have a recipe for some really horrible spinal positioning and subsequent back discomfort.
The biggest issue at this point is the loose pelvic ligaments that are a normal result of the hormonal changes to allow for the bones to widen for birth, combined with the relative inactivity of the abdominal muscles, as they have not been used properly for months owing to them being stretched out and elongated as the belly expands.
These two things leave your spine wide open…it loses its support structure rapidly…especially during the end of the second to third trimester and post-partum.
Thus the best way to combat back pain or prevent it is by beginning to engage the abdominal muscles again. This will afford some strength to the abdominals to help ‘brace’ the back, and stability to the loose pelvis as well. The problem is, this is generally taboo after delivery and C-section…most doctors will not allow ‘abdominal exercises’ after birth.
However, there are two moves in particular that will not only work to relieve back pain and get the spine protected and strong again, but are safe to do post baby because they are not abdominal contractions such as sit ups are…they are merely activation exercises. Although please always check with your doctor before beginning an exercise routine.
1. Pelvic tilt: This is a small exercise to help the body become accustomed to ‘turning on’ the abdominals to help provide back support and thereby not letting them atrophy post-surgery or delivery/pregancy. Using the abdominals in this small but effective way helps ‘brace’ or support the low back.
Simply start by laying on your back, knees bend and shoulder width apart. Think about bringing your navel towards your spine by using your abdominals. Don’t be tempted to use your buttocks or lower back to flatten out your spine. Instead use the deep abdominal muscles. At the same time draw the ribs down, dont let them flare. The back should be flatter on the floor than when yous started. There shouldn’t be a lot of movement with this exercise at all. If you are moving too much you are probably using other muscles. Its a small but extremely important movement. Think of it as simply turning on the abdominals and engaging them and holding 3-5 seconds, then relaxing.
This is a simple exercise but 90 percent of the time done incorrectly. The only muscle that should be used is the transverse abdominals. However as mentioned most tend to use the back and glutes to flatten the spine. To be sure the transverse abdominals are working, while holding the pelvic tilt, place your fingers below the navel and push them inwards to feel the muscle. Now cough. If the fingers remain where they are, you are holding the abdominals in properly. If the fingers come up or move, you are not engaging the abdominals. Reset and try again until you can feel the abdominals tighten and stay tight underneath you.
There is no set amount of sets and reps for this…do it as often as you can. 3 sets of 15 is a great start when you are laying flat.
In addition to doing this as an exercise, the position of this exercise should be done all day long: when you are standing with baby, when you are sitting with baby, and when you are standing or sitting alone. Always bring the naval back towards the spine. It can even be done in conjunction with other exercise maneuvers, such as a simple squat or my personal favorite, a wall squat. This is the same as a regular squat, but the back is flat against the wall and abdominals engaged. I did this regularly when holding my son and it worked wonders for my back pain. Be sure to do a pelvic tilt first and engage the abdominals, then slide down, then return.
Incidently, this pelvic tilt, or abdominal engagement/bracing position should be utilized anytime we are performing any activity, including simple standing, sitting or walking. The bottom line is the spine should always be protected. We do this by the abdominal engagement of the pelvic tilt.
2. Bridges: Now that you have the pelvic tilt going, add a bridge. Once the tilt is performed and the abdominals are engaged, slowly lift your butt off the ground, pushing down also through the heels of your feet, rising as high as you can until your spine is in a straight line as below. Hold at the top. Keeping your pelvic tilt and abdominals engaged the entire exercise, now slowly lower your spine as if from the top of the spine (nearest your head) down. The last thing to hit the floor should be your tailbone. At that point, but not prior, you can release the pelvic tilt. Now re-engage the pelvic tilt and rise up again. Practice 3 sets of 15 of these exercises.
Incidentally, these exercises are also very effective and safe if you were diagnosed with diastisis recti; the separation of the abdominal muscles from the longitudinal fascia. They are all great to do throughout pregnancy.
You may also notice the ball or yoga block between the knees. While not crucial to the exercise, it is a nice add-on for anyone suffering from some pelvic discomfort, those who have difficulty maintaining good posture of the knees (ie. knees roll inward instead of staying shoulder width apart), or those whose ligaments have severely loosened during pregnancy to the point of instability. Usually those with loose ligaments or “double-jointed” prior to pregnancy fall in this category.
Adding these exercises to your daily routine will help activate the abdominals from their sleepy pregnancy and post-partum state and help support your spine during the constant loading of lifting and holding your newborn.