Let’s face it-motherhood can certainly take its toll on our bodies. Minor aches and pains can escalate into full blown strain injuries with overuse. The positions we get into and the movements we constantly make throughout the day, quite simply put, can hurt us. Lifting a baby out of the cot, hunching forward to breastfeed, change nappies or bath children or even just carrying and holding a baby or child can cause chronic irritation to our muscles, tendons or joints causing physical wear and tear. Women are especially prone to repetitive strain injuries (RSIs) because, unlike men, we naturally lack upper-body strength. RSIs related to parenting commonly cause aches, pains and discomfort in the back, neck, shoulders, elbows, wrists, hip and feet and I will discuss the most common of these, how they arise and how hopefully they can be avoided!
1. Strained Neck
As mothers, we spend so much time seated, leaning forward and looking down at the baby during feeding sessions. Spending hours in this position means the shoulder and neck muscles have to work harder to support your head, which can lead to overstretching and may cause neck pain, headaches and even numbness in the arms or hands. The simplest way to avoid this is to look up periodically and perform neck rolling stretches. Make sure that you lean back against the back of a comfortable chair with your neck relaxed. Also place a small pillow or rolled towel behind your lower back to help you sit up straight while feeding and use an additional pillow or nursing pillow to raise your baby up to breast level. Keep your arms free, resting on the pillow, so they aren't bearing your baby's weight. If you're bottle-feeding, switch sides regularly to give your arms and shoulders a rest. Using a footstool can also help. Applying heating pads can improve circulation and help to loosen tight muscles and a deep-tissue massage may also provide relief.
2. Wrist Injuries
There are 2 common injuries that may affect the wrist in mothers of young children.
A. Carpal Tunnel syndrome can affect breastfeeding mothers often as a result of repetitive movements or excessively flexed wrist positions during breastfeeding. It is thought that this causes swelling and inflammation of the Median nerve as it passes through the wrist. Typical symptoms include numbness and tingling in the fingers, burning wrist pain and loss of grip and dexterity.
Here are some tips for breastfeeding mothers with carpal tunnel syndrome
• Try not to curve your hand and wrist around your baby when supporting or cuddling them and find ways to support your infant that don’t involve a bent wrist. Bed pillows, special breastfeeding pillows, rolled or folded baby blankets especially placed under the wrists can all allow you to hold your baby without excessively bending your wrists.
• Breastfeed lying down, continuing to pay attention to wrist position.
• Try to avoid static or awkward positions for prolonged periods of time.
• Minimise repetition.
• Use a loose power grip-loose grip keeping all the fingers together, thumb straight.
• Use a wrist brace to keep your wrist in the neutral position while breastfeeding. Sleeping with the brace on can be helpful.
The recommended treatment for carpal tunnel syndrome is conservative -rest, natural diuretics, hand splints, massage and stretching and strengthening exercises.
B. De Quervains tendinitis is a similar syndrome. It can be seen in mothers with babies aged 6-12 months as it is attributed to repeat lifting of an increasingly heavy baby. This occurs when the sheath around the tendons at the base of the wrist and thumb becomes swollen, due to overextension or flexing too much. Fluid retention and hormonal changes during pregnancy also cause the tissues around the tendons to swell and become inflamed. The area is often tender making a fist or rotating the wrist is painful.
To prevent this, hold your baby in a way that you keep your hand and wrist in the same line, with the least bending of your wrist to hold their head. Take frequent breaks from any hand intensive activity and allow your hand and wrist to rest in a neutral position. You may similarly use a wrist splint to stabilise the hand and thumb. You can relieve some inflammation by gently massaging the wrist, moving your strokes toward your elbow. Also, alternate warm and cool hand and wrist baths or cold compresses if inflammation is present. A natural anti-inflammatory diet can relieve pain.
If you suffer with either of these conditions, it is best to get it treated because if you ignore the problem in one hand, you run the risk of overusing the other and then both hands will be affected.
3. Hip injuries
Most mums usually hold their children by carrying them on one hip and tilting the pelvis to provide a shelf to sit on. However, the extra weight and strain this places through the hip can strain the hip joint pulling it slightly away from the hip socket. This results in pain and an awkward uneven gait with the possibility of pain in the opposite knee due to the extra weight placed upon it. It is also not advisable to hold your child with one arm when they are balanced on your hip as this causes continual contraction of your arm muscles reducing blood flow leading to trauma of the tissues in your arm and shoulder.
You can help avoid this by using a baby carrier to distribute your baby’s weight more evenly so that all areas of your body are taking equal strain. If you need to carry a toddler, hold them close to your chest, legs wrapped around your waist, balanced in the centre of your body. If you do use continue to carry on your hip, ensure that you switch sides often and hold them with both arms to avoid tilting too far to one side.
4. Back Injuries
Back pain usually starts during pregnancy thanks to the maternal hormones loosening the tissues around joints which allows the pelvis to widen to accommodate the baby before and during birth. Pregnancy also stretches the abdominal and pelvic muscles and with the baby's weight pulling our centre of gravity forward, this can often lead to a sway back especially in the third trimester causing pressure on the spinal joints and tension in the muscles. Tissue laxity can remain for many months after delivery especially if breast feeding and this can leave the joints vulnerable to strain. This means that once your baby arrives, the pain doesn’t miraculously go away and may even get worse.
A back injury often appears to be the consequence of a single wrong move, but it's more often due to months or even years of poor posture and weak core muscles. When you suddenly begin exerting your back in different ways as you care for a baby, the discs between the vertebrae, as well as the muscles and ligaments in the region, can all suffer strain. The constant strain on back muscles caused by carrying out routine tasks results in a low level of pain for new mums that they commonly ignore. Eventually the strain will reach breaking point, resulting in the sudden, intense pain of a pulled muscle, strained spinal joint or, worse still, a ‘slipped disc.’
Here are some of the common tasks that may cause back pain with tips on how to perform them properly.
Feeding your baby food: Sit down with your baby, close together and at a similar height. Ensure that you are not leaning forward each time you offer the spoon.
Lifting Your Child from the Floor: Use a half kneel lift. For this, stand close to your child, keeping your back straight, step forward with one foot and lower yourself to one knee. Keeping your child close to your body, hold them with both arms near to your belly button and lift with your legs to stand up, avoiding twisting your torso. Reverse these steps when putting your child down to the floor.
Picking up toys from the floor: Always bend your knees.
Getting baby in and out of the car: Do not carry the baby to and from the car in the car seat as this causes strain on your elbows eventually causing the equivalent of a tennis elbow. Ideally, take the car seat to the car empty and fix it in place. Then, with your baby cradled in your arms, sit next to the car seat and turn to face it, then place the baby into the car seat and fasten them in. If the car seat is next to the door bend your knees slightly and lower into a shallow squat as you place your baby in the seat and fasten the straps to try and avoid hunching your back. Alternatively, you can put one leg into the car and try to face the seat when putting your child in.
Carrying a car seat: Never carry the car seat to one side of your body or on your forearm. Instead carry the seat by the handle with both hands, elbows bent, holding it in front of and close to your body with your weight evenly distributed.
Lifting baby from cot: When you put your baby to bed, hold them close to your chest and spread your feet hip width apart as you stand facing the crib. Bend your knees to squat slightly before lowering the baby down. Avoid twisting and tuck your tailbone under tilting your pelvis so you activate the abdominal muscles and protect the lower back. Don’t lock your knees or hold your baby at arm’s length as this places pressure on the back. Instead, when lifting them out of the cot, it is better to lower the crib railing, place your feet shoulder width apart and bring your baby close to your body before lifting. Lower and lift using your legs.
Sitting and lifting a child to sit on your lap: It is important not to lean forward from the back of the seat because as you lift, the pressure on your spinal discs multiplies several times greater than the weight of your child. Instead, move forward to the edge of the seat and while keeping your back straight, bend your knees and lift your baby close to your body and then sit back in the seat. For a heavier child, get down on one knee with the other foot in front of you and hold them as you move back on to the seat or just have them climb onto your lap themselves.
Pushing a pushchair: This can lead to shoulder, neck, and upper back strain or tension. To avoid this, walk close to the pushchair without shortening your stride and keep your elbows close to your body and your shoulders relaxed.
Using a baby Carrier: A baby carrier worn over both shoulders when correctly positioned enabling your baby to be held close to your body evenly distributes the baby’s weight over your back, hips and shoulders. However, make sure that you readjust the carrier as your baby grows otherwise it can lead to upper or lower back pain.
The most important remedy for a strained back is rest, so try to lift your baby as little as possible. The muscles need time to heal and this can take a few days to a week or more. Heating pads can provide some immediate relief, although ice packs can be helpful too-make sure it is wrapped in a tea towel, do not apply ice directly on your skin. Ice reduces the inflammation and heat can help relax stiff tissues. Preventively, strengthening your abdominal, back, pelvic and hip muscles can reduce your risk of developing repetitive strain injury. If you feel pain radiating down your legs, seek professional help as you may have a bulging disc.
How Osteopathy can help
Osteopathic treatment can help mother’s return to normal, physically and emotionally, by releasing strains in the body caused by pregnancy, labour and daily childcare. Treatment helps with muscle soreness related to postural strains and feeding positions and balancing these tensions in the body can also aid relaxation, which in turn helps with boosting vitality. Other postnatal problems such as headaches, coccyx pain and pelvic pains generally respond very well to Osteopathic treatment too.
Treatment often includes gentle soft tissue massage, joint articulation and mobilisation, along with gentle stretching and some simple at home exercises.
Coping with the demands of a new baby is enough so you really do not need to be suffering with uncomfortable strain injuries as well.
Beverley Palmer has five kids and lives in Dubai for 26 years now. She has her practice at Keith Nicholl Medical Center, villa 610B Jumeirah beach Road, Umm Suqueim Road 1 and she can be contacted for appointments on 04 3941000 . Her kids kindly helped her set up her business page: https://www.facebook.com/beverleypalmerosteopathdubai
You can read our interview with her here.