Every woman embraces their journey of pregnancy and childbirth despite of the changes that her body goes through, though discomforts during pregnancy are considered normal but the truth is they are not, if you have discomforts during pregnancy that is neck pain, back pain, pelvic pain, hand pain, heal pain or any other musculoskeletal pain, understand that they can be cured by physiotherapy. Not only antenatal discomforts but physiotherapy and a qualified physiotherapist can help new mothers in their road to recovery after childbirth in their postpartum phase.

Wonder what exactly do we mean when we say a new mother needs recovery? In an interview with HT Lifestyle, Priyanka Khanna, Women’s Health Physiotherapist and Lactation Consultant at Cloudnine Group of Hospitals in New Delhi, explained that a mother’s body goes through some major changes during pregnancy and these are –

• Changes in the hormonal secretions
• Overall increase in body fluid
• Laxity of joints and ligaments due to relaxing hormone
• Changes in the curvature of the lumbar spine
• Stretching of the abdominal muscles to accommodate the growing foetus.
• Changes in the skin
• Weight gain

Priyanka Khanna added, “Soon after childbirth these changes tends to reverse and the body starts to regain its pre-pregnancy state back. But the bounce back phenomena depends on many factors such as the type of pregnancy a woman had, the risks and complications involved, mode of delivery and so accordingly a new mother needs care, attention and mainly time to recover.”

How a physiotherapist can help a new mother recover?

Most common concerns that are highlighted by every new mother can be addressed by a physiotherapist. According to Priyanka Khanna, the major concerns are

1. Pain around the sutures
2. Back pain
3. Difficulty in resuming daily activities like bed mobility- especially after a caesarean section
4. The loose abdomen
5. Poor posture while breastfeeding causing neck and hand pain
6. Confusions and questions regarding returning back to exercises

How can we address these above concerns?

1. Pain around sutures can be effectively reduced not only by the analgesics but via electrotherapy modalities that are used to manage pain. The most effective and safe modality that can be used to reduce the pain intensity around suture is TENS. Effective dosage of TENS machine can be beneficial for healing purpose. The adhesions around the surgery scar can be reduced which helps with improving mobility which is called scare mobilization technique where are physiotherapist applies various kinds of pressure that not only aids in mobilizing the scar but also helps with sensation around the scare area.
2. Back pain in new mothers is mainly due to the weak abdominals, tight back musculature, poor posture and lack of enough mobility soon after giving birth. Exercises that are lower in grade to strengthen the appropriate muscles, posture correction can help mothers with backache initially.
3. Difficulty moving in bed is accompanied by pain around the sutures – learning correct technique like correct way of pillow placements, rolling, pushing through the upper body, sitting & getting in and out of the bed helps the body distribute pressure uniformly and avoids pressure at the suture site which causes pain and difficulty moving. These techniques can be learnt by a new mother during the hospital stay itself.
4. The loose abdomen is the group of muscles that has reduced its tone, elasticity, strength also the stretching of the abdominal muscles during pregnancy causes the separation of the rectus abdominal muscle which may sometimes catch your attention as it gives you a bulge and most of women are often concerned about it. If this separation of the muscle is more than more than 2 cm it needs specific (diastasis recti friendly) exercises. There are 4 types of Diastasis recti and they are – Open Diastasis, Open Below Naval, Open Above Naval, Completely Open. Some exercises can be started soon after childbirth to engage the muscles and start the healing process which are – abdominal muscles contraction or activation exercise, deep breathing exercises. A Physiotherapist can prescribe you an exercise plan that can be continued in order to start the recovery process and suggest follow up.
5. Poor posture practices can harm your joints and your muscles in various ways, learning correct postures to sit and breastfeed, lift the child, while changing the diaper can prevent muscle stiffness and malalignment of the joints. Along with correct posture practices, certain exercises like, neck stretching, shoulder mobility exercises, forearm stretches allowing the nerves to calm and prevent arm numbness or tingling in lactating mothers.
6. Confusion to return to exercise routine after childbirth, here is a guideline that can help you understand

• Allow your body to heal for about 4-6 weeks.
• Start basic mobility and muscle activation exercises soon after childbirth.
• Intensity of the exercises can be increased and mild to moderate intensity exercises for upper body, back and abdomen can be started after 6 weeks.
• Moderate strength training can be started to strengthen upper and lower body with weights of up to 3-3.5 kg for beginners along with core activation exercises. Avoid lifting heavy weights during daily chores or as a part of exercise, weight training is an important part of the exercise routine but the weights must be increased in gradual manner to avoid any injury.
• Mild to moderate Cardio exercises like walking and brisk walking can be started after 6 weeks. Avoid HITT (high intensity interval training).

It is always recommended to consult your OBGYN (health care provider) and a physiotherapist for a detailed assessment of diastasis recti before you start any exercise routine to make sure that healing is complete and to prevent any kind of insult to your musculosketal health.

Disclaimer: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.