Friday, June 05, 2020

We prepare for pregnancy and birth. There are birthing classes, doulas to help with creating the best birthing experience, weekly emails that flood inboxes explaining what produce the baby is resembling that day and myriads of books telling us what to expect. And there is a lot of information available for caring for that new baby—mommy and me groups, sleep training websites, lactation consultants and plenty of outside parental advice (whether invited or not) for everything from how to best hold your baby to what type of stroller you must have.

However, there appears to be one component missing from the readily available information: You. Your body just went through ten months of massive transformations to support a growing human, and you somehow extracted said human from this body. Now what? Now we are expected to “bounce back” (a term that for anyone who has ever had a baby knows is absolutely absurd, with thoughts of the various effects that bouncing on a trampoline after returning from the hospital bring to mind). Even though there is no trampoline waiting for us at home, there are plenty of other physically challenging tasks that we are expected to return to: lifting toddlers, standing to cook a meal, washing dishes, grocery shopping, etc.

And what about returning to exercise? Sure, we have heard to wait until the six-week follow-up appointment at the OB-GYN to start any exercise, but what about walking? When should I start building my abdominal muscles again (remember those)? After the six weeks is up, can I go back to running three miles like I used to? Why do I still look pregnant five months after giving birth and being on a strict diet? Will I ever be able to sneeze without leaking, or does that just come with the territory after baby number three?

When I speak to mothers about these matters, the answers to these questions are a little more murky in their minds. Some have tried the YouTube postpartum exercise videos, some have gone back to the gym immediately and are not sure why they are having hip and back pain a few months later, and some are afraid to exercise at all because they are afraid of causing pelvic floor issues, more back pain and more bulging of their abs. But the common thread between all of them is the lack of any real guidance.

As an orthopedic physical therapist, I treat all ages and diagnoses. After the first few pregnant and postpartum women came to the office, I started to understand that there is a gap in the treatment of this population. Some told me that other therapists were not comfortable treating a pregnant woman due to unknown risks, or that they’d been seen by someone who only did very light and gentle treatment out of caution, but didn’t actually help their issue. I’ve heard patients say that their doctors tell them that pain just comes with being pregnant and will go away once they give birth. And my eyes were opened even wider when patients started coming six months or longer after giving birth with debilitating pain that had stopped them from returning to any activity, only to tell me after the first PT session “I wish someone would have told me about physical therapy sooner.” I have heard that line many, many times. It was for all of these reasons that I decided to delve deeper into this population, gathering research from different specialists in the field, and eventually becoming a Pregnancy and Postpartum Corrective Exercise Specialist.

In some European countries, physical therapy is part of routine care for every postpartum woman. As mentioned before, the body has just gone through a massive amount of change in a short period of time. Now it somehow has to return to doing the activities we demand it to perform. Sometimes the body gets back seamlessly and sometimes it has hurdles to overcome. That is where the physical therapist comes in. We can help during pregnancy with sciatica, low back pain and pelvic girdle pain. And we can help in the postpartum period with these same issues that did not resolve after birth, and with new problems that may develop such as diastasis recti, pubic symphysis disorder, pelvic floor disorders and more. There is also no time limit on being able to help yourself. I’ve seen women who had babies years ago, but due to improperly strengthened core muscles post-birth, eventually developed a back issue.

In the last few months, women have had a lot on their plate. Being at home and caring for the needs of the whole family all day every day without a break is mentally challenging. Many have turned to exercise as an outlet and a healthy way to relieve some stress. But if you are unable to be physically active due to pregnancy, recently giving birth, pain or fear, please know that there are those who can guide you and help to overcome whichever obstacle your body is facing. My hope is that this message reaches those who otherwise would have remained inactive or in pain, and that they make the decision to seek help in order to be able to get back to their most comfortable and healthy self. And who knows, maybe one day soon you will be the one on that trampoline after all!

Deena Elias is a physical therapist who owns Personal Physical Therapy, a private in-home physical therapy practice. She works with all adult orthopedic patients and is a Pregnancy and Postpartum Corrective Exercise Specialist. She is currently providing tele-health services for PT sessions. For more information contact Deena at [email protected]