Published May 2005

Injury prevention key
to bouncing back postpartum

By Kimberly Hilden
SCBJ Assistant Editor

Pregnancy, as many women will attest, can be a royal pain — and that’s before labor and delivery are considered. From first-trimester nausea and third-trimester leg cramps to persistent lower-back aches and the discomfort of weight gain, the nine-month gestation period can do a real number on the body.

And afterward, during the postpartum period, the body still can be vulnerable to aches, pains and injuries, said Christina Lee, who heads up the Women’s Health Program for Integrated Rehabilitation Group’s Mukilteo and Murphy’s Corner physical therapy clinics.

“With postpartum health, one of the biggest areas to educate people on is prevention of injury and the use of proper body mechanics,” said physical therapist Lee.

After giving birth, a woman continues to have a high level of relaxin going through her body. The hormone, which is secreted late in pregnancy, relaxes the pelvic ligaments and prepares the uterus for labor. It also can relax other ligaments, creating a physical environment ripe for injury.

“If you have had a previous knee injury or leg injury, it’s very easy for those things to flare up again, particularly in those areas where our bodies are full of ligaments, the very weight-bearing joints such as your knee or ankle,” Lee said.

To prevent joint and ligament injury, it’s best to invest in the right athletic wear, including supportive tennis shoes and bras, Lee said. And when choosing exercise, make it low impact, such as walking, swimming, riding a stationary bike or taking a yoga class. Even aerobics, if it doesn’t include jumping, can fit the bill.

Another injury-prone area during the postpartum period concerns the thumbs and hands, which can develop deQuervain’s tendonitis, in which swelling or irritation occurs along the thumb-side of the wrist. In the case of new moms, the condition often is caused by the act of picking up and putting down the baby throughout the day, Lee said.

As for preventing deQuervain’s tendonitis, it’s all about body mechanics, she said.

“When you are lifting the baby, just like when you lift any heavy item, keep him or her closer to you to begin with,” Lee said. “Don’t lift the baby with arms outstretched. Be as close to the crib as you can. And also, make the lifting distance shorter in the first place — don’t have the changing table down low. Have things at a better height to begin with.”

Besides preventing injuries, the postpartum period is a time of repairing the body following the wear and tear of pregnancy. This includes the abdominal region.

Some 70 percent of women suffer from abdominal diastases, a separation of the “six pack” abdominal muscles, Lee said, noting that weak stomach muscles can lead to poor back support.

“You want that muscle to come back together, and sometimes, it comes back together just like a zipper, and sometimes it needs help,” she said.

When clients suffering from abdominal diastases come to see Lee, they receive a full evaluation before a strengthening program is designed to meet their needs.

“We take them through a gradual strengthening program. We don’t want to start with the hardest (exercise) when they are not ready for that yet,” she said. “It’s about a step-by-step strengthening program and getting the most out of the exercises that you are doing.”

Another common health issue that has new moms coming in to see Lee is urinary incontinence.

“I see people, most frequently women after their first child, who come in and say they are trying to start running again and are ‘leaking,’” Lee said.

To combat this problem, she uses muscle strengthening exercises, biofeedback and bladder training techniques with her clients as well as educating them about bladder irritants such as coffee and carbonated beverages.

“It used to be that people wouldn’t talk about it,” Lee said of incontinence. “Now, more and more people are speaking up, which is really great. You know that if you’re seeing commercials on it on TV, people are talking about it.”

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