Hidden Issues in the Postpartum Body

Pregnancy changes your body

Pregnancy can bring about great changes to a female’s structure and alignment. The female’s body changes to accommodate the quickly growing fetus inside.  These changes to our body often persist through the post-partum period. If these changes to our body’s structure are not addressed through exercise and bodywork, problems can begin years down the line.  While some problems are commonly associated with post-partum, some problems arise that you may be unaware of related to post-partum. Here are some of the most common hidden issues in the postpartum body.

Postpartum issues: Incontinence

The most common problem post-partum is incontinence. Incontinence is the involuntary loss of bladder or bowel function. Around 20% of women encounter some form of incontinence immediately or years down the line after pregnancy. Even in women who never gave birth, 15% develop incontinence. During pregnancy and delivery the musculature of the pelvis, called the pelvic floor muscles can become overworked, overstretched, or injured in the birthing process. If the pelvic floor muscles are not rehabilitated with the proper exercises and stretches, urinary or fecal incontinence (leakage) can become a problem. The pelvic floor is a very important muscle that needs to be able to contract well to keep urine and feces in. It must also be able to relax and expand well to let urine and feces come out. If the muscle is weakened, overstretched, or damaged incontinence (leakage) can happen.

Pelvic Pain

Another more common problem some experience post-partum is pelvic pain.  According to some studies, pregnancy-related pelvic pain affects up to 65% of women. About 20% still struggle with pain 3 months after birth, and 10% of women continue to have symptoms 2 years post-partum. If the pelvic floor muscle contains scar tissue from a birthing injury or becomes too active because of postural changes that persist in the female body post-partum, pelvic pain can be a problem. Often pain in the pelvis is related to sitting, having a bowel movement, or having intercourse. These activities require the pelvic floor musculature to stretch.  With hypertonicity or scar tissue present, the pelvic floor cannot stretch without causing pain. Chronic pain can lead to depression, anxiety, and fear-avoidance of activities that cause pain.  Sitting pain-free, having pain-free bowel movements and intercourse is important to our well-being.

Low Back Pain

In addition to the pelvic floor, the other muscles of the core can become weak and ineffectively stabilize the spine. It is common, up to 50% of women, will experience low back pain related to core weakness that likely started around the childbearing years. After years of having a poorly functioning core, the back is overworked and or overstressed. Core rehabilitation (including the pelvic floor, deep abdominals, deep back musculature, and the muscles of breathing) after having a baby is imperative to keeping your spine moving well and stabilized. Although it is quick and easy to google core exercises, it is important to work with a trained professional to make sure you engage the muscles of your core in the correct order. It isn’t worth your time to work them out if you aren’t getting them to contract properly.

Plantar Fasciitis

It is common during pregnancy to experience changes in the female’s body position as the baby grows. Often the expectant mom will shift her pelvis forward, shift her thorax backward, round her shoulders, and externally rotate her legs (toes out). If the muscles that become tight in this pregnant posture do not get stretch in the post-partum time, often plantar fasciitis will develop. With the toes pointing outward with standing and walking, increased stress goes through the arch of the foot. Over time the arch becomes irritated and plantar fasciitis can occur. It is also thought that collapsed arches, common with pregnancy and ligament laxity can contribute to plantar fasciitis that is hard to get rid of post-partum.

Plantar Fasciitis can be very difficult to calm down and return the female to her prior level of function without pain.  Working with a physical therapist can help to establish good walking and standing habits which will help reduce the likelihood of developing foot pain (plantar fasciitis) down the line. Making sure the calf muscles, glute muscles, and posture are addressed postpartum is important.

Neck and Jaw Pain

Did you know your neck and jaw pain or headaches could be caused by your pregnancy and post-partum body positioning? With the shift of the thorax and rounding of the shoulders during pregnancy, and in the early years postpartum (due to feeding the baby) the female’s head may move into a forward head position. When the head moves forward there is increased tension in the back of the neck and muscles of the jaw due to gravity’s force on the body. When this happens pain, headaches, TMD, and neck pain can develop. Sometimes this takes months or years to develop due to the overwork of the muscles of the neck and head related to posture.

Proper care should be taken post-partum to address postural changes, stretch the upper back and chest, and develop alignment awareness. There are great positioning pillows and other pregnancy and post-partum tools out there that can help with posture and positioning. Using them will help prevent poor postures and decrease your risk for neck and jaw pain or headaches.

These are just some of the hidden issues of postpartum that can cause problems in the future.  Even if you don’t feel like your body needs attention right after giving birth, having a PT assessment with a pelvic floor specialist PT can help prevent possible problems years down the road. They can make sure you regain your flexibility, mobility, and strength to allow for pain-free and injury-free years ahead.