Postpartum Physiotherapy Tune-ups Should be a Thing

If you picked up two ten-pound weights, put them in a backpack, and then carried them around absolutely everywhere you went for a few months, do you think parts of your body would suffer for it? You might start to hunch forward to try to support the extra weight on your back. When this wasn’t enough perhaps you would start to have shoulder pain, neck pain, or upper and lower back pain. I think most of us can picture this and would find it understandable.

If after a few months I told you that you could put down the backpack, do you think you would just walk away unscathed? Most of us would not believe that our hunched up and painful body would just magically fix itself. We would probably go and get some treatment for it. 

Well, when a person is pregnant a similar thing happens. They are walking around with a whole lot of extra weight in one region of their body. They have to support this weight all of the time, even when trying to sleep. And yet when they finally can put down the backpack so to speak, we expect them to just walk away and carry on while caring for an infant to boot. 

Guess what? It just doesn’t work that way. When a body is carrying a baby there is a significant weight in the front. This pulls the front of the pelvis down. In medical speak we refer to this as anterior tilt of the pelvis. If you think about your pelvis as a bowl full of water, when we are standing still the bowl should be level and water should not be pouring out at all. Particularly in the late stages of pregnancy, the water will all be pouring out the front of the bowl. This is simple biomechanics and it is unavoidable so don’t go thinking Pilates will save you on this one. 

In order to try and compensate for this anterior tilt of the pelvis, the pregnant person will often arch the lower back. Do this for a few months and you end up stuck there. 

The other big thing that happens is that the hips get pushed out of alignment. We tend to think of hips as the curvy area on the sides of the pelvis, but the actual ball and socket joint lies very deep within the pelvis. As baby’s head drops lower into the pelvis, the hips get pushed up and back out of the way. This contributes to the signature waddle that occurs in the late stages of pregnancy. 

Changes to the rib cage also occur. The lower ribs get pushed out, particularly in people of shorter stature. The diaphragm also gets pushed up, a whole lot of organs get squished, and taking a deep breath can become difficult. 

The thing is, once baby is born these alignment issues don’t just magically go away on their own. Treatment is necessary to put Humpty back together again. I realize that this might appear to go against the school of thought that childbirth is a perfectly natural process that doesn’t need to be medicalized. However, I know what I know and I see what I see. I see people with these issues all the time and all of it is perfectly treatable.

If they are lucky, they have low back pain postpartum that brings them in early after giving birth. If they are not so lucky, they come in 30 years later with a blown disc in their lower back from all those years of walking around with their pelvis in anterior tilt, their lower back arched, and their hips somewhere up their butt. 

Yes, I am serious. These alignment issues will persist indefinitely until they are skillfully treated. If you catch them early it is a simple process requiring one or two treatments to send them on their merry way. If you wait 30 years then there is a whole lot more to deal with.

Every person who gives birth should have a postpartum tune-up a month or two afterwards. And if you have had a C-section then there is even more to deal with as described here. You can avoid so many issues down the road with a little preventative treatment at the beginning.

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