Current Year

Below are various issues and conditions that post-natal mothers may face and which #chiropractic treatment can help:

1) Neck and upper limb issues

Many mothers experience #neck, #shoulder, #elbow and #wrist #soreness throughout the baby-rearing period. It is best to start treatment of these issues with chiropractic and exercises even before and during pregnancy. Below are a few tips to help:
• Maintain a straight wrist when holding the baby or any heavy object.

• Keep the baby as close to you as possible when holding, picking up and placing the baby down. Brace your abdominal muscles and use your leg muscles to assist. Do not carry the baby on your hip. 
• Alternate sides when carrying the baby. 
• #Rest regularly

Below are a few some simple exercises. 

• #Wrist #Stretching: Hold the stretch for 10 seconds, do 3x a day.

• Wrist Stretching: Hold the stretch for 10 seconds, do 3x a day. 

• #Wrist #Strengthening: Expand the elastic band with your fingers 10x, do 3x a day. 

• Neck Stretches: Hold the stretch for 10 seconds, do 3x a day. Do this exercise on both sides. 

• Side-upper back stretch: Hold the stretch for 10 seconds, do 3x a day. Do this exercise on both sides. 

2) #Abdominal strengthening

It is crucial to strengthen and re-condition the abdominal wall post-pregnancy.

After giving birth and even multiple births, the abdominal is stretched and weakened. A weak abdomen may result in overuse of the back muscles leading to back pain. Approximately 30% of #pregnancy women experience abdominal diastasis (1). This is a separation or tear of the abdominal muscles, which is caused by the stretching of the abdominal muscles from a growing uterus. Specific post-natal exercises for this condition can be taught.

Please consult your health practitioner on suggested exercises.

3) Lower back pain, sacroiliac pain, pubic symphysis separation and joint sprains

The body produces the hormone relaxin during pregnancy, which allows the ligaments to be stretchy and elastic to prepare for childbirth (2). Relaxin affects all joints of the body and may take up to 5 months post-pregnancy for the joints to stabilise (2). During this period, your joints may feel weaker and sprain easily. Therefore, be easy on your body, do not do high-impact activities or exercises and rest regularly.

The lower back and #sacrioiliac joints can also be affected, hence some patients might need to use a sacro-iliac belt during this period. Chiropractic is effective in helping these conditions.
Some mothers experience pubic symphysis separation, where the joint in front of your pubic bone is wider than normal, causing pain and discomfort post-pregnancy (3). It will be best to begin chiropractic treatment as soon as possible to decreases the stresses on these joints and balance the body.
To protect your back:
• Use a baby carrier which has suitable back support 
• Change the baby’s nappy at level of abdomen, not too low or too high 

4) Sore hips, swollen stiff ankles and legs

Carrying the extra weight during pregnancy can place stress on the hips, knees and ankles.

Pressure from the growing baby may also slow down the circulation of the lower limbs leading to more swelling of the legs.

#Exercises:

• Stretches on your calf 
• Do regular exercises that can increase lower leg circulation, such as kicking in the water. 
• Do not sit too long 

5) Coccyx pain

The tailbone or coccyx maybe strained from the pressure of the baby passing the birth canal (4). The area will feel painful and might cause difficulty sitting. If the pain persist it is best to consult a health practitioner to derive whether it is a strain, a dislocation or not commonly a fracture. Chiropractic treatment will help in this area. A coccyx cushion can be used to decrease stress in the area when sitting. Avoid sitting on soft sofas and maintain a good sitting posture.

6)Pelvic Floor Muscle

The pelvic floor is stretched during pregnancy (5). It is important to begin pelvic floor exercise during and after pregnancy. Some post-natal women experience urinary incontinence as a result of a weak pelvic floor. A healthy pelvic floor helps to:
• Supports your internal organs, such as your bladder, intestines and uterus.
• Maintains bladder and bowel control including when you sneeze, cough or lift heavy objects.
• Plays a vital role, along with other muscles, in supporting your spine.

Pelvic floor exercise:
Contract your pelvic floor, as if you are holding your urine, for 5 seconds, then relax. This can be done 20-25 times a day.

7)Breast Feeding

Proper posture and technique is important during breastfeeding to prevent injuries from the mother.

• Bring the baby close to yourself, do not lean forward. 
• Sit on a sturdy chair with good posture and back support.
• Some others may like to lie down to breastfeed.

Dr. Karen Chan
Hong Kong Chiropractors Association Public Relations Committee Member
and Education Committee Member

References:

(1) Sperstad, J.B., Tennfjord, M.K., Hilde, G. et al. (2016). Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic pain. British Sports Journal of Medicine. 50:1092-1096.
(2) Dehghan, F., Haetian, B.S., Muniandy, S., et al. (2014). The effect of relaxin on the musculoskeletal system. Scandinavian Journal of Medicine & Science in Sports.24(4): 220-229.
(3) Chawla, J. J., Arora, D., Sandhu, N., et al. (2017). Pubic Symphysis Diastasis: A Case Series and Literature Review. Oman Medical Journal. 32(6): 510-514.
(4) Hwang S.K. (2015). Labor and Delivery Considerations: Pubic Symphysis Separation, Fractures Associated with Transient Osteoporosis of Pregnancy, Sacral Stress Fractures, and Coccydynia/Coccyx Fracture. In: Fitzgerald C., Segal N. (eds) Musculoskeletal Health in Pregnancy and Postpartum. Springer, Cham.
(5) Barham-Floreani, J. (2009). Well Adjusted Babies — Your Complete Guide to Pregnancy, Birth, Babies & Beyond. Vitality Productions.