In so many ways, we send harmful and unrealistic messages to women who just had a baby.
When a new mom goes to her midwife or doctor for a six-week check-up, she often hears, “Go ahead. Go do everything you were doing before you were pregnant. You are good to go.”
Pregnancy is a massive change to the musculoskeletal system. We should treat pregnancy as an injury to the body and the postpartum period as a time of rehabilitation.
Let’s dive into this! You can watch my facebook live or read below.
What Happens with an Injury
Think about an ankle injury. If you sprain the outside of your ankle, the ankle loses stability and can’t work the way it normally does.
The body DOESN’T like instability. Other areas start taking over to support and stabilize the injured area. All sorts of compensations happen.
You stop putting weight on the outside of that foot. You shift more of the muscular work to the inside of your ankle. That creates a chain reaction up your entire body.
The knee, hip, shoulder and even neck work differently because of the ankle injury. Crazy, right?!
What Happens to Your Body During Pregnancy
This isn’t a far cry from what happens during pregnancy.
Think about it: you’re growing a giant baby in your belly.
Even if you are active during pregnancy, the core muscles get weak. They cannot support the body in the way they did before you were pregnant.
Normally, the core stabilizes both the spine and the pelvis.
When the core isn’t working, those areas become unstable. And, remember, the body doesn’t like instability.
So some compensations happen to maintain stability in your body.
- The paraspinal muscles in your back start working hard to make up for the work your core was doing (They get tight!).
- The psoas, the main hip flexor, starts working overtime. This huge muscle is designed to move your legs. But when the core isn’t working, it will start working to stabilize the spine. So your hip flexors get really tight!!
- On the outer hip, a group of muscles called the TFL starts gripping to help keep your pelvis stable. So your outer hips are tight!!
- The TFL is a bully to the glutes and make it hard for your glutes to fire. Overtime, your glutes get weak.
So not only is your core weak, but you have major compensations in your back, hips, and glutes!
If that isn’t reminiscent of an injury, I don’t know what is!
Typical Approach to an Injury
When someone injures an ankle we don’t say “You injured your ankle a few weeks ago. Your muscles are working completely differently. But go ahead and go run that half marathon. Go ahead and do that HIIT workout that you were doing before you hurt yourself. You waited 6 weeks, right? That’s cool. You’re good.”
We say “You sprained your ankle and let it rest and heal. NOW let’s rehabilitate it. Let’s balance out the muscles that were overworking to create stability. Let’s get the joint working properly again so that you can run or do HIIT again, without injuring yourself.”
After rest, you rehabilitate, THEN you move back into higher demand activities.
Typical Approach to the Postpartum Period
This is not the approach taken in the postpartum period.
We tell postpartum woman “Rest for six weeks…and then go do everything you did before you were pregnant.”
Starting into activity before rehabilitation perpetuates the imbalances created during pregnancy.
Practicing yoga or running with a weak core makes your back and hips work even harder to stabilize your spine…Which strains them further.
You are asking an injured body to do things it isn’t ready to do.
A New Model for the Postpartum Period
Let’s treat pregnancy as an injury and rehabilitate the postpartum body.
Let’s tell women “Rest and recover for 6 weeks. Then let’s correct the imbalances created by nine to ten months of pregnancy. Let’s rebuild the weak muscles and teach those overworked, overactive muscles to chill out! THEN, let’s move on to all that higher intensity stuff.”
Bring the core back online. Rebuild strength in muscles that grew weak during pregnancy. And release tension that has built up in the hip flexors and back.
Once everything is working the way it’s meant to, you can get back to the activities you love.
Next week, I’ll be sharing where the heck you should begin this rehabilitation process.
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