As I was walking home from class yesterday a father and his toddler walked past me. The dad was taking tiny baby steps in time with his son, was crouching in a squat position to be at his son’s level and was leaning over to one side in order to hold his hand. This reminded me of how Becky used to love to hold my finger as she walked – up until her hand was big enough to hold mine. And how it hurt my back let alone nearly dislocated my finger!!!
The trouble with having bad posture when you’re caring for children is that you’re going to repeat that same position over and over again each day and this will take it’s toll on your body. And because of the interconnectedness of our body parts, that pain could show up anywhere, with the back often being the prime suspect.
Here’s my 5 top positions to be aware of your posture:
- Bending over to change nappies and other jobs at waist height – stay in close, hinge from the hips and keep the upper back in alignment. You’re trying not to just round your shoulders and hang from your ribs. If the task is lower down, bend at the knees into a squat or lunge
- Getting out of bed – roll over onto your side and push yourself up. Try not to just sit straight up – this causes pressure through your stomach and could prevent diastasis from improving as well affecting your pelvic floor and back. I demonstrate this on video here
- Pushing the pushchair/shopping trolley – stand upright, not too far away, with your arms slightly bent and think of powering through your legs, it’s a great bum work out! Don’t rest your weight on the pushchair and don’t think of it as pushing with your arms – your whole body is doing the job. Applies even more so when going uphill!!
- Picking baby up from the floor – bend at the knees into a squat or lunge keeping your back in alignment, pull baby in close, exhale as stand up (using the knack). The same with car seats – and it’s better if you can carry them close with both hands when baby is small. Picking up from the cot you need to stay in close and again bend at the knees and hips
- Carrying baby – try not to lean back to rest baby on your chest. Drop your ribs down and keep them in alignment with your hips – you will feel your core tire quicker but that will just remind you to change positions. Try and keep baby high and in the centre. If you carry to one side keep them high and let their head rest on your shoulder – try not to push your hip out and try to vary sides rather than always favouring one
Bear in mind that any continuing pregnancy conditions need to be assessed – pelvic girdle pain, piriformis/sciatica, diastasis, pelvic floor dysfunction. These can all contribute to back pain as well.
Pelvic girdle pain (PGP), sometimes known as Symphysis Pubis Dysfunction (SPD) or SI Joint Pain – can be felt in the back, bum, legs and front of pelvis.
It’s a common problem in pregnancy – 20% of pregnant women get it, although it can be as much as 50%. But remember common does not mean normal – so you don’t have to just put up with it!
The good news is that it does tend to clear up after pregnancy – only 7-8% women still have a problem postnatally. But how you deal with it in pregnancy will have a bearing on your recovery
There are various risk factors for the condition including:
- pelvic girdle pain in previous pregnancy
- gaining excessive weight during pregnancy
- lack of core strength
- poor posture
- pelvic misalignment or history of trauma to the pelvis
- hypermobility, connective tissue disorders or laxity in the joints
- expecting a large baby or multiples
- baby’s position
There is also a range in the severity of pain felt and different activities can affect differently – some movements may cause no pain in some women but be excruciating for others. For instance, the classic going up stairs was not a problem for me but turning over in bed was always painful. The general rule of thumb is – if it hurts, don’t do it! There is no benefit in pushing through the pain and you’re more likely to make it worse.
Here are a few ideas to try which may help out with day to day activities:
- Walking – take smaller steps and go slower. Be aware that if you have a small child or a dog pulling on you that will also exacerbate it. Otherwise walking is a great exercise and should be continued as much as possible
- Sitting – don’t cross your legs – either at the ankles or the knees. Sit upright and with both feet on the floor – an upright chair or birthing ball is helpful rather than the sofa. Click here to go to my YouTube channel where there are videos instructions on sitting, standing up and getting up from the floor or bed. Using the Knack on movement will also help.
- In bed – turning over is usually the issue. Keep a pillow between your knees then squeeze your knees, perform the Knack and try to keep your hips stacked as you roll. This can be aided by having a duvet under the bottom sheet. Also reducing friction to turning can help – using silk sheets, a snoozle slide sheet or if you’re desperate, a bin bag!
- In the car – getting in and out is a challenge. Think 1950s and keep your legs still and swivel round! You don’t want the knees to move inwards past hip width, so again a pillow between the knees (or a yoga block) and squeeze and perform the Knack as you swivel. A plastic bag on the chair can help. Also when in the car try sitting on a rolled up towel so that your hips are more in line with your knees.
- Avoid one legged positions – sit down to get dressed and walk upstairs by bringing the second leg up to meet the first before you take the next step. Think of stepping upwards with each step rather than forwards. You may also want to avoid carrying things upstairs. If you need to get down to the floor try to use a squat position and onto all fours instead of a lunge.
- Avoid wide legged positions – anything wider than hip width apart will either cause pain or risk pulling the pubic bones further apart. This also applies to your birthing position – safest position is actually on your side.
- Avoid heavy lifting and pushing – this means vacuuming and shopping trolleys are not good idea. Time to get help where possible.
- Work on your posture and try to keep your pelvis in alignment – get a referral to see a women’s health physiotherapist or a chiropractor for an assessment. They will be able to give you manual therapy and may advise a support belt to help.
- Exercise – it’s important to keep moving if possible. Gentle walking and swimming are good – but avoid breaststroke legs. Pelvic floor and deep abdominal exercises are essential – my pregnancy Pilates classes are ideal for this. Other key exercises we do are those that work on keeping the pelvis both stable and mobile. Try to practice these at home regularly.
Also, make sure it’s written in your notes – mine wasn’t and I ended up in stirrups with a forceps delivery. I was kept in that position a long time after birth too and this made my postnatal recovery from PGP much harder.
For more information the best website to use is
www.pelvicpartnership.org.uk – loads of information there.
If you need any more help feel free to contact me and remember I can always teach you exercises in class that you can use at home.