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I vividly remember toting my 2-week old newborn and 2 year old out of the house on a serious mission. It was a MOPS meeting (Mothers of Preschoolers) and the theme for the day was "spa day". While our children were being watched by childcare, we could hang out with friends, eat brunch and get chair massages. I didn't care how difficult it was to get out the door with a newborn and a toddler, I needed that massage! I'm pretty sure I had knots the size of softballs lodged between my shoulder blades that shot lasers of pain through my body. When the rest of my body was trying to recover from childbirth and adjust to nursing a baby, the last thing I needed was one more area of pain.
Between snuggling, rocking, nursing and sitting, your posture can quickly go down the drain once baby arrives. This hunched-over position frequently creates serious pain in the form of knots and stiff muscles. Aside from getting a good massage (which I highly recommend!) there are other strategies that you can implement between feedings and naps.
The areas that are the most effected in the days following childbirth are your upper back, lower back and hip flexors. When you lay, sit, nurse and hold your baby, your shoulders hunch forward placing stress on the upper back especially between the shoulder blades. Your lower back and hips become stiff in a hinged position, creating issues for the front of the hips and the low back. Your goal should be to manipulate your soft tissues into a neutral position as much as possible to counteract the hunching. Once you feel up for it, you can even perform some strengthening exercises to hold your joints in the neutral position.
In the first week following childbirth, some of these techniques may be too difficult to perform while your body is still healing. However, as your body begins to heal and you feel more mobile, begin to implement as much of these techniques as you can.
Self massage (self-myofascial release)
Myofascial release is a form of manual soft tissue therapy intended to manipulate the fibrous fascia (a web-like wrapping surrounding the muscles, organs, and skeleton), encouraging them to realign into a more functional and flexible fashion. When you get those nasty "knots", it's usually in the fascia. When this myofascial system (the muscle and fascia) is bound up tight, it can lead to soreness as well as imbalances. The body will be pulled in different ways according the patterns of tightness.
The most obvious form of myofascial release is getting a massage. I definitely recommend scheduling a thorough massage with a good massage therapist during the first few weeks to months following birth, or at least enlisting your spouse or a friend to give you a good back rub.
There are also ways to perform self-myofascial release, or massaging your own myofascial system...you just need to use some tools. A foam roller and a tennis ball become magical instruments for sore muscles. You can practice foam rolling the muscles surrounding your hips and upper spine. It may hurt a little bit at first, but soon it will feel amazing!
A tennis ball to release the tissue on an even deeper level feels incredible, so you may want to keep a tennis ball handy. Leaning up against a wall and rolling on a tennis ball through your shoulder blad area is completely practical to perform during the first few days/weeks after birth because you won't need to lie down your maneuver your sore body on top of a foam roller.
Stretching
Once the knots and constrictions are released in the soft tissues from massage, you should perform some very specific stretches. Again, your focus should be on finding neutral with your neck, upper back and hips. The following stretches are ideal for targeting the culprit areas. When stretching, ease into the stretch to the point of slight discomfort and tightness. Your body is still healing, so your goal should not be to drastically improve your flexibility here. Once you feel the stretch, hold the position for 4 to 5 deep breaths.
This is a list of the stretches that are shown in the videos below (very thorough, right?!):
- Upper trapezius stretch (neck & shoulder)
- Sternocleidomastoid stretch (neck)
- Levator scapulae stretch (back of the neck & shoulder)
- Rhomboids stretch (between the shoulder blades)
- Latissimus dorsi stretch (armpit and side of the back)
- Pectorals stretch (chest)
- Adductor stretch (inner thigh and hip flexors)
- Rectus femoris stretch (quads and hip flexors)
- Hamstrings (back of thigh)
- Piriformis (deep hip)
Targeted Strengthening
Once you feel up for it, probably by the end of the second or third week following birth, you can try some basic strengthening exercises to encourage good posture. The goal with these strengthening exercises are to open your chest up and pull your shoulders back, strengthen your glutes and engage your core.
This is a list of some of the best the exercises, and are listed from easiest to most difficult. I have also provided recommendations for when you are most likely safe to try these exercises:
- Wall angels (upper back strengthening) - perform 8-15x; can be done anytime postpartum
- Bent-over thoracic rotation (upper back, core & hip strengthening) - perform 6-10x/side; can be done 1-2 weeks postpartum
- Perfect plank (core strengthening) - perform on knees or toes, 4-6 deep breaths; can be done 2-4 weeks postpartum
- Bridge (glute & core strengthening) - perform 8-15x; can be done 3-6 weeks postpartum
- Biped thoracic rotation (upper back & core strengthening) - 8-15x/side; can be done 1-2 weeks postpartum with both knees down; can be done 3-6 weeks postpartum with one knee down
- Prisoner squat (upper back, core, glute & quad strengthening) - 8-15x; can be done 3-6 weeks postpartum
Not interested in figuring this out for yourself? The Postpartum Renew program holds your hand through all of this so you don't have to guess.
Be gentle
Make sure that with every massage technique, stretch and exercise you try that you ease into it and be gentle with your body. Remember, it is still healing from childbirth. Your day will come when you can get back into a serious strengthening routine, but not in the first weeks postpartum. Your goal right now is to find relief and comfort from the positions you find yourself in, focusing on correcting your posture.
If you feel ready to do a little bit and begin safely moving again this program is a great place to start.
