Physical therapy for pregnancy, postpartum and forever

When I was pregnant, my husband asked me: “Does your back hurt just all of the time?”

From the profile view of my pregnant body, not only did my large belly stick out but my poor back curved in with an exaggerated slope near to an angle.

Like a hinge.

Look. at. all. that. baby.

Pregnancy was not kind to my body. Turns out, it was especially unkind to my back.

Around 28 weeks into my pregnancy, I complained to my doctor about a pain in my butt and how much of a pain-in-the-butt it was to sit and stand, roll and turn. The only thing I could do without pain was walk. My doctor told me this pain was common to pregnant women with sudden weight gain, loosey-goosey ligaments and all around changes in my body. It had a name: sciatica.

She also told me I wouldn’t have to live with it.

I went to a physical therapist to treat my pain and confirmed the diagnosis: poor posture coupled with the every-growing weight of my child put too much pressure on my poorly cared for spine. The pressure inflamed the sciatic nerve — the giant one based in the low back — and caused my pain. Sciatica.

Pregnancy-safe floor exercises, hourly backbends and a near-constant ice pack soothed my inflamed nerves, and I got through the remainder (plus four days) of my pregnancy as pain-limited as possible expecting it would go away once I was free of the torment of carrying around 9-pound, 5-ounce monster baby.

physical therapy towel for pregnancy
Daily exercises with my towel roll.

And I fared well for a time postpartum. Prescribed pain medication for breakthrough cesarean pain — because that’s a real thing, and it’s real bad — and rotating Tylenol and ibuprofen for the days after delivery likely did a great deal to cover up what would be one of the most painful sensations I would come to remember.

Because I don’t remember labor pain. You were all correct. Thanks in advance for not rubbing it in.

Eventually, postpartum turned out to be just as bad for my back as pregnancy. Poor posture during breastfeeding — I would have sat on my own head to get that kid to latch — and hunching during diaper changes, clothing changes, bath time, even pumping caused my nerves to fire up.

The pain wasn’t in my butt anymore. It was in my back. It got so bad I couldn’t stand to sit for my workday, and lifting my son became a strain. So back to physical therapy I went.

The physical therapist prescribed the same stretches, the same floor exercises, the same little backbends and the same heaven-sent ice pack. She proscribed the same lifestyle she’d steered me clear of during pregnancy: no yoga, no sitting without support, no hunching, no high-heeled shoes. And added that I shouldn’t bathe the baby in the tub.

And I did it. Exercises, backbends, lumbar support everywhere I go. I did it all.

Old People Bed
My husband even helped. Sleeping on an ice pack in solidarity.

At the end of my treatment, when we had worked my pain to a manageable number — 1’s and 2’s instead of 9’s and 10’s — and, yes, there were 10’s — she checked my transverse and rectus abdominis. Pregnancy and a C-section thankfully didn’t completely destroy my core, and I escaped with only minor separation of my abdominal wall, called diastasis recti.

Two inches is a minor separation.

Pregnancy introduced me to back pain. Postpartum, I assumed everything would go back to normal. I assumed wrong. This is my new normal, my every day. Because it never goes away — it gets better, and it gets worse.

I recently went back in physical therapy to treat 9-level pain. How did I end up here again? I stopped doing my exercises, my backbends, and I ignored lumbar support. I stopped treating my back. I was healed, after all.

When the pain is better, you don’t see the immediate need to correct your posture, stretch your spine, ice your flare ups. Take care of yourself. Because you’re not in pain right at that moment.

I know now I can never stop treating my back.

The pain comes back, and it comes back like Batman — vengeful and usually at night.

My physical therapist says, “We’re going to get you well.” Which means we’re going to get me on a program that makes the pain better — 1’s and 2’s at the worst, never a 9 or a 10 — and then I’m going to stay on that program for three months on my own.

And then I’m going to keep doing it forever.

Palmer Physical Therapy Lumbar Support Pillow

2 Replies to “Physical therapy for pregnancy, postpartum and forever”

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