Post Partum Series – 4 weeks

Mom, stop with the photos.

Four weeks.  FOUR WEEKS!  How has a month gone by already?!  

Motherhood is not kind on the body and mind.  Sleepless nights.  Awkward breastfeeding postures.  Constant holding and rocking.  Hormones.  Breastmilk EVERYWHERE.  Trying to figure out when you can eat.  Oh, and how your neck, back, wrists, shoulderhips, head, feet—really everything—ache!  On top of trying to figure how to care for a tiny human, you are trying to figure out how your new body operates and moves.  I remember taking a deep breath the morning after Skylar was born and turning to my husband saying, “I can’t feel anything.  No resistance.  I feel so floppy”.  Or, trying to move around in bed or take a shower…lots of concentration!  It is the weirdest sensation to not be able to perform a routine task or movement that you just did two days ago.  You can feel your brain send the signals to the body, feel how your body should perform the movement, but then either nothing happens or there is a significant delay.   

Being a rehab professional, I was excited to plan out my post-partum recovery.  I had a loose plan based on the minimal research out there and listening to experiences of other mamas.  However, that plan completed changed after an unplanned C-section.  Restrictions and guidelines become more strict.  It was unclear when and how to begin incorporating more daily activity.  The guideline is to wait 6 weeks for clearance for activity and not lift anything heavier than your baby.  But, what can you do in the meantime to help the body prepare for activity? 

I feel very fortunate to have a great understanding of my body, healing timelines, movement patterns, body mechanics, exercise progressions, appropriate and inappropriate pain responses, etc.  And, to have a husband with this knowledge as well.  I can’t imagine going through the post-partum phase without it.  Every Mama’s recovery process is vastly different.  Some are up and at it within days.  For others, it can take weeks to start to feel more normal.  I think our healthcare system is doing a disservice to women by not having physical therapy as part of standard post-partum care.  You have a lactation consultant come to your house to help learn how to breastfeed.  Why not have a physical therapist come to your house to learn how to use your body again Or, help adjust the set-up of your home to accommodate for how you can move.  Or, learn some gentle stretches and movements you can do to help counteract the awkward postures associated with caring for an infant.  Your outpatient PT can do that! 

Based on my knowledge of my own body and the human body, here are the soft goals I made for myself for the first four weeks.  I say soft goals because there are no timelines associated with them and they are adjusted based on feel. 

#1 Edema Control:  There was so much swelling!! I literally couldn’t put on my socks or shoes because my feet and ankles were so big.  Crocs were almost too small!  My first goal was to incorporate breathing exercises and self-lymphatic massage to help reduce swelling.  Whenever I was lying down, I would go through a modified self-lymphatic massage and breathing sequence to stimulate the clearance of edema since I couldn’t lift my legs up yet to elevate them.  Not only did it help clear the swelling, it also calmed my body to allow for better sleep during naps or at night.

#2 To be able to cough, sneeze, and laugh painfree:  My second goal was to be able to cough, sneeze, or laugh without significant pain.  This was the goal that held back my urge to start doing more around the housebegin some gentle exercises, or go for long walks.  It was my reminder that I am still healing and recovering.  

#3 To be able to wash my feet in the shower:  This is actually a very challenging task! You have to be able to bend over far enough to touch your feet, balance on one leg, have the strength and coordination to lift your leg up to your chest, and do all of this on a slippery surface.   

#4 Start breath work focusing on abdominal awareness and engagement:  This is a work in progress and will be my primary focus in the coming weeks.

#5) Go for daily walks building up tolerance to 30-60 minutes:  This started with my husband pushing the stroller for 10-20 min walks and built up to 60 minutes with Skylar in an ergo-baby.  At first, a long rest was needed on the couch after walks but now they feel reinvigorating and energizing.  Now I do solo “power” walks for mental health until cleared to use the stationary bike 

#6) Start some gentle exercises to counteract the breastfeeding position and posture:  This started off with gentle chest openers, shoulder blade squeezes, chin tucks, and no resistance seated shoulder external rotation.  Basically, any movement opposite of the breastfeeding posture that felt good and didn’t put strain on my abdomen.  As I felt comfortable, I added in band tear variations, light rotator cuff exercises, and some gentle pec and chest stretching.  Banded tricep pull downs were a no-go due to the strain on the abdomen (still an no-go).  Bookopeners and other twisting movements were a no-go as well until yesterday.  Now, they feel amazing.  Once again, everything goes by feel. 

#7) Respect the healing timeline:  this is a daily reminder to myself to respect how long it takes tissues to heal even if feeling great and painfree.   

#8)  Not worry about weight loss:  Say that again, Do Not Worry About Weight Loss.  This can be very challenging and requires patience but very important for the recovery process.  No calorie restriction.  No food limitations.  Just try to incorporate more nutritious foods, limit multiple daily sweets, and focus on quality.  It helps that the batteries to our scale are dead ; ) 

Remember, this is NOT medical advice.  Every post-partum journey is different.  Please seek a consult your OBGYN or a physical therapist with any medical questions.   

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