Help for Postural Pain After Breastfeeding

Help for Postural Pain after Breastfeeding

International Journal of Childbirth Education. March 2009

Heather Jeffcoat, DPT

Help for Postural Pain After Breastfeeding

This article provides help for postural pain after breastfeeding. In this joyous time of life, you don't want neck, shoulder and back pain to enter into your experience. With some key postural exercises, you can help reduce or eliminate the postural pain you have after breastfeeding.

One of the most precious bonds between a mother and her new baby is sharing the closeness of nourishing her child. Whether this occurs by breast or by bottle, there is nothing that compares to holding that little baby close, looking into their eyes and taking in that sweet baby scent. Over time, with poor positioning of her infant and adaptive postures that the mother will take on, musculoskeletal pain may develop. The most common place to develop these aches and pains are in the neck, upper and mid-back regions. They can be as mild as a dull ache felt between the shoulder blades to a debilitating tension headache that can make it difficult to care for her child.

With nursing and bottle-feeding, it is important that the child be supported to minimize the requirement of the mother to round her shoulders forward, slump her back and dropping her head forward (Photo 1). There are numerous nursing pillows on the market that aid in correcting this postural dysfunction (Photo 2). Sometimes, multiple pillows may need to be used for increased comfort. There is no one correct way to hold the baby, so different positions should also be attempted in order to identify which is the most comfortable.

Even with postural support and correction, looking down at their new little love is unavoidable. This posture leads to increased strain on the posterior neck and upper back muscles while the muscles in the front of the neck and shoulders are placed in a shortened position, causing them to lose flexibility over time. These postures that have been adapted need to be counteracted in order to reduce or eliminate pain and dysfunction. An exercise routine that emphasizes restoring postural balance is key.

The following list of exercises is generally appropriate for clients who complain of postural pain related to breastfeeding. However, if the pain is severe, or does not improve with the following exercises, referral to a women's health physical therapist is in order. The patient should feel better after completing the exercise. If an increase in pain occurs, she is likely performing the exercise incorrectly or the exercise is not appropriate for the cause of her pain.

Chest openers and biceps combo stretch:

Cue the client to clasp her hands as pictured (A). Inhale, lift the shoulders down and back. Exhale, maintain that posture in the shoulders and lift the arms up (B). This stretch is intense, and should be broken down into 3 sets of 15 seconds for your client's comfort. This stretch should be performed after each feeding.

Neckstretch series:

Cue client to first tilt her ear to her shoulder as pictured (A). Then, client should rotate her head down and to the side (B). Finally, the client should tilt her up and away (C). Each position should be held for 30 seconds and repeated twice each side. Additionally, this series should be performed at least 2 times per day.

Seated rows with resistance tubing:

Cue the client to inhale and extend her spine into an upright position (A). Then, have her exhale as she pulls her arms, like she is rowing a boat (B). Perform 2 sets of 15 repetitions, 3 times a week. This exercise can also be performed without resistance.

Prone flies over birthing ball:

Position your client as above (A) and have her inhale to prepare. Then cue her to exhale as she lifts her arms up to the ceiling (B). She should begin with at least 10 repetitions and gradually work up to 30 repetitions before adding any weight. Creating a balance between strength and flexibility is key.

If a client's symptoms do not improve with the above techniques and exercises, additional intervention may be required. A pelvic floor physical therapist can assist you with finding other potential causes of pain and provide a more directed treatment plan. Visit us in Los Angeles or reach out for a Coaching or Telehealth session today.

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My husband and I were married for 5 years and unable to have intercourse, but I never knew why. After numerous awful experiences at doctor’s offices (where many doctors told me I “just needed to relax”), a surgery that didn’t fix the problem, and a year of owning dilators that didn’t get me anywhere, someone finally referred me to Heather for Physical Therapy. I finally had answers and information from someone who knew exactly what I was dealing with!

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Heather is without exaggerating AMAZING! After years of trouble with a certain part of my body, in no time, she made everything change back to equilibrium and to what would be considered normal. She explains everything in detail and therefore gives you a better understanding of why things are the way they are, and how you can work towards turning things around. I would highly recommend Heather for any type of Physical Therapy. She has created her own "Method/Therapy" through years of studying (with some of the greatest practitioners), practice and breaking down the issues of her past patients, enabling her to fine tune her own system. I'm so thankful to have found her, and I'm especially grateful for the quick recovery I've achieved, after years of distress. If you cannot afford her, I recommend you purchase her book. Although it may not be Heather in person, it can still help you to get on the right path to recovery!

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My last appointment with Heather was over 6 years ago but I still think of her every day. I don’t take for granted that I can easily get out of bed, care for my two active and busy young boys, run, play tennis, clean my house, or sit at a desk for several hours at a time. None of these tasks were easy for me before meeting Heather. Eight years ago my car was struck from behind by a tractor trailer that was estimated to have been speeding. I spent 3 years working with different PTs and Drs trying to heal and move on with my life. When I became pregnant and the hormone relaxin that “relaxes” all the joints of the body and the additional weight gain erased all my progress and I was suddenly in a lot of pain again. My OB sent me to Heather for one last try.

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Testimonial by R.M., Age 40

I can’t speak highly enough of the theapists at Femina Physical Therapy and how much they have helped me grow, discover, and love my body. I had had painful sex for my entire life, and didn’t know that there was anything that could be done about it. It was at the point where my husband and I were not having sex for MONTHs, because it was just too frustrating, and I hated feeling like I was the ONLY woman out there who had this problem, especially at my age. I finally brought it up to my doctor because I was turning 40 and my husband and I were barely having enough sex to conceive. And she brought up pelvic floor, PT. I didn’t even know this was a “thing”.

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Testimonial by R.H.

No one could tell me why I was having pain during sex--sharp pain, not just uncomfortable, pain. I was referred to Heather Jeffcoat after researching several different options. I had seen a specialist who told me physical therapy would not help and my only option was surgery. I really didn't want to go that route, so when we got a referral, I decided to try it--it can't hurt, I thought. I am so glad I did. She diagnosed the problem right away, which was a relief in itself.

To know why I was having pain eased my mind immensely. And to hear that she could fix it without surgery was another relief. She said she could fix the problem in 6 weeks. I think it was actually 4 for me. She was very methodical, and treated me as an intelligent human being capable of participating in my own recovery. I would absolutely recommend her to anyone. She did not try to prolong my session numbers, she worked hard to accommodate my schedule (and the fact that I had to bring a baby to sessions), and she was completely honest the entire time. It is so hard to find someone with these characteristics, much less a professional who is so good at what she does. She has my highest respect.

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Testimonial by J.B.

My husband and I were having problems with painful intercourse. My therapist recommended that I go and get a pelvic floor evaluation from a physical therapist. Having never been treated by a physical therapist, I wondered how this really was going to help me. My husband who is a physician was very supportive and agreed that a PT evaluation would be a great idea. So i made the appointment and was blown away by what I learned. I had no idea that pelvic floor muscles could get tight and have trigger points just like any other muscle in the body. I'm a massage therapist and very familiar with tight muscles, and this new thought really amazed me. Heather's program to help relax and strengthen these muscles made such a difference. I can say that I am 100% pain free during intercourse now. Yippee! Going to the PT appointments and doing the at-home exercises was definitely a discipline, but it's 100% worth it! The rewards are amazing.

-- J.B.

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