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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Testimonial by Julie T.

Femina PT (née Fusion Wellness & Physical Therapy) has honestly changed my life. Before receiving treatment at Femina, I was going doctor to doctor to try and find the answer to my pelvic pain. It has taken me YEARS to find someone that can help fix this. It wasn't until my gynecologist recommended your clinic that I finally felt relief. My pelvic pain is almost gone, and granted I still have a lot more to work on with Laureen (my PT), my original problem is nearly cured. I am so grateful to her.

What is even better is she gave me practical exercises to do at home that were not tedious and provided instant (and lasting) relief. Although I mainly work with Laureen, my interaction with the owner (Heather) has been great. She is very generous, kind, and committed to her business.

It hurts to know there are women out there suffering who will never know or have the opportunity to work with women like Laureen and Heather because this issue is hardly talked about and this field is so rare. I hope more doctors and physical therapists see the value in this work and can relieve more woman of their pain.

-- Julie T., 12/4/16 via Yelp!

Testimonial by P.M.

I was hopeful but frankly skeptical when the doctor treating me for Interstitial Cystitis recommended that I go to Heather for physical therapy. Medication and diet helped control my IC symptoms, but I had never heard of physical therapy being used to treat IC. The education and treatment I received from Heather was a revelation. She explained that the pain I experienced with IC had helped create a cycle of muscle guarding which affected the entire pelvic area. I had no idea of the amount of tension being held there. No wonder my husband and I had not been able to have sexual intercourse for years!

Read more: Testimonial by P.M.

Testimonial by A.W., age 32

I wanted to let you know that my pelvic floor held strong and gave me no trouble whatsoever in my trail race this morning (12 miles)! In a way, I felt like I ran better than ever because my core feels so rock solid from all the exercises you have me doing. That was especially valuable on the technical downhill - I just flew down the trail because I had confidence in my balance and form. Thank you for helping me get back to doing what I love.

-- A.W., age 32
(completed Post-partum Renewal Program using the InTone biofeedback/stim unit)

Testimonial by Carolina J.

I had tried Pelvic Floor Physical Therapy before (with another PT) and I had a really bad (painful) experience. A friend of mine and fellow patient, told me about Heather, Laureen and Femina PT (née Fusion Wellness & Physical Therapy) and I decided to try again. I am so happy I did! Femina PT have, literally, changed my life. I was able to do again things I couldn't do for over 10 years!! Their bedside manners are impeccable, their knowledge and understanding make me feel comfortable to recommend this place to anyone in pain. Specially if you have Endometriosis. 100% recommended!!

-- Carolina J., 12/28/16 via Yelp!

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”.

Read more: Testimonial by R.M., Age 40

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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