I am a mum. Why do my hips, back and knees hurt all the time?
So, you made a human. Congrats! Now your hips, back, and knees are screaming at you and you feel like you've aged 80 years overnight.
Postpartum pain is a common complaint, don’t dismiss it! Understanding the underlying causes of your aches and pains is the first step to finding effective relief. My latest blog explains 5 key reasons that contribute to postpartum discomfort and real solutions to help you deal with them.
First, let’s frame how pregnancy actually feels vs what we’re told.
Pregnancy can feel like an assault on your mental and physical health. Throughout pregnancy, we are repeatedly examined, weighed, monitored and poked. Our body changes until it is unrecognisable. Then just when we are totally fed up of feeling like a whale, we give birth. This involves either exploding our vagina or by having someone tear our bellies open and drag a baby out it. Then our little treasure arrives covered in our bodily fluids and blood - what a joyous, tear jerking moment!!
Then after all that, the medical system forgets about us and our kids are examined, weighed, monitored and poked regularly instead of us. In Europe, we do however, we are luckily enough to receive one postpartum check (just a little one!) at 6 weeks postpartum and then we are left to get on with the rest of our lives. A lot of us then experience depression, riding waves of emotional uncertainty and physical aches and pains on an almost daily basis.
Can you believe the most common advice I got throughout this period from other people with kids was: “Just enjoy it!!! :)” to which I always secretly thought: “There is no way that is going to happen. Please stop giving me such shit advice.”
Did you get this advice too?
Our mindset (and mind) literally shifts after pregnancy.
After childbirth, we are forever in ‘I am a parent now, so I guess I come second’ territory. It can feel like a blunt shock. I coach many mothers and I see this learned reprioritisation that takes place in their heads, often passively. “The system puts my baby first and me second, so I will put my baby first and myself second.”
It’s a subliminal message that the universe sends us. Self care slowly falls down the priority list. What we may not realise is: our brain actually reorganises itself during pregnancy, check out this study.
We often have aches and pains for days or weeks, but sometimes these last months. We tell ourselves; “I’ll deal with it tomorrow or when my child is older”. Depending on the severity of these aches, they can drive us a little crazy and make us feel like we have been transplanted into someone else’s body.
So why does your body hurt? Are you destined to ache forever? Can you actually do something about this?
Yes you can - hallelujah! But first, you’ve got to understand the root cause. I’ll tackle the 5 most common reasons I see for the body hurting in pregnancy and beyond.
Here is why you might be experiencing issues:
1. You’re deconditioned.
2. You’re breastfeeding.
3. You jumped back into exercise too fast (or you didn’t get back into exercise at all after pregnancy).
4. You’re not doing effective postpartum exercise (what worked before pregnancy doesn’t work now).
5. Something more serious is up and you need to seek medical help.
Helpfully, I experienced ALL of the these symptoms despite assuming my body would just pop back into shape like the movies and adverts promised. Once I became a Woman’s Health Specialist and Strength Trainer, I saw numerous women with the exact same ailments and successfully trained them to be stronger and live ache free and pain free lives. This article is for all of you ladies, it is based on my real experience training post partum women.
1. You’re deconditioned.
Fitness professionals use the word ‘deconditioned’ to describe when a person’s body is not functional for the activities they need to perform. In an everyday life context, it might mean you might begin to struggle with every day activities like picking up a growing child every day or picking up groceries.
When our bodies birth babies without being physically prepared, it takes its toll. There is a tremendous strain on your pelvic organs and it can feel like your body was hit by a truck. Yet, i’ve never met a single woman who has been told this by her health providers during family planning, not one. Knowing what I know now, it is my strong personal and professional belief that before pregnancy, you need to get really fit, strong and comfortable in your body. Seriously - Like, a year before the egg and the sperm meet, you need to focus on getting really, incredibly strong! Sadly, many women are entering pregnancy already deconditioned. The reason our hips, back and knees are most affected is because they are all connected to our core, specifically the pelvis which softens during pregnancy, so if your core is already weak then any pre-existing imbalances in our hips are often exacerbated by pregnancy.
PRACTICAL TIPS for dealing with a deconditioned body:
Strength Train - Get yourself into a strength training routine with weights. First get comfortable with doing bodyweight exercises in a mirror to check your alignment, then build up to picking up weights at home or in the gym. Slow and gradual is better than fast and hard. You’ll feel some benefits immediately and within a month of training, you’ll see larger impacts. This will also futureproof your body for aging and the joys of menopause (a topic for another time!). It doesn’t need to be a mega 2 hour trip to the gym, it just needs to be little and often.
Time poor? - Start with short 10 min strength or cardio routines to get your heart rate up. If you can’t get to a gym, just youtube them and do the first thing you find to get your body comfortable moving again. There is no perfect routine, our bodies are designed to move.
Make it fun! - Aches and pains often force people to stop moving which often makes things worse. Can you make it fun? Whatever that means to you, do a zumba class, dance around your living room with your child or a friend. Whatever will put a smile on your face and promote increased blood circulation.
Pilates classes - These are good for to bringing balance to the core and learning about the breath, this is an excellent foundational step before moving into strength training.
See a specialist - Consider working with a women’s fitness specialist for period of time to gradually build up strength, especially if you have pain or injury. Motherhood can occupy the mind fully and be mentally exhausting. Sometimes, we just need someone to tell us what to do fro a few months to get us into a consistent habit.
2. You’re breastfeeding.
You’ll feel that your hormonal balance has gone wild during and after pregnancy. An influx of the hormone ‘relaxin’ enters your body right before childbirth, this softens your pelvis and your ligaments to prepare your body for birth. If you choose to breastfeed, relaxin hangs around in your body for the duration of the breastfeeding period resulting in your joints feeling softer (hence, aches and pains) for longer. Know that it is entirely normal to feel like you have the skeleton of a 95 year old that has just run a marathon. You are not broken, its just the damn relaxin, ok?
PRACTICAL TIPS for dealing with a breastfeeding body.
Your boobs, your choice! - Know that it is ok to breastfeed for as long as you choose to. Also know that it is a trade off and it may not feel good in your joints, especially if you are deconditioned too (see point 1 above). It’s not forever and once the journey of breastfeeding ends, the 95 year old skeleton sensation will die down as the relaxin leaves your body.
Walk, walk walk - When it is comfortable, walk as much as you can to gently encourage blood circulation in your body and passively condition your pelvic floor.
Posture - Try to keep as good a posture as your can during breastfeeding to reduce downward pressure on your spine, pelvic floor and hips. Use props or have a breastfeeding chair set up at home.
Goals - If you are someone that is driven by goal setting. Set yourself a goal, activity or treat to look forward to when the breastfeeding journey ends so it doesn’t feel like an endless grind.
Connect with your community - Double down on the fact your baby is attached to you quite often. Go to mum and baby activities classes with them. They could be fitness related, or just be a coffee morning with other breastfeeding mums. Many mums isolate themselves during this time so any social activities with people like you will allow you to connect and not feel alone.
3. You jumped back into exercise too fast (or you didn’t get back into exercise at all).
Whilst I am a massive advocate for exercise, I don’t advocate rushing into anything after your body has gone through something as major as pregnancy. You have a lot of relaxin in your body and your body needs to heal after the marathon it just went through. Resting will heal you. The more intense the exercise you dive into in the first few months after childbirth, the more your body will experience stress. Normally, putting stress on your joints and muscles is be a good thing, it’s how they grow stronger, but if you load on this stress too quickly, add it to a relaxin filled body and an already stressful lifestyle with a child that hasn’t developed a sleeping pattern, it can be a recipe for harm and exhaustion. There is only so much stress your body can handle at once, especially if you’re not sleeping and you have multiple kids you are caring for.
I appreciate that no woman I’ve ever met ever thinks this ‘in the moment’. After all, when the baby is out of you and you no longer feel like a whale, you want to feel immediately fitter and (often) are desperate to be thinner. I see symptoms of Body Dysmorphic Disorder in every postpartum woman I coach. I know it doesn’t feel like it now, but you do have the rest of your life to tend to getting fitter. Why risk injuring yourself now for a short term gain? While we’re on this topic, please can we stop using the phrase ‘lose my baby weight’ like it is an emergency situation that needs to be addressed. Remember your ‘baby weight’ protected your body and grew your baby for months, it is nothing to be ashamed of. It is a powerful symbol of what you did with your body.
PRACTICAL TIPS for dealing with having jumped into exercise too fast:
Slow it right down - This promotes healing, calm you nervous system down. Sound baths and Yin Yoga are good, slower options until your body is healed enough for more intensity.
Walk - Go on walks, especially in nature. Walking passively conditions the pelvic floor and nature is an instant mood booster.
Goals - If you are someone that are driven by goal setting. Set yourself a date to start upping the intensity with exercise, Until then do nothing, seriously, don’t even think about it! or just go on walks. Reentering higher intensity exercise after pregnancy is a gradual step by step process, not a one and done task.
Turn off the apps - Stop looking at social media. Either reduce and regulate your access or take a break entirely for a while. Sadly, social media often makes newly postpartum women feel extra bad about themselves, it paints very unrealitic pictures of what postpartum ‘should be like’. I can be a particularly triggering time. Is it really worth the negative impact to your mental health to keep on scrolling? Remember, you’ll also feel emotions more intensely whilst your hormones are rebalancing, so it’s healthier to cut yourself off to help yourself. Spend time around loved ones and real postpartum mums rather than looking at idealised instagram versions of mums.
4. You’re not doing effective postpartum exercise (aka what worked before pregnancy doesn’t work now).
Are you one of those people that did not find a fitness routine after pregnancy or struggled to find one that worked with your new parent lifestyle? It might have been years since you had a baby. It is never too late to adjust your exercise routine.
After pregnancy, I also didn’t understand that the 1 HIIT & 1 spinning class that I used to do every week before pregnancy weren’t the right things to do after pregnancy for my body and the condition I was in. Reintroducing the same type of exercise into my life simply felt worse after pregnancy. This totally infuriated me. First there were all the things no one told me about going through pregnancy, now this?!?! WTF??
In the end, what most postpartum women need is gradual, effective core conditioning (your core includes things you can’t see like your pelvic floor!) and unilateral exercises to bring their body back into balance, not 1000 ab exercises that are suddenly introduced into the routine.
PRACTICAL TIPS for when you’re not doing effective postpartum exercise (aka what worked before pregnancy doesn’t work now):
Focus on ‘unilateral’ exercise - This means single leg and single arm work. Why? Because doing a movement where you have to balance both sides of the body at once, like a squat, actually masks your imbalances. If you have to do single leg squat, on the left leg, then on the right leg, you’ll quickly realise you have a weaker side! Regularly doing unilateral work will help to make you stronger, and narrow the gap between one side and the other to bring balance to your body.
Actually do the pelvic floor exercises your doctor or pelvic floor physio gave you - That counts as a workout too! The pelvic floor is the most important muscle in your body, the core of your core. There are too many benefits to list here but often women find that once they work on this, it takes the load off their lower backs which were compensating for a weak pelvic floor.
See a professional - I saw a corrective exercise specialist and learned I had always had hip imbalances that caused some core issues that were exacerbating my pains during spinning and HIIT classes. Once I worked on reducing my imbalances, I was able to return to some of my former routines.
Tap up your community - Ask other mums what worked for them after pregnancy, can they recommend any effective classes or specialists that helped them?
5. Something more serious is up and you need to seek medical help.
Thankfully, not as many women fall into this category as the others, but it is the category that can be the most difficult to resolve since it often a while to get diagnosed so this requires patience.
My pelvic floor physio once said to me; “I would be a millionaire if I got 1 euro for the amount of women I come across that say ‘I knew something was wrong’ but they don’t follow up with their medical providers to figure out what it actually is.”
I experienced constant pain after childbirth and to cut a long story short, it turned out that I had a double prolapse. It took years and visits to multiple specialists to figure this out. Eventually, I had a major surgery and rehabilitated my body, read about it here. It would have been a quicker cycle if I had followed some of the tips below.
PRACTICAL TIPS if you believe something more serious is up and you need to seek medical help.
Good people know good people - Many people go round in circles from doctor to doctor with long term health issues. If you don’t have a good relationship with your doctor and you feel they aren’t listening, don’t just accept that. Get another opinion. I found that having a good gynaecologist that listened to me, referred me to other specialist they knew helped a lot with getting a diagnosis and took a lot of stress away.
Don’t ignore the boring checks - Although I was advised to after my 6 week post partum gyno check, it took a while to see a pelvic floor specialist because I couldn’t be bothered with the admin and I didn’t understand the importance of it. It just felt like more boring work. Then after experiencing further pain, I was forced to get it together to see someone which put me on the path to a formal diagnosis. I wish I hadn’t wasted time, I knew something was wrong and I shouldn’t have ignored my body. Don’t ignore yours when it might be trying to tell you something.
Beware of group fitness classes - If you suspect have a condition, check in advance whether an instructor teacher is trained to teach postpartum bodies. It is a sad fact that most aren’t and may give out counter-productive advice so be cautious. It is common for women to really injure themselves in group classes after pregnancy because these classes were designed for athletic, fitter, injury free bodies. Not postpartum bodies!
Do something new - A lot of postpartum women fear their bodies because they don’t recognise them anymore and then they get stuck mentally. So if you always wanted to go boxing, or pilates or swimming, now is the time to do it. There is nothing like something new to push you out of a rut physically and mentally and reframe how you feel about your body especially coming out of surgery rehabilitation. Just make sure you or your trainer can modify exercises for your condition first.
Try injury rehab resources - One under-utilised resource that often doesn’t come up for helping postpartum bodies are injury rehabilitation clinics. They are for people who might have a broken limb or had a serious accident. These people are fountains of knowledge about how to gradually and safely build up and return to exercise without re-injuring yourself. You may be able to get a referral from your doctor or physio depending on what your issue is.
Our bodies got though a lot in pregnancy. We each only ever have one body so it is vital that we listen to it when it is sending us messages! These messages may come in the form of aches and pains, with a little bit of prioritisation and self care, it is possible to get your body to a place where it is stronger than it has ever been. Go you! Be kind to your amazing body, think about what it just did.
YOU MADE A HUMAN FROM SCRATCH IN YOUR UTERUS. Yeah! You’re a badass mother!
Did any go the above resonate with you? I would love to hear your thoughts.