back pain – kaylee may

19
Jun
2015

Diastasis Recti | Dealing with a common postpartum condition

diastasis recti, pregnancy, pregnancy abs,

Diastasis recti, a separation of your abdominal muscles, is a common condition during and after pregnancy.

The linea alba is a line of fibrous tissue between two sides of the rectus abdominis that runs vertically. When this muscle is stretched throughout pregnancy, there can be a physical separation or widening between the two sides of the abdominal muscle.

rectus abdomis, diastasis recti, linea alba, postpartum, pregnancy,

As outlined in previous posts, the abdominals act as a natural back brace for us. If there is weakness or separation in our natural back brace, a number of pain conditions arise. Unfortunately, diastasis recti is not always recognized early, and I see mothers of all ages in the clinic for hip pain, back pain, knee pain (etc, etc, etc) that arose from weak abdominals. (side note: Obgyns should just start referring women to physical therapists after any type of birth, right?)

I searched the web to find a quick video of how to tell if a diastasis recti is present. I found this video you can use to assess for the presence of this condition:

Let’s all freak out for a minute because we all just realized we have diastasis recti…

ok, I’m still freaking out…

still freaking out…

ok, now I am desperate to fix this!

How convenient there is a post right here about postpartum abdominal strengthening!

There is one thing to add to this strengthening program if you find that you have diastasis recti. Use your hands (or a brace, etc) to physically pull your abdominals together as you perform the exercises. In other words, push your abs together.

diastasis recti, pregnancy, pregnancy abs,

I want to note a few things you should most definitely NOT do if diastasis recti is present:

1. SIT UPS. Like, never. Never, ever do sit ups.

2. PILATES before you do this program.

3. YOGA positions where you are pushing your stomach out (aka abdominal breathing, dead bug, to name a few), yoga positions that STRETCH the abs (cobra), or anything on your hands and knees with poor abdominal control (cat, cow, sunbird).

4. LIFTING without engaging your abdominal muscles. This includes lifting your dear little (or big) baby.

5. Did I already say don’t do sit ups? Just don’t. If you want strong abs, do this.

diastasis recti, postpartum, pregnancy, abdominals, rectus abdominis

I strongly encourage you to seek help from a physical therapist if you have a significant diastasis recti. There is nothing like having an expert treat you one on one to prevent and treat pain. I am not speaking of a personal trainer or fitness guru, although they are helpful for many things. A physical therapist is a movement system expert with a physical therapy degree (7 years of post high school education for a doctorate degree) and has been up close and personal with the rectus abdominis and line alba a la cadaver labs. TMI?! I just want to be clear that seeing a personal trainer is NOT the equivalent.

Your health insurance may help you out with the cost of physical therapy. If you don’t want to see a doctor first to get an order for physical therapy, call your local PT clinic and see if they have direct access. If you don’t know what direct access is, please read my explanation here.

Happy abdominal strengthening, ladies!

If you are interested in more pregnancy and postpartum health tips, read my previous posts!

The Do’s and Don’ts of Breastfeeding: How to prevent musculoskeletal pain

Postpartum Abdominal Strengthening

Pregnancy and Back Pain

Top 3 Exercises Every Pregnant Woman Should Do

Return to Running After Pregnancy

***The content of http://www.kayleemay.com is for informational purposes only. The information presented is not to be taken as professional medical advice, diagnosis, or treatment. If you are having pain, or seeking medical advice, talk to your health care provider. Do not delay in seeking treatment because of information you have read on http://www.kayleemay.com. Taking recommendations presented on http://www.kayleemay.com is solely at your own risk***

22
May
2015

The Dos and Don’ts of Breastfeeding | How to prevent musculoskeletal pain

categories: Health, Low back pain, neck pain, Pregnancy

Sometimes it seems like breastfeeding is a sport. It requires concentration, endurance, a balanced diet, practice, patience, and sheer determination.

The more you do it, the more weight you lose. (insert thumbs up emoji)

The more you do it, the more you are prone to injury. (insert thumbs down emoji)

Breastfeeding can cause back pain, neck pain, shoulder pain, and wrist pain. Each pain condition is directly related to posturing while nursing. The good news is, posture can be easily adjusted to reduce the risk of pain associated with breastfeeding.

In this post, I will discuss the most common breastfeeding positions and talk about how they can cause pain and what you can do to prevent the pain.

The key to good breastfeeding posture is taking the time to prepare for the nursing session. Your baby might be screaming his precious little head off, but take 5 extra seconds to think through your position and set up before latching on the starving little babe.

CRADLE HOLD

Source: BabyCenter.com | Positions and tips for making breastfeeding work

I’ve never personally done this position because…ouch. Seton was born at a whopping 8 pounds, 10 ounces and (obviously) has only been getting bigger. I was NOT ABOUT to hold that weight in the crook of my elbow for 15+ minutes at a time. In the picture above, one can see the weight of the baby will pull the entire right shoulder blade forward which subsequently rounds out the upper back.

This picture also shows the mother tenderly looking down at her child. Let’s all let out a group sigh…”awwww”… and then let’s never do that. Looking down at your infant for the duration of the feeding causes the muscles on the back of your neck to work really hard for a really long time in a really elongated position. Really. And that’s a workout those muscles just don’t need. (did I say “really” enough to make my point?)

A better option is to place the infant on a stack of pillows (and/or a boppy) to take the pressure off the supporting arm and shoulder. Once the baby is latched, keep your neck tall and look forward. Alright, you can peak at the cutie pie once in a while.

To prevent lower back pain, make sure your feet are supported and not just dangling from the couch or rocking chair. Sit evenly on your buttocks. If you have one foot tucked under your hips, your back is in a bent and rotated position that can cause pain.

THE CROSS OVER HOLD

This is similar to the cradle hold, but the position of the arms are switched. For this position, I suggest to make all the changes recommended above.

These two positions put an enormous amount of pressure on the arms and pull your upper back forward. Unless you’re going for the hunchback look, USE PILLOWS to support the baby!

Also make sure your back is fully supported. In some chairs your feet may not reach the floor if your back is supported on the back of the chair. In this case, you may need to use pillows behind your back to support your back and allow your feet to touch the floor.

THE CLUTCH OR FOOTBALL HOLD

This position is great for so many mothers including those with large breasts, those with twins, and those who have had a Cesarean section.

As you may have guessed, I recommend placing the infant on pillows so you take out the work your arm would have to do. Sit with your back supported so that the arm that is guiding the infant’s head does not have the tendency to pull your shoulder girdle forward and cause your back to round out. As always, once the infant is latched, keep your head up and look forward. Your feet should be supported.

THE RECLINING POSITION

Great was the day that I mastered this position because it meant I did not have to sit on my postpartum bum. (TMI?) This is also a great position if you have low back pain. Just remember to support your head with pillows so your neck is in a neutral position. I’ll take this moment to refer to my post on the Ergonomics of Sleep where I mention the importance of keeping your neck in a neutral position while laying down. Don’t prop your head up with your hand like the ever-so-informative cartoon shows above.

To summarize the dos and don’ts of breastfeeding:

DON’T support the weight of the baby with your arms.

DO rest the infant on pillows and/or a boppy (I use a boppy and pillows galore and have remained pain free).

DON’T look down at your baby for the duration of the feeding…(or your Kindle, Nook, or iPad…)

DO keep your neck in a neutral position.

DON’T allow legs to dangle or be crossed under your booty.

DO make sure feet are flat on ground or stool to take pressure off the low back.

Happy nursing and feel free to message me with any questions!

27
May
2014

{Health and Body} Pregnancy and Back Pain

categories: Health, hip pain, Low back pain, Pregnancy

Lately I have been eating, sleeping, and dreaming pregnancy. So when I thought about what I want my readers to know about {health and body} this week, backaches during pregnancy seemed to be an appropriate topic.

Does anyone else’s husband break out into this song when you say to him, “My back aches…”?

No? Just my husband? Figures.

What is it about pregnancy that makes our backs hurt, sometimes to the point of sending shooting pain down our legs?

There are a million-ca-trillion things going on in our bodies during pregnancy that contribute to backaches.

One of the main reasons for back pain is our changing hormones. Yes, you read it right, those little buggers not only bring us into an emotional roller coaster and make us think cruel thoughts. The hormone relaxin also makes our ligaments looser, causing instability in our spine and pelvic area. Instability can lead to pain.

Weight gain, especially rapid weight gain, puts strain on our body by increasing pressure through all our joints. We are supposed to be gaining 25-35 pounds in pregnancy–sheesh! Think about how that weight can pull down on our backs, reducing the space between our vertebrae and causing compression of various nerves and blood vessels.

As pregnancy progresses, our cute bumps start to pull our backs forward leading to an extension force (as described here) The force that pulls our low backs forward also leads to pain.

Additionally we have lost our “natural back brace“, that is, our abdominals. Our abdominals are being stretched to the max, so no matter how hard we try, it’s nearly impossible to use our abdominals to support our backs during daily activities like walking, washing dishes, bending over to pick things up from the floor, and going up and down stairs.

So what’s a pregnant woman to do (besides listening to her husband’s version of Ciara ‘Got Me Good’ daily)? Refer to my previous post on the Top 3 Exercises Every Pregnant Woman Should Do. Each exercise can help relieve back pain and promote stability in our pelvic girdle and spine

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***The content of www.kayleemay.com is for informational purposes only. The information presented is not to be taken as professional medical advice, diagnosis, or treatment. If you are having pain, or seeking medical advice, talk to your health care provider. Do not delay in seeking treatment because of information you have read on www.kayleemay.com. Taking recommendations presented on www.kayleemay.com is solely at your own risk***

08
Feb
2014

Improve Your Running Stride Part III: The Running Shoe

categories: Exercise, foot pain, Health, hip pain, knee pain, Low back pain, running

I have spent a long time looking for a running shoe that has firey blazes shooting from the back that miraculously make me run faster. My search continues to this day. I will not give up.

"Mama says they was magic shoes." — “Mama says they was magic shoes.”

In the meantime, it’s important to find a shoe that fits the shape of your own particular foot, promoting the best and most optimal relationship between your foot and the ground. A fitted shoe has the ability to lower your risk of injury.

Finding the right running shoe requires an understanding of foot mechanics. To simplify foot mechanics, think of two different foot movements: supination and pronation. Both of these movements are very complex and involve multiple joints, but for the purpose of this post, pronation is when the arch of the foot moves toward the floor and supination is when the arch of the foot is raised.

In a static standing position, you may have a supinated foot defined by a raised arch. This type of foot is classically more rigid.

A pronated foot has a collapsed arch and is classically more flexible.

To decide what type of shoe is best for you, the first step is to figure out if your foot is pronated, supinated, or neutral. To figure this out, I recommend having someone trace your foot while you are standing. Look at the tracing and determine if it is more pronated, supinated, or neutral. It is important that you are standing so the you are fully weight bearing.

This is an example of a pronated foot with a notable rectangular shape:

This is an example of a neutral to supinated foot with a larger curve on the inside:

Ideally, the bottom of the ideal shoe should match the shape of your tracing. If your foot is pronated (or flat), the bottom of the running shoe will look more like a rectangle. If your foot it supinated, the inside of the running shoe should curve inward.

It is also very important to consider what happens to the arch of your foot when you move. Some people may stand with a very high arch, but once they walk or run, their arch collapses. If you feel as though you fit in that category, I would recommend finding a local running store that has a good reputation. They should be able to watch you run and recommend a shoe for you.

So as we wait for rocket shoes to be invented, make sure your current running shoe is the right shape for your foot–and if it’s not, be sure to invest in a new pair to prevent injuries.

***The content of www.kayleemay.com is for informational purposes only. The information presented is not to be taken as professional medical advice, diagnosis, or treatment. If you are having pain, or seeking medical advice, talk to your health care provider. Do not delay in seeking treatment because of information you have read on www.kayleemay.com. Taking recommendations presented on www.kayleemay.com is solely at your own risk***

25
Jan
2014

Improve Your Running Stride Part II: The Gluteals

categories: Exercise, foot pain, Health, hip pain, knee pain, Low back pain, running

In my previous post Improve Your Running Stride Part I: The IT Band, we discussed how runners typically have stiff IT bands. A stiff IT band has the potential to lead to hip pain, knee pain, foot pain, and back pain. Simply stretching the IT band will not solve the problem; rather, a runner has to change how he uses his muscles when he runs to prevent the IT band from tightening up.

As mentioned in Part I, the key to reducing the use of the IT band lies in increasing the recruitment of the gluteals during runs (a stronger booty!)

Changing your running form can be a daunting task and may require increased energy expenditure at first. But with these three basic tips, you will be using your gluteals—which are some powerful muscles—in no time.

On your next run, practice these three things:

1. Think of yourself as one of two types of runners: a runner who pulls himself forward with each step, or a runner that pushes himself forward with each step. To use your gluteals, you need to be a runner that pushes yourself forward. Give the ground a good push to get to your next step.

2. With respect to number one, make sure your foot hits the ground directly below your body as opposed to reaching ahead of your body. If your foot reaches too far forward, you will likely have to pull yourself to the next step. When you think of placing your foot directly below your body during your next run, you may feel as though you are leaning forward. Strangely enough, that’s okay. Leaning forward a little puts your gluteals in a position in which their contraction will much stronger.

3. As your leg is swinging through, but before it contacts the ground, raise your knee a little higher. Colleagues of mine commonly use the cue, “pretend you’re riding a bike down a hill and your legs are trying to keep up with the pedals.” Raising your knees up will bend the hip more, allowing the gluteals to work through a greater range of motion. Another benefit of bringing your knees higher is that it allows more time in the air and less time on the ground. Research shows that faster runners spend more time airborne than slower runners. Therefore, this little clue may get you to the finish line quicker.

Changing the way you run in even the smallest way will initially make your runs more fatiguing. I encourage you to practice these three things in two minute intervals until you feel like you are getting the hang of it. You’ll feel funny running this way at first, and you will be sore the next day. But no worries; keep practicing, and it will become second nature.

Now you can spend more time running and less time stretching your IT band.

Are you curious about which running shoes are the best for your foot? Part III will discuss how you should go about choosing a running shoe based off the shape of your foot.

***The content of www.kayleemay.com is for informational purposes only. The information presented is not to be taken as professional medical advice, diagnosis, or treatment. If you are having pain, or seeking medical advice, talk to your health care provider. Do not delay in seeking treatment because of information you have read on www.kayleemay.com. Taking recommendations presented on www.kayleemay.com is solely at your own risk***

22
Jan
2014

Improve Your Running Stride Part I: The IT band

categories: Exercise, foot pain, Health, hip pain, knee pain, Low back pain, running

Are you a runner? Or, in my case, are you an inconsistent light-jogger that moves at a slightly faster pace than speed walkers?

Whatever your speed is, you probably have a stiff IT band and have tried a gazillion stretches to loosen it up. Maybe you have even tried one of those foam rollers that just hurts so good. But after all that, is your IT band still “tight?”

Probably.

Maybe you aren’t sure if your IT band is stiff. In that case, I want you to ask yourself if you have any bothersome pain while running or after running, like knee pain, hip pain, back pain, or foot pain. Your IT band may be contributing to these frustrating symptoms that affect your runs.

So how can you get that annoying band to loosen up?

First, let’s discuss what the IT band is. God is clever, and He didn’t put tissue in our bodies to hang out there. It all serves a purpose.

Image: Netter FH. Iliotibial band friction syndrome. Image Source: http://www.netterimages.com/image/iliotibial-band-friction-syndrome.htm — Image: Netter FH. Iliotibial band friction syndrome.
Image Source: http://www.netterimages.com/image/iliotibial-band-friction-syndrome.htm

IT band stands for iliotibial band. By its name, it is a band of thick fascia that connects the ilium to the tibia. The connection to the ilium, a part of your pelvis, is by way of the tensor fascia latae muscle, aka the muscle that tenses your fascia a-lotta!

When the tensor fascia latae contracts, the IT band tenses. If this happens repeatedly (a lotta!), the IT band gets tight, or as I like to describe it, short or stiff.

So the answer to the age-old question of stiff IT bands across running circles all over the world…

Image source: http://blogs.bmj.com/bjsm/category/children/

If you’re a runner whose IT band is stiff, it’s because you contract your tensor fascia latae too much.

Contract a muscle too much? Is it so? Can it be possible? Yes. It is possible to contract a muscle too much if it means you are neglecting the muscle’s counterpart, therefore altering the joint’s balance. In the case of runners and IT bands, a stiff IT band usually signals that the runner does not use his/her gluteals enough. This muscle imbalance commonly leads to pain because it alters hip and knee joint mechanics.

You may think I am going to tell you to do gluteal strengthening exercises and bippity-boppity-boo, you’re healed.

I wish it were that easy. While strengthening exercises can be useful, I am going to suggest that you change the way you run.

It is incredibly difficult to change your running form, but in my next post, I will give you 3 simple clues to think about when you’re running so you use your gluteals relatively more than you use your tensor fascia latae and IT band. With these 3 tips, you will rely less on your tensor fascia latae and IT band, therefore it won’t get so stiff! And word on the street is, these tips will help you run faster…

***The content of www.kayleemay.com is for informational purposes only. The information presented is not to be taken as professional medical advice, diagnosis, or treatment. If you are having pain, or seeking medical advice, talk to your health care provider. Do not delay in seeking treatment because of information you have read on www.kayleemay.com. Taking recommendations presented on www.kayleemay.com is solely at your own risk***

15
Jan
2014

Save heels for the weekend

categories: foot pain, Health, hip pain, knee pain, Low back pain

Here’s a riddle for you.

Who owns 200+ pairs of high heels and suffers from low back pain?

This girl:

“Who, me?”

I LOVE high heels. I NEED high heels. (side note: my husband tells me I use the phrase “I need it” too much. Don’t know what he’s talking about). I feel like high heels were MADE for girls like me. God blessed me with short, stubby legs and a torso long enough to make me think I have extra vertebrae. I NEED the length that high heels offer my short legs.

But let’s talk about what high heels do to our bodies from a mechanics stand point, and how that can result in pain in strange places (not just our toes).

First, we need to think of our bodies in terms of lever arms, joints, forces, and vectors. Remember physics? Remember Newton? His third law stated, “For every action there is an equal and opposite reaction.”

Let’s keep this in mind.

There’s a million and one ways high heels change the orientation of our posture and movement, but I am going to focus on 3 for today.

1. Due to the upward force of the actual heel (aka the stiletto), the posterior part of our pelvis is raised. This is awesome for the booty. This exact effect is what I believe inspired Sir Mix-a-lot’s song, “Baby Got Back.” If Newton’s third law is correct (which it is), then there must be an opposite reaction from our upper body so we don’t get thrown forward. We have to lean back to keep our shoulders over our hips. This causes an extension force on our low back, and subsequently pain if this position is maintained for long periods of time. You can see this happening to Kim Kardashian when she tries to figure out how to pump gas.

2. Keeping in mind that the posterior part of our pelvis moves UP due to the force of the heel, the front part of the pelvis must move DOWN. The muscles on the front part of the pelvis that connect the pelvis to the femur (thigh bone) are subsequently placed in a shortened position. No big deal if this is for one night, but over time, shortening of these muscles feeds into pulling the pelvis forward even when we are just in our slippers at home! Pulling the pelvis forward causes that extension force in the low back we talked about in #1. Ouch.

3. The third and most obvious consequence of high heels is that they shorten our calf muscles. Again, this is pretty awesome when we feel inclined to wear heels after that killer calf workout so we can show off the definition we worked so hard for. Thank you, heels, for making my stubby legs look fake-muscular. But once we take those heels off, the shortened calf muscles pull our knees backward, likely causing hyperextension. Do you know a female over the age of 50 who has had a knee replacement? You can tell her to thank her knees for all that hyperextension in her youth. At least now her new metal knees give her an excuse to avoid the metal detectors in the airport. Oh, but unfortunately that results in an awkward pat-down. It’s a lose-lose.

Photo from lotusimprints.com

So there you have it. High heels cause our backs to extend, our hip flexors to shorten, and our calves to pull our knees beyond where they should be.

But, if you’re like me, you can’t give up heels completely. We NEED them, right? So wear heels in moderation and live by my mantra: Save heels for the weekends.

Cheers to being female.

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Tag: back pain