Posture and movement in women after childbirth
The extent to which womens’ postures and movement patterns change after childbirth is somewhat ignored, possibly due to the fact that we do not measure the alignment and movement health of mothers until there are symptoms, if at all!
The changes are not necessarily due to pregnancy and childbirth but also the lifting and carrying that are necessary after childbirth. A proactive approach that routinely measures and prescribes personalised corrective exercise is needed - for everyone!
It is much easier to train a pain-free body, and to maintain an active lifestyle, both of which are positive for the physical and mental health of our beloved mothers.
Mother with a 1 year old child still complaining of lower back pain and limited function during activities of daily living. Alignment just in standing is clearly off.
Mother with 1 year of back pain that has equal reach distance but very different movement strategy in the hips.
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Pelvic and lower back pain are very common issues for women after childbirth, with varying incidences reported across different studies. Here's a summary of what the research indicates:
Lower Back Pain (LBP) after Childbirth
High Initial Prevalence: Many studies report that a significant percentage of women experience LBP immediately after delivery. Some sources state that up to 75% of women experience back pain right after birth.
Persistence:
While many cases resolve within a few months, a notable proportion of women continue to experience pain.
25-43% of women report persistent LBP beyond 3 months postpartum.
Around 40% may still experience pain beyond 6 months.
Some studies indicate that 21.1% of women have ongoing back pain 24 months after delivery.
Even years later, a history of pregnancy and childbirth is associated with an increased prevalence and severity of functionally significant back pain. One study found that 14% of women with acute postpartum back pain did not have resolution more than 5 years later.
Risk Factors: Factors associated with persistent postpartum LBP include:
Pre-existing back pain before or during pregnancy.
Physically demanding work.
Multiple pregnancies
Being overweight.
Severe acute postpartum back pain.
Mode of delivery (some studies suggest higher incidence after C-section, while others show no significant difference or even reduced odds of long-term pelvic pain with C-sections, particularly planned ones).
Epidural analgesia (some studies suggest a higher risk).
Pelvic Pain after Childbirth
Common in Early Postpartum: Pelvic pain is also very common. Around 1 in 4 women have some pelvic pain at 3 months after having a baby.
Resolution and Persistence:
Many cases improve naturally, with only about 1 in 10 women still having pain by 8 months postpartum.
However, genital and pelvic pain can persist for longer than a year for a significant percentage of mothers. One study found that almost half of participants (at an average of 14 months postpartum) reported a current (18%) or resolved (26%) episode of genital or pelvic pain lasting 3 or more months.
Chronic pelvic pain (lasting for an extended period after three months in the hypogastric area or perineum) is less frequent, with estimates around 0.3% to 1.7% of vaginal births at 12 and 18 months after delivery in large population studies.
Types and Causes: Pelvic pain can manifest in various ways (pubic area, tailbone, groin, generalized ache) and can be caused by:
Hormonal changes (relaxin loosening ligaments).
Birth-related trauma (tearing, episiotomy, nerve stretching, coccyx injury).
Pelvic girdle pain (pain from muscles, ligaments, or joints of the pelvis), which is common during pregnancy and can persist.
Weak abdominal and pelvic floor muscles.
Pelvic organ prolapse.
Scar tissue from tears or episiotomies.
Assisted vaginal delivery (forceps or vacuum cup) may increase the likelihood and intensity of pelvic pain.
A history of other chronic pain conditions.
Key Takeaways
Both lower back pain and pelvic pain are highly prevalent after childbirth.
While many women experience improvement within the first few months, a significant subset experiences persistent or chronic pain. C-section appear to have more problems with function/physical activities.
These pains can significantly impact a new mother's daily activities, well-being, and ability to care for her newborn.
It's important for women to seek professional evaluation if pain is severe, persistent, or interferes with their daily life, as much of this pain can be managed and improved with proper care, such as physiotherapy.
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Practical tips:
Give the body time to recover - don't jump into Nordic Military training / Crossfit within the first few months. I have had clients who want that six pack asap, and they end up with back pain instead. Focus on engaging the pelvic floor and control of the deep 'core' muscles with a progressive corrective exercise regime.
Consult a physiotherapist, if you have persistent pain, especially if you have had complications during pregnancy or childbirth, or if you have a history of lumbopelvic pain. Better safe than sorry.
Find a personal trainer who can supervise your technique during training. Correct alignment and technical form are so important for avoiding/correcting compensations.
Get your posture and movement patterns measured using MoovmentPro by Qinematic so you can see the compensations in your body, and you get some feedback about improvements. This is great for monitoring progress and for motivation (for you and your trainer/therapist/(and your partner who is worried about you)).
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There is so much literature about this, yet too little done about it!
Postpartum low-back pain: https://pubmed.ncbi.nlm.nih.gov/1531555/
Association between history of childbirth and chronic, functionally significant back pain in later life. https://pmc.ncbi.nlm.nih.gov/articles/PMC9809019
Factors associated with persistent pain after childbirth: a narrative review. https://pmc.ncbi.nlm.nih.gov/articles/PMC7187795/
Pelvic Pain Org, Australia. https://www.pelvicpain.org.au/pelvic-pain-afterpregnancy/
Implications of pain in functional activities in immediate postpartum period according to the mode of delivery and parity: an observational study. https://pmc.ncbi.nlm.nih.gov/articles/PMC5537436/
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Find out more about how to measure posture and movement quality using advanced digital technology at www.moovment.pro
The systematic review just published
The relationship between malocclusion and body posture in children is a topic of growing interest among researchers and clinicians. This systematic review explores the association between dental malocclusion and various aspects of body posture, including the neck, the feet and even the way we walk.
Dorota Różańska-Perlińska et al, The Correlation between Malocclusion and Body Posture and Cervical Vertebral, Podal System, and Gait Parameters in Children: A Systematic Review, J. Clin. Med. 2024, 13(12), 3463
Key Findings:
Malocclusion and General Posture
Studies show a significant association between malocclusion and faulty body posture. Children with severe malocclusions often exhibit poor posture, which can lead to further health complications.
The importance of posture should not be underestimated as a contributing factor to many secondary or downstream problems such as chronic pain, musculoskeletal disorders, and even systemic diseases.
Cervical Vertebral Column and Head Posture
Malocclusion can influence the alignment of the cervical vertebral column and head posture. This misalignment can affect overall body balance and stability.
Correcting dental malocclusions may help improve head posture and reduce related issues.
Feet and Foot Posture
There is a notable correlation between dental malocclusion and foot posture. Proper dental occlusion supports balanced weight distribution on both feet, which is crucial for maintaining good posture and foot disorders.
Gait Parameters
Malocclusion can impact gait parameters, affecting how children walk and move. This can lead to inefficient movement patterns and increased risk of injuries.
Addressing malocclusion through orthodontic treatments can improve gait and overall mobility.
Ref:
(1) Paphalmy, Z.; Kállay, M.; Tomory, I. Scoliosisos gyermekek kezelése közben fellépö fogsordeformitások megelözése [Occlusal deformities in children treated for scoliosis]. Fogorvosi Szle. 1974, 67, 374–376. (In Hungarian)
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