How to Take Care of Your Joints During Postpartum Recovery?

What is Postpartum Joint Pain?

Postpartum is the immediate period after a woman gives birth. It lasts for at least one and a half months. 

It is common for a pregnant woman to undergo specific changes in the body, including adverse effects such as pain in different areas of the body. But is postpartum joint pain normal?

What Causes Postpartum Joint Pain?

The hormonal and musculoskeletal changes that occur during pregnancy can continue to stay so at least for a few weeks after delivery. So, yes, this pain is expected for another six months post-delivery. 

Medical experts say that if the pain remains even after that point, it has to be related to some other causes than the hormonal changes which occurred during pregnancy.

Though the most common joint pain after carrying your baby for nine months is hip and back pain, it can manifest in other joints like hips, knees and wrists.

Postpartum Joint Pain: Why and How?

The most common cases of postpartum joint pain have the following causes:

Hormones: There is a drop in the hormone oestrogen after childbirth. A sudden deficiency in oestrogen can affect your joints and the structures around them. 

Physical Strain: There is a considerable gain of weight and increased pressure on the body structures during pregnancy. This strain and stress are even more during childbirth, such as slight changes in the position of the pelvic bones from their original place.

Change in Body Mechanics: Pregnancy changes your posture and the way you walk. You may continue holding yourself that way even after childbirth by habit, which can impact joint alignment.

Natural Relaxation of the Body: Your body produces a particular hormone during pregnancy called relaxing. Relaxin is a get-ready hormone that helps the uterus to relax as much as possible to accommodate your baby. But somehow, this hormone impacts other tissues, thus loosening the ligaments in joints.

Reduced Physical Activity: Women tend to move less during pregnancy and reduce their general physical exercises. Reduced physical activity reduces muscle tone and strength.

Inflammation: There is an increased fluid retention in the body during and immediately after pregnancy. The fluid retained in joint spaces can lead to inflammatory changes due to unoccupied pressure on the structures.

Even any pre-existing inflammatory conditions such as osteoarthritis or rheumatoid arthritis can exacerbate.

Fatigue and Stress: Postpartum is a period of sleep deprivation which leads to fatigue. Stress is also sometimes inevitable during this stage of life. But these can impact the body, increasing the inflammatory response, muscle tension and joint pain.

Carrying the Baby and Breastfeeding: You may change posture and take physical strains while having or breastfeeding your baby. These are inevitable, though you can adopt better postures and accessory aids to help you take care of your body.

Injuries During Childbirth: If you have faced any unexpected injuries to your joints, especially the pelvic joint, you may feel pain during your postpartum period.

Nutritional Deficiencies: Postpartum is when you excessively provide for your child.

What if this joint pain does not reduce even after your postpartum recovery? What are the usual causes besides the physiological changes in the body?

• The continued effect of oestrogen on joints.
• Severe injury or trauma to the joints during childbirth.
• Overweight or obesity.
• Exacerbated autoimmune condition.
• Endocrine imbalances such as thyroid dysfunction.
• Psychological effect on the pain factor.

Medical experts stated that most women experience long-term sustained pain even after postpartum solely because of stress and psychological causes.

Common Joint Pain Areas After Pregnancy

There is a lot of stress during and after pregnancy on a woman's body. Some of the most common areas are as follows:

Hip Pain 

Hip pain can be due to two conditions during pregnancy;

Symphysis Pubis Dysfunction (SPD)

The relaxin hormone, which can relax all the muscles and ligaments in the body, loosens up the pelvic ligaments to accommodate the baby moving down during delivery. These structures may remain loosened for a period, causing SPD.

Hip Muscle Strain

There is a lot of stress on the muscles in and around the waist and hip region due to the constant pressure you put on them during childbirth. These muscles may become weak and overused.

Hip Pain After C-Section

When anaesthesia is delivered, a C-section involves a lot of strain on the hip and back. Sometimes, there can be pain from the injection, which radiates to the hip from the back.

Knee Pain 

Patellofemoral Pain Syndrome (PFFS): A change in posture, how you walk, and irregular weight distribution can strain the knee joint immensely and cause knee pain after delivery. This strain is because the knee joint takes a large part of weight bearing in your body.

Back Pain 

Lower Back Pain

Childbirth involves the whole of your lower back muscles. The strain may sometimes cause a slight slipped spinal disc or a heavy pressure on the back muscles. 

Upper Back Pain

Neck pain can come from staying in one posture as long as you breastfeed the baby.

Wrist and Hand Pain

Carpal Tunnel Syndrome

Carpal tunnel syndrome is severe pain in the wrist region due to inflammation around the nerve passing through your wrist. 

De Quervain's Tenosynovitis 

It is an inflammation of the tendons passing to the thumb.

The inflammation and increased fluid in the wrist area, repetitive injury and muscle stress can lead to these causes.

Ankle Pain 

During pregnancy, there is a heavy load on the lower limb. Sometimes, there are chances that the blood circulation of the legs may become weak. This weakness causes fluid retention in and around the legs, especially the ankle joints. This swelling causes pain.

Generalised body pain and joint pain are common after childbirth. But, extra care towards individual joints can help you spend your happy time with your whole heart. 

Importance of Postpartum Joint Care

Refrain from thinking that you can solve your problems some other time after giving your full attention to your baby after childbirth. It is always great to care for yourself only to provide better care to your child.

You have to prioritise your postpartum joint pain for reasons such as;

1. Taking care of your joints helps you heal and recover sooner.
    
2. A good, healthy joint allows you to engage in daily activities while completely taking care of your newborn.
    
3. A painless postpartum period can make your mood better.
    
4. Considering a proactive approach towards postpartum joint pain can prevent chronic conditions.
    
5. A pain-free time will improve your bonding with your baby by completely being active with them.
    
6. Being strong physically naturally boosts your confidence and self-esteem.
    
7. Being muscular in joints and muscles can even prevent any future injuries. 

Postpartum Joint Exercises: A Step Towards Strengthening

The basic concept of improving joint health is improving your muscles' strength.

• A well-built muscle helps support and hold on to your bones, thus anchoring them in place. 
   
• Exercise also makes the bones work more efficiently, thus regenerating the weak areas.
   
• In addition, exercise helps you improve the functioning of your brain, especially the hippocampus area, which is susceptible to brain degeneration and psychological conditions. Improving this area can help you improve your mood and positive attitude during your postpartum period.

Some of the exercises you can start doing during your postpartum period are : 

1. Pelvic floor exercises
2. Deep squats with wall support
3. Side-lying leg lifts
4. Seated knee exercises
5. Heel raises

Let us go into detail on some of the important ones for you.

Pelvic Floor Strengthening Exercises Like Kegel Exercise

Kegel exercise is essential for a woman who has recently given birth. Pelvic floor muscle strengthening is crucial as it supports the organs in the region like bladder, uterus and anal canal.

The exercise is essential for the following reasons:

1. Strengthens the pelvic floor muscles, which become weak due to the stress and strain of delivery.
    
2. Reduces the chances of symptoms like urinary incontinence (involuntary dripping of urine), uterus slippage, etc., after childbirth.
    
3. As the strength of the joints reduces during pregnancy and childbirth, strengthening of pelvic muscles aids in giving more power to the joints.
    
4. Kegel exercise also improves your sexual satisfaction by increasing the vaginal tone.

How to Perform Pelvic Floor Exercises? 

1. Identify the muscles that you use to stop your urine midstream or those that you use to prevent passing gas. Now you know which are the muscles that are involved in the exercise.
    
2. Squeeze the release of these muscles repeatedly whenever you can, at least 3-4 times a day.
    
3. Squeeze without breathing or tensing your back muscles, abdomen or thighs.
    
4. Whenever you squeeze, hold it for around 5 seconds. Gradually increase the duration to 10 seconds.
    
5. Let your muscles fully relax between contractions.

Low-Impact Workouts for Joint Health

When you are too busy or stressed to carry out exercises in your daily routine, adding low-impact exercises can be an easy way to strengthen your joints.

Some of the options you can go for are as follows:

Leisurely Walking

Start slowly and gradually increase your pace and duration according to your stamina. Simple walking can strengthen your leg and hip muscles.

Swimming and Water Aerobics

Whether you are good at swimming or not, floating in the buoyancy of water puts less stress on your joints than regular exercises. It is suitable for muscle toning and overall blood pumping.

Cycling on a Stationary Bike

When you cycle, your hips, knees and ankle joints move regularly. Cycling can immensely help in strengthening your lower body.

Postpartum Yoga

Yoga is a gentle strengthening technique that helps you align with your mind. Many yoga poses, like the cat, cow, and child's poses, are gentle stretches that are beneficial. Breathing exercises, along with yoga, can also strengthen your abdominal muscles.

Seated Exercises

You can sit in a chair and do activities like seated march, sitting torso twists and leg lifts. These are good for joint mobility.

Try low-impact exercises for your other joints to reduce the whole body's fluid retention. You can rotate and move your wrists, shoulders, neck or any part of your body to keep your muscles and yourself active throughout the postpartum period.

Self-Care Practices for Postpartum Joint Relief

Taking care of yourself is much needed to take care of your baby. Adjusting to your new routine can be overwhelming, but a woman can mother mountains for her child.

If you experience on and off joint pains during your postpartum period, here are some easy tips to alleviate your joint pain.

Heat and Cold Packs

Apply cold to an area if it looks sore and if you have injured any joint. Cold packs can immediately reduce inflammation. 

Apply heat packs if you have had this joint pain for many days. Hot packs can relax your muscles and improve blood flow.

Gentle Massage

Use your fingers, knuckles or base of the palm to gently massage in circular motions to relax and improve circulation in the area of pain.

Epsom Salt Baths

Epsom salt is a known muscle relaxant. It contains magnesium and acts well on muscles and joints by soothing and reducing soreness.

Rest and Sleep

You need the right amount of rest and sleep so that the strain of childbirth can heal by itself. Moreover, the excessive pressure and stress on your joints during childcare need some rest. Fatigue also can increase joint pain.

Compression Garments

Postpartum compression garments like belly wraps and supportive bras are available. These can provide gentle compression and support to the joints.

Daily Postures and Body Mechanics

Good body mechanics is essential to keep your musculoskeletal system strong. Body posture is important during your postpartum period and your whole lifetime.

But are there some constant postures in the postpartum period that can negatively affect your body mechanics?

Yes, some of these are from how you run up and down the whole day doing things right for your child.

Sometimes, it may be how you keep your body when breastfeeding.

Did You Know?

The centre of mass of the human body is around the lower abdomen and pelvis.

Let's check some tips to keep your body mechanics sound and centre of mass aligned.

1. Maintain a neutral spine when sitting or standing by aligning your ears, shoulders and hips in the same line. Use pillow support if necessary.
    
2. Use your abdominal core muscles to support your back whenever you use your back for daily chores.
    
3. It is usual to have prolonged standing pain near your shoulder and upper back region due to breastfeeding. Roll your shoulders backwards and move your neck sideways whenever you sit to feed.
    
4. You may use supportive pillows when you are breastfeeding to avoid hunching forward. 
    
5. Keep your hips and knees in the exact alignment whenever you sit. Doing this will relax the thigh muscles and the hip joint.
    
6. Try not to keep your legs crossed for a long duration.
    
7. Avoid uncomfortable footwear such as pointed heels, shoes which are too tight and footwear without proper hold on your leg. 
    
8. Developed ergonomic strollers, carriers and other baby gear can reduce the strain of carrying your child. These props help you distribute the weight evenly and reduce stress on your shoulders and back.
    
9. Use whatever props you may need to adjust your sitting postures. Using a footboard to keep your foot flat on the floor or using adequate lumbar support can help reduce the strain on the muscles and joints.
    
10. Adjust your posture for discomfort or pain in a particular position. Your body knows the sign to let you know.

Seek Support When You Need It

Taking care of yourself is essential, but understanding when you must hand over the baton to whom and when is another crucial thing. 

Know that you must seek professional advice when your self-care methods no longer work for you.

Some of the experts you can turn up to are as follows:

• Obstetrician/Gynaecologist
• Orthopaedic specialist
• Physical therapist
• Postpartum rehabilitation experts
• Chiropractor
• Nutritionist / Dietician
• Holistic and integrative medicine practitioners

Get in touch with our team of caring health experts to know more about your joint pain.

To Sum it Up

Postpartum joint changes sound simple, yet the condition is complex. The changes that take place in a woman's body is just a change of hormones. It can range from simple joint pain to severe weakness of the whole musculoskeletal system. Keeping oneself physically fit can help keep the joints and muscles going more than you imagine.

Explore Nirva Health's postpartum recovery programmes and resources for further guidance on joint health after pregnancy.