Week 3-4 Exercise Progression:

• Step Matrix
• Clamshell
• Bent knee fall out and March
• Quadruped – Rockback; Pelvic Tilts, Cat/Cow
• Resisted Row
• Shoulder matrix < 90 degrees

Management of thumb and wrist pain:

Mommy’s thumb and wrist is the inflammation of the tendons that lift the thumb up or out to the side and the nerves that run along the inside of your wrist. Managing this early is important for symptoms to not get worse. Symptoms you may experience with tendonitis are pain and burning along the top of your thumb and wrist, tightness in your forearm and hand. Symptoms you may experience with nerve tension along your arm are numbness and “falling asleep” feeling along the inside of your upper arm and forearm or hand. Nerve tension presents from muscle stiffness surrounding the nerve which can present after sustained postures, for example, slumped posture while breastfeeding or holding your newborn for an extended period.

Treatment Strategies:

• Self Massage
  • Forearm- tennis ball or Lacrosse ball 2 min
  • Thumb massage – golf ball, focus on web space between thumb and index finger
  • Upper Trap – tennis ball or Lacrosse ball
• Movement
  • Wrist and finger circles
• Stretching
  • Wrist
  • Pec
  • Cat cow
• Nerve glides
• Bracing and Ice
  • Wrist and thumb brace while holding your child or breastfeeding
  • Ice Wrist and Thumb for 5-10 minutes
  • I found that the Lanisoh Therapy Breast Packs also made perfect wrist and thumb ice packs that I could wrap around my wrist
• Ask your partner or friend for a massage
  • Pressure should be tolerable not painful, if you find a sharp point maintained sustained pressure for 30-60 seconds until it releases and then move to next point

I tried to spend 5-10 minutes during the day to perform these movements or when I was actively experiencing the pain. Pick 2-3 of the 5 things and it will help manage your pain. If your pain progressively worsens for greater than 2 weeks and you have tried these exercises, I recommend seeking out help through Physical Therapy. It is much easier to manage and resolve your pain early on.

I hope these tips were useful. If you are looking for more one on one guidance and support MOTI Physiotherapy has a Pelvic Floor team that has an expertise in pregnant and postpartum population. We offer in person and telehealth visits that are covered by insurance. Do not wait for your first postpartum checkup if you are starting to experience pain from the new demands of motherhood. Our Pelvic Floor Doctors of Physical Therapy can guide you through a personalized plan of care that will support you!

The post Postpartum Recovery Weeks 3-4 appeared first on MOTI Physiotherapy.

Week 2-3 Exercise Progression:

1. Walking
   • I started with walking around my parents pool 3-5 laps and using a short stride because I was recovering from a cesarian delivery.
   • As I felt comfortable I continued with backwards walking and side walking for 5-10 minutes
   • At the end of week 2, I felt comfortable enough to walk to the end of the block and back with my abdominal binder
2. Weight shifting in a quarter squat position – the depth of each movement is unlocking the hips with a slight knee bend
   • Focused on maintaining my breath in the up and down phase of the position
     • See week one postpartum blog for breathing pattern
   • Quarter wall squat
   • Lateral squat
   • Quarter body weight squat
     • Focus is all on maintaining breath in the depth of the up and down phase
     • Spreading the floor with my feet
     • 5-10 reps max, 3-5 second pause at bottom
3. Pelvic Tilts
   • Lying in bed with my knees bent and feet on the bed
   • Small tilting of my pelvis
     • Anterior pelvic tilt: focus on moving your pubic bone towards your belly button
     • Posterior pelvic tilt: focus on moving your tailbone towards the bed
     • As you feel comfortable sink your inhale with the anterior pelvic tilt and posterior pelvic tilt with your exhale
4. Upper Body
   • Body weight wall angel
   • Body weight row
     • 5-10 reps, slow and controlled
     • Try to maintain length of your spine around the region of your bra strap

Cesarian Scar Desensitization

At week two postpartum I also began feeling comfortable with initiating scar tissue desensitization. It can be scary to look or have a material or physical touch to a healing incision. If you go too long avoiding movement or contact to the area muscle guarding and pain can occur in the long run. Desensitization is different than massage and stretching, avoid doing those things until after 8 weeks postpartum, scar tissue is not a bad thing and you want it to occur to have strong and healed incision. I highly recommend reviewing Dr. Lindsay Brunner’s post on Cesarian Scar Mobilization when it is appropriate in your recovery timeline.

Desensitization is using touch, after washing my hands I placed my hands over my scar and would breathe into the area, I would do this for only as long as I was comfortable and a few times a day. Ways to build on desensitization are with different textures, for example, your sheets or clothes. Finally, you can also have your partner gently place their hand on your incision. The goal is to introduce stimulation to the area that is non painful or threatening so that your brain does not create a pattern of needing to over protect the incision.

I hope these tips were useful. If you are looking for more one on one guidance and support MOTI Physiotherapy has a Pelvic Floor team that has an expertise in pregnant and postpartum population. We offer in person and telehealth visits that are covered by insurance. Do not wait for your first postpartum checkup if you are starting to experience pain from the new demands of motherhood. Our Pelvic Floor Doctor’s of Physical Therapy can guide you through a personalized plan of care that will support you!

The post Postpartum recovery weeks 2-3 appeared first on MOTI Physiotherapy.

I was grateful for an amazing nursing staff at the hospital we delivered at and my knowledge as a physical therapist for how to move without straining my incision. I realized that there was no discussion on expectations pre cesarian on pain management and recovery, all our focus was on the birth plan but not what to expect afterwards. I felt so disconnected from my body with not being able to exercise during the last part of my pregnancy and especially after receiving an Epidural.  I would like to share some bed mobility tips and gentle exercises I started in my first 72 hours after my cesarian birth. 

BED TRANSFERS

Log Roll: Going from your back to side to prepare for sitting

• Utilize your hospital bed to your advantage and adjust the head and leg rest to help assist yourself to a semi reclined position
• Exhale and roll to your side
• Once in this position exhale again and use your bottom forearm and top arm hand to push yourself upright. *Exhaling with movement reduces abdominal pressure and puts less stress on your incision
• Once in sitting scoot towards the edge of the bed, raise your bed height as high as you can go without feet coming off the floor
• Lean forward and exhale as you focus on pushing the ground away through your feet to stand

Shifting upward in your bed:

• Adjust the bed to be semi flat
• Hold the hand rails or push through forearms/hands and pull or push your self upwards without holding your breath or pushing through your legs

HOSPITAL EXERCISES

• Diaphragmatic breathing – sitting, sidelying, lying on my back 5 minutes. Focus on nasal inhale/exhale guiding my breath below my belly button, to the side of my rib cage and back of my rib cage
• Glute squeeze – Lying on my back, squeezing my butt cheeks for a 3 second hold
• Quad squeeze – Lying on my back, squeezing my quads to make my legs straight and rigid, for a 3 second hold
• Shoulder blade squeeze – Sitting upright or standing, squeezing my shoulder blades together and pulling my elbows behind me, for a 3 second hold
• Weight shift – standing weight shifts in place working on loading evenly into each foot going side to side and forward/backwards

HOME EXERCISES

*wearing my belly support wrap, here is a link to the one I used https://itsbodily.com/products/belly-band

• Walking 5 minutes – forward, backward, side step…small steps to not pull on incision. Standing weight shifts in place working on loading evenly into each foot going side to side and forward/backwards
• Diaphragmatic breathing – sitting, sidelying, lying on my back 5 minutes. Focus on nasal inhale/exhale guiding my breath below my belly button, to the side of my rib cage and back of my rib cage
• Toe Yoga – Seated – focus on grounding through my feet with even weight bearing through my big toe, fifth toe and heels. Then lift only the big toe off the ground without losing contact on the rest of the foot after about a minute switch to lifting the other four toes without lifting the big toe

Continuation of Hospital Exercises *can be performed during naps or breastfeeding

Breastfeeding:

I felt like Goldielocks trying to find the right spot that felt the most comfortable for breastfeeding. I moved from the bed to the couch, sitting on the toilet or kitchen chair. I was happy I did not purchase a rocking chair or glider because I have moved around so much and found the most comfortable spot has been my home office chair and using my nursing pillow. My friend gifted me the My Breast Friend Nursing Pillow which has been great and when I attempt to nurse in bed I also use a Foam Bed Wedge Pillow.

Breastfeeding has definitely been challenging and anxiety driven, and I learn something new each day. I highly recommend a lactation consultation in the hospital, when you get home and even before you deliver to help with expectations. When my milk first came in it was painful and overwhelming. I found my neck, wrist and thumb starting to hurt, making sure he was maintaining a good latch.

Movements I started to incorporate early on to help ease this pain were:

1. Massage to my forearm and hand

2. Wrist circles

3. Double hand cradle to support my sons head so that the arm supporting his body wasn’t overstressed by taking on the full weight of his head as well

4. Thumb and wrist position – Supporting his head with both my hands allowed me to not wrap my thumb around his head

   • Try to make sure the tip of your thumb is relaxed and not pointing backwards towards your wrist, this will alleviate the stress placed on your thumb extensor tendons

5. Mom’s head and neck position while feeding – Pause every minute or to look forward, roll your shoulders back and sit upward. Gaze along the horizon and gently draw your chin in towards your neck making a double chin and hold for 5 seconds, release and repeat 5 times with a shoulder blade squeeze

6. Diaphragmatic breathing

   • This is a great time to practice your diaphragmatic breathing utilizing your breastfeeding pillow for feedback and focus your inhale going into all aspects of your pillow that is wrapped around you

Changing table and Bassinet lifting mechanics:

• Just like your bed transfer mechanics exhale with lowering and lifting
• Wearing your belly band can help support your back
• Unlock your knees with bending and lifting and don’t round through your mid back
• If you are not ready to lift ask for help from your partner

I hope these tips were useful. If you are looking for more one on one guidance and support, MOTI Physiotherapy has a Pelvic Floor Specialilst team that has expertise in pregnant and postpartum population. We offer in person and telehealth visits that are covered by insurance. Do not wait for your first postpartum checkup if you are starting to experience pain from the new demands of motherhood. Our Pelvic Floor Doctors of Physical Therapy can guide you through a personalized plan of care that will support you!

The post My first week Postpartum: Cesarian birth recovery and body mechanics appeared first on MOTI Physiotherapy.