Pregnancy Diary: Week 20 – Dealing with aches & pains
We’re half way there! That’s definitely a cause to celebrate – as is the subsiding of nausea and fatigue – but now that bump is growing bigger the aches and pains are starting to settle in. Relaxin is an incredible hormone. We all have it to some degree, however, during pregnancy a woman’s production ramps up to help loosen the ligaments and joints of the pelvis to assist with childbirth. The downside of this is that it can’t target than one area which means it also affects the rest of your body. This can result in aches, pains, and an increased risk of joint injuries, and is partially why high impact activities are not recommended during pregnancy. It may even affect you beyond being pregnant; did you know that a woman’s increased production of relaxin continues up to 6 MONTHS following the end of breastfeeding?
I’ve mentioned before that my previous pregnancy was a breeze, however, I was actually postnatal when my joints started to give me grief. I continued to breastfeed my girl until recently – she was 23 months and self-weaned after I fell pregnant – and I do question whether my body is a little more sensitive to relaxin than your average woman. This was a bit crap because for the past two years I can’t remember a time when I didn’t have joint issues of some kind. But as a personal trainer and yoga teacher it’s provided many incredibly valuable lessons to help other women as I’ve troubleshooted each problem, and taught me the value of slowing down when your body’s not feeling right.
When previous aches and pains return
Just months before this pregnancy I’d managed to reset my body from the previous one. I don’t know if this was because we were down to one breastfeeding session per day and that affected relaxin production, or whether the rehabilitation and strengthening work I’d been doing had sorted it, but I was finally feeling normal again.
Unfortunately the joint issues have already started again beginning with my hips! At least this time I have a better idea of how to sort things out and I’ve worked with a lot of postnatal mamas over the last two years that have given me better experience to deal with it. Here are a few of the key problems I’ve dealt with that are relatively common during pregnancy and postpartum.
If you end up with any of these I’d highly recommend that you see a physiotherapist as soon as possible, as everyone’s body is slightly different.
De Quervain’s Syndrome (aka Mother’s wrist/Mother’s thumb/Gamer’s thumb)
Not officially diagnosed with De Quervain’s syndrome, but according to Dr Google I was pretty textbook case and a PT client of mine experienced the same thing during her pregnancy so I could recognise it. It’s when you get inflammation in the wrist tendons at the base of the thumb which can typically cause pain around the thumb and the wrist.
Mine was likely aggravated by repeatedly picking up new baby under the armpits as you would usually do by spreading your hands and using the space between your thumb and index finger to ‘hook’ under them which puts a lot of strain on the thumb. Also probably not helped by all the time on my phone in the wee small hours of the night spent with baby (as this is often also an RSI issue that can be caused by console gaming and overuse of texting on phones).
My symptoms were bad enough that when reaching back over my head for my bedside lamp switch, my thumb would feel like it dislocated and have to be wiggled back into place. The other times it was at its worst was in downward dog for yoga (I’d have to keep my thumbs locked hard into the sides of my index fingers rather than spread out) or when picking up the baby.
The client I mentioned had great success with steroid injections after being referred to a specialist. I managed to sort mine by picking up the baby in a different way by scooping my entire hand under her body so her armpits would rest over my wrists instead of in the crook of my thumbs.
Sacroiliac Joint (SI Joint) Dysfunction
About one year postpartum I developed sacroiliac joint dysfunction, which was aggravated by ill-advised yoga instruction and teachers forcing me into adjustments at the classes I was attending (the importance of working with experienced teachers who are trained in pregnancy and postnatal assistance when it comes to physical activity!). It manifests as a pain in your lower back that’s typically to the side of the spine on one or both sides and you could literally put your finger on the place where you feel the pain. It’s super common during both pregnancy and postpartum.
For those who end up with this, there has to be a lot of rehabilitation around stabilising the core muscles from your mid-ribcage right down to your inner thighs. There needs to be a lot of focus on pelvic alignment and stability, especially when you’re doing squats and lunges. It can help to do squats and mat work with a yoga block or ball between your thighs which helps assist the core muscles and keeps your hips, knees and toes in alignment straight over the top of each other. I’d recommend seeing a physiotherapist, and potentially a qualified and experienced personal trainer or yoga teacher well-versed in prenatal and postnatal issues (if you ask them about SI joint dysfunction and they don’t know what it is, look into other options).
General back and shoulder issues
When your baby – and your belly – are growing larger by the day, your centre of gravity shifts and typically takes with it your posture and body alignment. And then there’s the boobs… Last pregnancy I went from a C-cup to a G (!!) and this time they’ve taken no time to inflate like water balloons pretty much as soon as the pregnancy test came up positive. My upper back feels pretty crappy most of the time, but a simple stretching routine over 5-10 minutes can usually iron it out (and a massage whenever I can wrangle one!).
Here are some tools that have helped me out through my own journey…
The Smiley Belt
This Kiwi product came up as highly recommended throughout discussions during my postnatal yoga course for hip aches, lower back pain and pelvic instability issues. Although I didn’t need it at the time, I bought one shortly after the course to show any mama clients in my postnatal or pregnancy exercise/yoga classes and luckily had it on hand when my hip problems started a month ago.
There’s not a lot to them, but they wrap firmly around your hips and lower back to provide extra support which can provide amazing relief during pregnancy and postnatal as well. They are also great as a general physiotherapy tool for anyone with back issues – men or women. If you want to look into them, find one at www.smileybelt.co.nz.
Maternity pillows (aka body pillows)
I never felt quite broken enough during my last pregnancy to buy one of these; I just shoved a regular pillow between my knees to help feel more comfortable. However, this time around my hips started giving me so much grief around the start of my second trimester I was waking up every 30 or so minutes throughout the night to shift positions, then waking in the morning feeling like I’d barely slept at all (plus I’d have to hobble around like I was broken for around an hour until the aching would ease off!).
I resisted buying one of these ridiculously long pillows for as long as I could. Not only does it feel like there’s a third person in the bed with you and your partner, it takes up a lot of room and I wasn’t willing to spend the money on something that might not work. I ended up finding one at Kmart for $25 which wasn’t too bank-breaking (for those looking, here’s the one I bought) and despite still having to fight it in bed every now and then if I want to roll over, my hip aches have pretty much completely disappeared.
It took a bit of trial and error to find what works, but I find it works best by full body hugging it by shoving it between your knees and ankles then hugging it into your chest with your arms while resting your head on it.
As non-pregnant-me usually likes to sleep on my back (it’s recommended to side-sleep during pregnancy, especially on your left which encourages blood flow to baby and mama while also being slightly better for your digestive system), I sometimes like to replicate this as closely as possible by rolling onto my left side and tucking the pillow lengthwise down my back as close as possible. This way I can kind of roll onto it without being flat on my back and maintaining the positioning to my left side but it still keeps me supported.
UPDATE: Mattress topper
Shortly after writing this post I bought a mattress topper to make our bed a little more cushy; this has been completely worth it and I no longer have aching hips (I’m currently at 28 weeks pregnant so I’ve been trialling this for a while now!).
I bought a decently thick one that’s usually worth around $230 from Briscoes at one of their 60% off sales but they typically range anywhere from around $70-$500 off sale depending on the materials they are made of, so there are mattress toppers to suit different budgets. NOTE: This is NOT a mattress protector as some people have asked me; its much thicker and almost like a layer of duvet/extra layer of cushioning that goes over the top of your mattress.
Stretch it out
Taking yourself through a basic stretch routine to get the spine moving and to free up the hips can go a long way towards alleviating aches and pains during pregnancy. Some gentle rounds of cat/cow or standing up and circling your hips in figure-8’s in both directions are simple to do and feel amazing.
Remember, if anything doesn’t feel right, listen to your body and stop doing it!
Image / NZ Real Health