Health & Wellness , Aches & Pains , Physical Therapy , Blog

Tips for Pregnancy and Postpartum Health

Written by Molly Hoppenjan, PT, DPT, ATC

Hey everyone! I’m Molly Hoppenjan, a physical therapist and one of the new moms at Dubuque Physical Therapy. As all moms know, pregnancy, birth, and postpartum times are truly a journey. A journey that can be very different between moms, and even between kids of your own. Our bodies are amazing! We not only grow and develop a baby, but bring them into this world, then care and nurture them afterwards. Now that I have gone through it once, I feel like I have a little more knowledge to share. Don’t get me wrong, I know there is still plenty to learn. With my experience, as well as my knowledge as a physical therapist, I want to give a few helpful tips for each stage. Please keep in mind that everyone and every journey is not the same, so feel free to reach out to your OBGYN, Midwife or favorite Physical Therapist for help to tailor to your own specific needs.

Pregnancy

The body is made to move, and continuing to do so throughout your pregnancy, to the best of your ability, is a great idea! However, this isn’t a great time to pick up a new form of high level activity if you weren’t used to doing it before becoming pregnant. If you have concerns about your baby being able to tolerate your activity, you can always ask your health care provider if you are cleared for certain exercise programs.

Some of the great benefits of exercise during pregnancy include:

improved energy levels
better circulation and less swelling
improved sleep
better digestion with less constipation
reduced backaches and muscle/joint soreness.

The further along you are in your pregnancy, the more your body releases a hormone called relaxin. This hormone is responsible for allowing your ligaments to relax and stretch so your pelvis can expand for your baby to pass through the birth canal. This is when having enough strength in your back, hips, pelvic floor, and abdomen is important to provide your pelvis with support. It is also important to remember to drink plenty of water throughout your pregnancy.

Early Postpartum

Congratulations! You are a Rockstar and don’t let anyone tell you differently! This time is for loving on your new beautiful bundle of joy and giving your body time to rest and recover. You can start some kegels to help get some of the strength back in your pelvic floor, but don’t feel like you have to get back to exercises right away. If you had a c-section you will have to be a little more careful about not overexerting yourself with lifting or bracing with your core. However, once your incision has healed, roughly 2 weeks post delivery, it is important to start scar massage to help with sensitivity and mobility of your scar.

Breastfeeding and Bottle Feeding

If you missed the video that I made in our baby ergonomics series, (check it out!) here are my 4 key tips for positioning with nursing and bottle feeding. I also want to remind you that regardless of if you are breastfeeding or bottle feeding, the saying is “fed is best”. So again, you’re a Rockstar regardless of your journey!

Top 4 baby feeding tips:

1: Sit with your back supported

2: Bring baby to you, not you to baby (for nursing mommas)

3: Avoid always keeping your hand in the supinated (palm up) position

4: Avoid excessive/prolonged neck flexion

Lifting/carrying your baby

Try to remember the trusty saying of “lift with your legs, not your back” for all your lifting tasks. That includes lifting baby off the floor, out of bed, out of a car seat, out of the tub, and in a car seat. When carrying your baby’s car seat longer distances or when lifting into the car or onto a taller surface it is best to use both arms. (check out the rest of our baby ergonomic video series for crib transfers, carrying a car seat, and lifting your child off the floor)

Common vs Normal

There are a lot of things that our body goes through when having a child and unfortunately that can be the excuse for problems such as urinary urgency and frequency and leakage even long after baby is born. Even though it is common for women to leak when they laugh, cough, or sneeze, that is not normal. There are a few other common vs. normal things listed below. If you are experiencing any of these common, but not normal things, it is time to see a physical therapist! There are so many simple things that can be done to help you improve incontinence and your pelvic health!

Common	Normal
Voiding less than 3 times or more than 9 times a day	5-8 voids in a 24 hour period, so voiding every 2-4 hours
Just in case peeing: going before you leave a place “just in case” you have to go even though you just went a little bit ago	Voiding every 2-4 hours
Waking up several times throughout the night to void	0-1 times if you are under 65 years old. Only 1 time is considered normal for 65+
Leaking a few drops with activity like running or jumping or with laughing, coughing, or sneezing	NO leaking
Urgency with triggers like cold weather, putting the key in the door, or with running water	Feeling urgency when the bladder is full
4-6 servings of fluid a day with some being water and some other fluids	½ of your body weight in ounces, with ⅔ of that being water

The human body is truly amazing for everything it goes through to have a baby. New moms are usually very wrapped up in taking care of their baby afterwards, however it is also important to take care of yourself. Getting back to certain activities after having a baby can be challenging and a physical therapist may be exactly what you need to get you there.

Health & Wellness , Aches & Pains , Blog , Physical Therapy

Returning to Activity After a Pandemic

(Used with permission from The American Physical Therapy Association, July 2021)

During the COVID-19 pandemic, activity levels dropped for a lot of people. Between stay at
home orders, gym closures and working from home, people became more sedentary. On top of
that, there were shortages of equipment like dumbbells and bicycles, making staying active at
home difficult even if you wanted to.

But this summer, things look different; vaccines are widely available, restrictions are loosening
and people are looking to get active and enjoy the warm weather. That’s all good news, but if
you had a long break from activity, your body might not be ready to jump right back in. Here
are a few tips to help you get more active without getting hurt:

Start Slow

● If you’re a runner, think about a walk to run program
● If you’re a weight lifter, start with lighter weights and less reps.
● Whatever your activity of choice is, start with short periods of activity and gradually
work your way back up.

Warm Up and Cool Down

Warming up gets your heart and lungs ramped up and prepares your muscles and tendons for
the increase in activity about to come. Include some light cardio like jogging, calisthenics, or
cycling, followed by active stretching like butt kicks, high knees, or yoga.

Cooling down transitions your body back to a lower state of stress – it brings your heart rate and
breathing down, decreases blood flow to your muscles and back to places like your digestive
system, and helps you relax. It’s also a great place for static stretches if you need some work on
your flexibility.

Take A Day Off

Rest days let your body recover and keep you from getting burned out. Not enough exercise
isn’t good for you, but too much of a good thing can cause problems too.

Watch for early signs of injury

Some soreness for a few days after activity is normal, especially if you’ve had a long break. But
there are a few common issues to watch out for as you return to activity:
● Swelling or bruising
● Joint pain, especially in the knees or shoulders
● Foot pain, which could be a sign of plantar fasciitis
● Muscle strains – particularly common in the hamstrings
● Sprains – most common in the ankle

Any of these issues justifies a call to your physical therapist. Getting checked out early can
prevent an injury that derails your attempt to return to activity. PTs see all of the issues just
mentioned on a regular basis and can help safely guide you back into a more active lifestyle.

Physical Therapy , Health & Wellness , Aches & Pains , Blog

Use It and Improve it!

Written by Anne Kruse, PT, DPT, Therapeutic Pain Specialist, Cert. MDT

As I reflect on my own physical fitness over the years I am amazed at how true what I learned years ago in school really is. One of the phrases I have heard and now use is:

“If you don’t use it, you lose it.”

I distinctly recall the first time I found this phrase applied to me. During my first year of PT school I had settled into a routine of little to no exercise. The following summer a friend asked me to run the Bix 7 Road Race with her. I thought, “Sure, I was on the track team in high school and ran some in college, this will be fun.”

Little did I realize how completely out of shape I had become and the seven mile race was absolutely brutal. I must confess I walked the majority of it. That was a wake up call and I began to make a concerted effort to exercise a few times a week; walking with friends after class, playing an occasional game of racquetball, lifting weights, etc.

Why Not Me?

Fast forward to the spring of 2018. As my husband and I sat in the stands of Drake stadium watching our sons compete in the Drake Relays, I had another awakening. I was amazed as I watched an elderly gentleman take to the track and compete in the Masters 800. While his time didn’t break any records, he was out there doing it and clearly having fun. Yet again I had become too busy in my own life to exercise regularly, and yet this is what I teach people every day. With the support of my family and friends, I returned to running, ugly as it was. I found it challenging to even run a half mile initially, but have grown to really appreciate running as a means of exercising, relaxing, and spending time with my family and friends.

Why do I share this tale?

Because we are all human and have times in our lives when our own wellness plans get derailed. But fortunately, as humans, we also have an amazing ability to improve our wellness. In recent years I have learned the phrase, “Use it and improve it” and this holds true with all of our bodily systems.

What Does the Research Say?

In 1966, the Dallas Bed Rest and Training Study was conducted in which five healthy 20 year old male volunteers were recruited to spend the summer in bed. The cardiovascular fitness levels of the participants was measured before beginning the study.

After just three weeks in bed, without any weight bearing activity, the participants were found to have had such significant declines in their cardiovascular fitness that the bed rest was stopped.

On average the participants had a:

27% decline in their ability to absorb and use oxygen
26% decline in the amount of blood their hearts could pump through their bodies in a minute
35 point increase in heart rate during a submaximal workout

To complete the study, the participants were taken through an eight week workout program.

45% increase in their ability to use oxygen
40% increase in the amount of blood their hearts pumped through their bodies in a minute
49 point decrease in heart rate with a submaximal workout

Hmm, working out improved their heart and vascular system function to better than they were before the study.

But wait, there is more!

The same five participants were studied 30 years later (1996). Only two had continued to exercise and all had gained weight and body fat. At baseline it was found they on average had only declined 12% in their ability to absorb and use oxygen.

Thus, three weeks of bed rest at age 20 was more detrimental to their cardiovascular fitness than 30 years of aging.

Compared to the original study, there was no bed rest, but a training program was begun. In 1996 the training was less intense and involved walking, jogging and cycling over a period of six months instead of eight weeks based on the age of the participants and to reduce the risk of injury. After the training program, the participants had improved their ability to absorb and use oxygen by 14% to similar levels attained in the 1966 study.

Wow! Ok, but why do I care?

So, the take home point is this: no matter where you find yourself in life, it is important to your health to move. Whatever you choose to do, be it walk, jog, bike, or swim, have fun and realize you are helping to reverse the effects of inactivity and aging and are improving your cardiovascular fitness. If you find yourself needing some guidance, consult your physician, PT or personal trainer.