Dr Kathryn Johns

Giving birth can involve lots of tears, love, fear, gratitude and a little bit of OMG! The transition to parenting is a time of discovery and working out your new life as a mother or father of one (two, three or more)! There is so much emphasis on #selfcare for mothers, but when the new addition arrives mama tends not to come first or second. Selfcare is forgotten or put to the bottom of the ‘things to do’ list.

At Eastern Osteopathy we believe there is no better time than postnatally to embrace the self care message, and look after you. For postnatal mothers, we offer postnatal appointments with our women’s health osteopaths. Aside from self care, here are the four main reasons why we believe you should put mama first, and make an appointment.

1. Change

In the hours to days after giving birth your entire body goes through rapid anatomical changes; in particular the anterior abdominal wall (the front of your stomach/belly region) and the pelvic floor. These two areas make up a major component of your core canister.

Your sleep (if any) will be interrupted. You will be tired (aka exhausted) and spending your time breastfeeding (or bottle feeding, or expressing, or both), carrying, cuddling, settling, all while your body is adjusting to its new posture without the support of a strong core. At Eastern osteopathy we encourage all new mamas to make an appointment in the weeks following the birth of their little one to make sure their bodies are in alignment, and moving correctly. When this is achieved we place less stress and strain on our muscles and joints, creating an environment optimum for healing.

2. Pelvic floor

Pregnancy, and giving birth vaginally places huge stress on your body; in particular your pelvic floor muscles (PFMs). It is estimated that during a vaginal birth the PFMs stretch up to 3.5 times their normal length, (WOW!) allowing your little one to pass through your vaginal canal. For some women, to aid in this process, tearing of the perineum or an episiotomy may be required. It’s no surprise it can take some time for these muscles to recover and heal.

Pelvic floor dysfunction can look different for everyone. We find many of our patients only associate accidental leakage with PFD. For many people, this is not the case. PFD can present with a variety of symptoms ranging from, but not limited to, incontinence of urine or faeces, urgency and frequency of urination to constipation or pelvic girdle pain. Not sure if you have an issue with your pelvic floor? Take our short questionnaire here.

At Eastern Osteopathy, we don’t believe you should wait for pelvic floor symptoms to present before seeking postnatal osteopathic care. Being proactive about your health with osteopathic treatment, and getting an appropriate rehabilitation program, involving movement practices, breathing exercises and pelvic floor strengthening, or relaxation techniques is essential after pregnancy.

Both myself (Dr. Kathryn Johns - osteopath) and Dr. Elizabeth Johns - osteopath have completed further training in the assessment, retraining and rehabilitation of the pelvic floor; using both internal and external techniques.

We have also been trained in the use of a Real Time Ultrasound to diagnose pelvic floor and deep abdominal dysfunction. The RTU machine allows Elizabeth and myself to assess your pelvic floor without the need for an internal assessment.

When assessing your pelvic floor, we don’t just assess its function (i.e. how strong it is, and how many kegals you should do), we also look at your body as a whole to see if there are any biomechanical issues that could be impacting on how well your pelvic floor functions.

For more information check out our blog on What to expect from a women’s pelvic health assessment.

3. Diastasis Recti Abdominal (DRA) abdominal separation

During pregnancy DRA is a normal, natural process which allows your body to stretch and change as your little one grows. Research has estimated that by 35 weeks gestation, 100% of soon to be mamas have DRA and by 12 weeks postpartum just under 40% of new mamas will have a DRA. (1) If at 8 weeks postpartum you have a DRA, studies have shown that without intervention, you will still have a separation 12 months after giving birth. (2)

Assessment of the DRA is not about the size of the gap, what we will be looking for is the ability to create tension across the gap (anatomically known as the linea alba). Creating tension in the Linea alba is achieved by correct contraction of the core muscles. If you are unable to create tension, we will endeavour to work out why. Is it due to whole body alignment impacting on the function of your deep core? Or do you need to learn to reconnect and strengthen your deep core?

During your appointment you will be taught how to assess and monitor your ability to generate tension within the linea alba, as to determine when an exercise is appropriate for you.

For more information see Diastasis Recti on our website

4. Pain

For many mamas to be, pregnancy pelvic girdle pain (PPGP) is reality and for most of these ladies, giving birth resolves the symptoms of their PPGP! For some women, it’s not that simple. 1 in 10 women with PPGP are still suffering with chronic and severe PGP up to 11 years after giving birth (3).

Giving birth, feeding, carrying and settling your young babe can result in a variety of new complaints including, but not limited to, the following:

Lower back and pelvis pain
Pelvic girdle and pubic symphysis pain
Mid back pain during and after breastfeeding
Neck pain and headaches
Wrist pain

As osteopaths, the emphasis of our treatment is on the whole person and not solely on their symptoms. We use a variety of techniques to gently release any strains present; relieve pain, discomfort and improve mobility to support the body’s ability to heal.

A common question we regularly get asked by our pregnant patients is: How soon after giving birth can I have treatment? If you are in pain, you can receive treatment within hours.

Nine months ago I gave birth to my second daughter. Hours later I could barely sit due to coccyx pain, making breastfeeding near impossible. Lucky for me, I have a twin sister who is an osteopath (and my business partner, aka Liz) Less than 12 hours after giving birth I had an osteopathic treatment. The relief soon followed and shortly after, I was able to breastfeed and care for my daughter in comfort.

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At Eastern Osteopathy we see postnatal women at all stages, from those who have been mamas for only a couple of days to mamas who are now grandmothers, and have been putting up with their symptoms for a couple decades. We believe it’s never too late to start looking after yourself and putting mama first!

Regardless of your concerns during your postnatal check up; as osteopaths, we look at your body as a whole and create an individualised treatment plan, addressing any areas in your body (joints, ligaments, fascia and muscles), movement patterns, dysfunctional postural or breathing patterns that may be impacting on your overall health.

The treatment will include a physical treatment, lifestyle advice and a specific rehabilitation program to support your treatment outcomes. Generally these programs will include movement practices, breathing exercises and pelvic floor strengthening or relaxation techniques.

To book your postnatal appointment: book online here or call us on 9042 0407.

Want to know more? Call the clinic on 9042 0407 to speak with us today.

References

Moto P G, Pascoal A G, Carita A I, Bo K 2014 - prevalance and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain. Man Ther 2014
Coldron Y, Stokes M J, Newham D J, et al 2008 - postpartum characteristics of rectus abdominis on ultrasound imaging. Manual therapy 13: 112
Elden, H et al (2016). BMC Musculoskeletal Disorders, 17(1), 276.