Postpartum Back Pain With Scoliosis: How To Heal
Congratulations! You did it - after almost 10 months of carrying, growing and then delivering a baby - he or she is here!! Well done, mama. It is quite a marathon, physically and emotionally. And as a mama of two myself, I know just how full your heart must be right now.
And yet, sometimes with scoliosis, we can find ourselves having some unexpected back pain after baby comes. While it can be common to experience postpartum back pain, having scoliosis or spinal fusion can make it feel even more unsettling. Any time we are feeling pain in our backs, we may start to feel panicked that something has gone wrong or that our scoliosis has gotten worse.
While that last phrase will be its own blog, let me reassure you: your spine is stable. Even with scoliosis or spinal fusion, there is limited research that our curves change at all during pregnancy, and when it does, there’s also evidence that it reverts back within a short amount of time. But more on that in another blog.
So… what can we expect during pregnancy??
Body Changes During Pregnancy
It’s important to keep in mind the huge structural changes that happen when baby is growing within your body, as well as how quickly our bodies change - literally overnight - once baby arrives. Our bodies were built to grow and nurture these babies, and at the same time it is an extremely taxing endeavor for them!
Here’s just a handful of ways our bodies change during pregnancy:
Our ribcage flares outward to make space for the growing baby
The diaphragm (main breathing muscle) flattens & can’t expand as much
Our feet may flatten and widen
We may notice an increase in pelvic tilt or tip our ribs outward
The organs in our abdomen literally move around to make space
Our abdominal muscles (specifically, the rectus or “six pack” muscle”) stretches to twice its normal length and naturally separates in those final months
Our skin stretches as baby grows
Our center of balance typically shifts backward and our stance widens - hence the “baby waddle”
All normal and expected - but actual changes in our bodies and how we hold ourselves.
Then, baby arrives and 9 months of gradual but progressive body change encounters a sudden loss of all that internal support the baby was providing to your abdomen. Add the overly stretched core muscles and the loosened joints from the pregnancy hormones… and we can feel like a limp noodle.
No wonder our bodies feel so foreign and unstable after baby!
Postpartum With Scoliosis & Spinal Fusion
One of the many amazing hormones that allow us to birth a baby is called relaxin, which allows some loosening and stretching of our joints and ligaments. This is necessary because our pelvis needs a little help to allow that baby’s head to pass through. Research tells us that the average woman can expect that hormones like relaxin circulate through our bodies for at least 6 weeks postpartum, not to mention the systemic impacts of other hormones like prolactin that circulate if you’re choosing to breastfeed or nurse your baby.
Again - all normal physiologic changes. However - when we have scoliosis or spinal fusion those hormones are also having an impact on our spine. Because we also tend to have some muscular imbalances and movement patterns we are also more susceptible to uneven mechanical stress on the spine and certain joints are more impacted than others. Therefore: we are more likely to experience mechanical back pain postpartum simply because of the scoliosis.
Why Postpartum Back Pain Happens
Hormonal changes aside, taking care of a helpless (though adorable!) newborn requires a lot of repetitive physical tasks such as:
Lifting baby into and out of a bassinet, bouncer, or car seat
Prolonged sitting and nursing or bottle feeding
Lugging around car seats and overstuffed diaper bags
Pushing a heavy stroller
Picking baby and other things up off of the floor
Getting onto and off of the floor for tummy time
Oh, and that sweet baby usually doesn’t sleep very well through the night for a while, so you’re running low on sleep. Also, you’re physically healing either from a vaginal delivery (with or without tearing) or a major abdominal surgery - which can take upwards of 6 months.
Are you starting to see why your body may be particularly vulnerable to pain or injury?
Because our movement preferences are usually shaped by scoliosis (preferring to carry baby on one hip, tendencies to put more weight through one leg or lean one direction more than the other), we are repeatedly setting ourselves up for more discomfort and strain on certain areas than others.
But don’t be discouraged! There are many things we can do and ways we can stave off some of this discomfort and set ourselves up for success in those grueling postpartum days. Even if you’re already experiencing back pain postpartum with your scoliosis - keep reading. I’ve got you!
As a gentle reminder: this blog and all the information therein does not serve as medical advice. This blog is solely for your information from an expert in scoliosis, spinal fusion and pelvic health during pregnancy & postpartum. Please discuss your specific situation with your personal pregnancy medical & wellness team, or you can book a consult with me for my expert opinion.
Postpartum Recovery Road Map
Regardless of where you’re starting today, here’s a general guideline to get you started on regaining control of your postpartum body and feeling empowered throughout your recovery:
Phase 1: Rest & Reconnection (weeks 0 to 6)
Prioritize the basic essentials for early recovery, including:
Quality rest (as much as baby will allow!)
Hydration - particularly important if you’re nursing
High quality, nutritious foods
Aim for high protein & colorful fruits and vegetables if you can
Ask for help early and often, whether it’s your partner, family, friends or beloved members of your community.
If you have the means to use a postpartum doula, they can be extremely helpful in those earliest days where you’re the most sore and shell-shocked.
Consider using a postpartum belly band for those early days, particularly if you have hypermobile joints (common for those of us with scoliosis).
It’s important to retrain the core muscles and not become reliant on the belly band - but there’s no harm in a little extra support early on!
Reconnect with your breath. Below is a video I created to reconnect to your core and pelvic floor muscles starting on the floor. Check it out!
Phase 2: Rebuild Stability & Mindful Movement (weeks 6 to 16)
Yes, I know this is a big range! This is by design: someone recovering from an uncomplicated vaginal delivery will likely recover quicker than someone who had significant tearing, an injury or a c-section - a major abdominal surgery.
As a reminder, this blog is not intended to speak to your specific situation. I’m happy to provide more individualized advice in a virtual consult or be your postpartum coach.
Some general recommendations to regain some stability and muscle strength:
Exercises on hands and knees are great to find core stability and re-engage your core. Try:
Marching your hands while keeping your back and hips stable
Lifting one arm up next to your head & alternating sides
Extending one leg behind you & alternating sides
Lifting opposite arm and leg with stable back & hips, then switching (also called a bird dog)
Engage your core and pelvic floor, and practice alternating arm or leg lifts. Keep your hips and back stable!
Our breath plays a powerful role in decompressing our ribs and untwisting our spine. Focus on creating some lengthening in your spine and unlocking the power of your breath.
If you are looking to return to running, CrossFit, any sport or activity involving jumping, begin ‘preparing for impact’. Sometimes our bodies can feel a bit unstable after baby arrives and leaving the ground can be difficult or daunting. I love using an agility ladder or even a jump rope on the floor can make a great target to hop over. Check out this reel with ideas on how to rebuild!
Work on gently reactivating the shoulders:
Wall angels
With your back against the wall, place the backs of your arms on the wall, hands up, and slide them up and down.
Wall push ups to wake up the chest and shoulder blade muscles
As this starts to feel easier, begin bringing the hands down to a kitchen chair or stool for more challenge from gravity!
Focus on rebuilding muscle endurance with cardio activities such as stationary biking or walking. Add challenge to your walks by pushing the stroller - particularly if you live on hilly terrain!
Start with shorter distances and gradually go for longer bouts
If you feel comfortable with short jogs and have access to a jogging stroller,
Stretch lengthwise over a foam roller to open the chest, allow your elbows to open and pull your shoulder blades together to make a “W”
Begin doing some intentional movements to re-engage the lower body. Try:
Wall squats or sit to stands, focusing on keeping a stacked body position & slowing the movement way down to get more muscle activation
Walk your feet away from the wall, slide down into a squat and hold.
Calf raises, with hand support or without - then progress to single leg
Balancing on a foam pad barefoot to reactivate the foot and ankle muscles
Glute bridges
Add hamstring curls on an exercise ball
Hold your bridge, hips level, and using your hamstrings to pull the ball closer to you!
Keep in mind - these are all just suggestions and basic movements to generally retrain your main muscle groups. Feel free to take these and tailor them to what you need, or add others that feel important. Remember I’m always here to walk alongside your recovery, as a coach or as a one-time consultant! Let’s work through this together.
Phase 3: Rebuild Intensity & Troubleshoot Issues (weeks 16 and beyond!)
After week 16, the majority of women should have been able to physically heal from delivery and be able to be more active, depending on several factors. Once you’re feeling more comfortable with the movements you can work on progressing the exercises, getting back into the weight room or returning to your fitness activity of choice. Even then - remember you’re still relatively early postpartum and I’d still recommend starting at a lower intensity than you did before baby. Your body went through huge amounts of change within the past year, so you can’t expect to pick up a full intensity fitness routine without working your way into it.
*If you’re at (or past) this point and still not feeling ready to get moving again - that is okay! There are so many factors, including how much sleep you’re getting, your support system (or lack thereof), the health and growth of your baby, and how many other people you’re having to care for.
Remember- these are general recommendations and may not work for everyone.
If you’re finding there are certain activities that are painful or hard to do, be a scientist and ask yourself the following questions:
What movement specifically is causing you trouble?
What part of the movement?
How soon do you notice it? (Immediately? After a certain number of reps?)
Where in your body are you feeling discomfort? A certain part of your back? To one side, or right in the middle?
How would you describe it? (Ex. burning, aching, sharp, dull)
When do you notice it? During a movement or later?
This is where having access to a trained movement professional like a personal trainer, a pelvic health physical therapist or scoliosis specialist can be worth its weight in gold. We can help you work through movements, figure out what could be causing the trouble and get you back on track.
What If You’re Still Having Back Pain Postpartum?
For some people, getting back to gentle stabilizing exercise may not be quite enough to get rid of the pain. That can be normal, and doesn’t mean that you’ll have this pain forever. Most often, that’s a good indication to you to take the time to reach out to a movement professional like a physical therapist. I would still recommend staying curious and keeping a log of the activities that are painful (certain positions, movements, times of day, that type of thing) so that you can have an accurate picture and give your team the information they need to help you feel better.
In most places in the United States, you can see a physical therapist without a referral. If you don’t have anyone locally to work with remember I can see you virtually to work things out.
Also it’s important to remember that pregnancy and postpartum are both huge changes and demands on your body, and some of us simply need more time to recover than others. This is normal, and expected. We don’t all heal on the same timeline.
Some other things to try to moderate your pain:
Make sure you’re staying hydrated, particularly if you’re nursing your baby
Eat whole foods with plenty of colors for vitamins and nutrients
Make sure you’re getting healthy fats and high quality protein for healing
Prioritize rest when you can and get outside in nature
Limit external stressors where you can
Find gentle, non-irritating movement such as:
Walking, with stroller or alone
Stationary biking
Yoga flows
Swimming
Avoid inflammatory foods and beverages, which may include:
Dairy
Gluten (for those who are sensitive)
Alcohol
Excess sugar
Highly processed foods
Postpartum Recovery And Beyond
There’s you have it: all the info on how pregnancy & delivery impacts us with scoliosis and spinal fusion, and why we’re more susceptible to postpartum back pain. Having navigated my own two pregnancies and childbirths, as well as working with pregnant and postpartum women for over 10 years, I have a unique perspective on our unique challenges and how to overcome them. I hope this blog gave you some insight and appreciation for your spine and body - after all, how amazing is it that you grew and birthed a whole human?? Incredible.
If you’re doing all the things and still having a hard time, don’t fret! Consider scheduling a personalized virtual consult with me for more tailored information for you and your specific spine and body! Alternatively, I offer monthly 1 on 1 pregnancy & postpartum coaching which includes monthly coaching calls and anytime access to me via Voxer (a video and chat app). My coaching clients receive individualized movement recovery programs filled with corrective exercise and plenty of opportunities to troubleshoot the issues that come up.
Make sure to contact me with any specific questions or if you’re needing more personalized guidance. Happy to be on your postpartum recovery team!
