During pregnancy there is a higher potential for injury due to release of relaxin hormone as well as estrogen and progesterone. These hormones are essential for growth and development of the baby but at the same time cause laxity of the muscles and ligaments. Abdominal muscles lose tone and therefore do not help in stabilising the lower back. The muscles supporting the spine also are not as effective in protecting the spinal structures. These changes can continue during breastfeeding, but once the hormones balance out, muscles and ligaments tend to tighten. This is often the cause of pain post-pregnancy, as nursing postures or carrying for extended periods of time will often cause spasm of the lower & upper back, shoulder and forearm muscles. Additionally, there is more potential for disc injury due to a decrease in stability specifically in the lower back and changes in centre of gravity throughout and after the pregnancy.
New parents often begin the rigorous routine of caring for their child without being able to allow for full recovery. Laxity of the ligaments and muscles remain. Often this includes lifting car seats, baby strollers, and carrying the infant and other children. This is often done with no time to think about proper back ergonomics due to fatigue and or due to having to stick to bub’s schedule. Commonly there is a level of self-neglect. These activities along with laxity of muscles and ligaments create a canvas for injury.
Most parents find themselves armed with every possible item needed to raise, feed and entertain their bub.
90% of these lead to awkward positions, heavy lifting and prolonged carrying.
The infant removable car seats:
Encourages twisting of the parents’ spine and also repetitive lifting. Commonly it will cause strains and sprains of the lower back muscles. Most of the time this is hard to avoid because bub is sleeping or is hard to transfer. Additionally, carrying the capsule and the bub and allowing it to swing on 1 side puts a lot of biomechanical stress on one side of the body.
1. Hold the car seat as close as possible to the midline of the body.
2. Lift the car seat out of the car using both knees and not the back.
3. Employ the use of “snap-n-go” stroller to avoid having to carry the capsule.
4. Be square to the car when removing the capsule to avoid twisting the spine.
Initially this is ergonomic when bub is small enough to fit in the sink. This is great because the carer can stand straight and have all the bath time accessories in a convenient place to reach. Some parents choose to use a stool to avoid having to reach into sink.
As bub gets older they graduate to the baby bath that usually sits inside the bath or in some cases is freestanding. The freestanding type is less stressful on the carer’s spine. The other type forces the caregiver to be in a kneeling hunched position.
1. Use a little stool to sit on to avoid a flexed posture.
2. Lift baby out of bath and hold close into body while standing or pass bub to another carer if possible while you stand.
These are great when you need your hands-free for a period of time. Back injuries are often sustained when placing or removing bub from the pen. This is because it requires a flexed spine and often a twist, the weakest position for the spinal discs. As the child gets bigger the lifting motion is also hard on the upper back, muscles and forearms.
1. Get in the playpen with child to place them in and do the same to get them out. This allows for use of the knees to lift.
2. Make sure you have both hands free to do this. This will help avoid twisting and overloading the spine.
Carrying the child:
We always have a favourite side! It is common that the child will also have a favourite side, often due to learnt behaviour very early on. Most commonly the side is chosen to allow for the dominant hand to be available for chores. This also means the hip on the non-dominant side is jutted out. This creates an acute angle between the carrying arm and the hip and will often strain the upper thoracic spine on that side.
Additionally, we will often multitask while carrying the child. The common tasks are cooking, cleaning, vacuuming, packing lunches and talking on a mobile phone. This puts strain on the neck and shoulder of the dominant hand
1. Use a carrier to allow use of both hands. Make sure that it is fitted correctly to avoid strain on the neck, lower back and shoulders.
2. Have a morning or evening stretching routine for the muscles of the lower back and shoulders to alleviate the tightness- consider this preventative care.
The most important considerations for the “pusher” is ergonomics. Often the pram is heavy and puts strain on the body when getting it in and out of the car or house.
1. Look for a multi-age stroller to allow for easier transitioning for bub.
2. Look for stroller with higher handles to allow for upright posture.
3. Look for wheels that turn easily to allow for easy manoeuvring.
4. It is helpful to have a stroller with pockets for handbags & cups etc. This frees up the hands and arms.
5. Use the knees rather than the back to place and remove bub from the stroller.
6. Practice using the stroller in the shop, chat to friends/family and look at reviews so that you make an educated choice.