NEED MORE HELP? WHEN, WHERE, HOW, AND WHY.
For more on postpartum posture as it relates to pain and incontinence, see Part 1: Posture. For more on exercises to reinforce proper posture and restrengthen over-stretched postpartum muscles, see Part 2: Exercises.
It can be so hard to know when to seek additional professional help for postpartum issues for many reasons. Nobody talks about these problems, so most women don't know what a "normal recovery" is supposed to look like and even if you know you could use help, you might be held up by insurance coverage gaps, lack of time/childcare, or just not know where to go. Many physicians and even obstetricians don't know where to send women who are dealing with chronic postpartum pain or incontinence. Luckily for you (less so for me), I have the wisdom of experience working with people who really know what they're doing... and people who really do not. Allow me to direct you to the former!
Chiropractic: The reason I put this one first is because often times if the postural checks and exercises are not doing the trick, it may be due to an anatomical issue. Between carrying a heavy load on your front for almost a year, pushing a small human out of your pelvis, and then trying to carry that small human around, your pelvis, hips, ribs, etc. can get into all kinds of funny positions. If they're in those positions long enough, the surrounding muscles and ligaments may tighten/stretch to accommodate that position and before you know it, you're "stuck." Chiropractic can be a great way to get your joints back into proper alignment so that your muscles can function more optimally, and then you can do the postural work and exercises to get them to stay that way over time. I will say that not all chiropractors are alike! Many postpartum women respond better to a chiropractic approach that is more gentle, rather than using drop tables and other traditional techniques. I recommend the following chiropractors on the North Shore:
Dr. Courtney Brooks Neill, DC of Inner Source Wellness in Beverly, MA
Dr. Jennah Dieter, DC, CACCP of Healthcare Complete in Newburyport, MA
Physical Therapy: If you are dealing with a specific postpartum issue, such as prolapse, incontinence, or a broken tailbone, physical therapy can be really helpful with encouraging full recovery. I will caution you that even more so than chiropractic, it is imperative that you find a physical therapist who specializes in working with postpartum women! A PT who lacks knowledge regarding anatomical concerns in the postpartum period can do more harm than good. I found Pamela McIntosh, PT, DPT, WCS of the Center for Rehabilitation and Sports Medicine at Addison Gilbert Hospital to be extremely knowledgeable and helpful for my own postpartum issues. She was also nice enough to pass along an extensive list of all physical therapists in MA who specialize in pelvic floor issues, which is about as close as you can get to a list of postpartum specialists. Pelvic floor PTs located North of Boston are listed below:
Anne Levesque at Anne Levesque Physical Therapy in Beverly, MA
Elaine Racki at Lahey Clinic in Danvers, MA
Elizabeth Lewis at Lewis Physical Therapy in Gloucester, MA
Celia Brunette at Spaulding Hospital North Shore in Salem, MA
Kristen Stokes at Spaulding Peabody in Peabody, MA
Dina Kacandes at Winchester Hospital in Reading, MA
Patricia Jenkyns at Jenkyns Physical Therapy & Wellness in Woburn, MA
Nancy Potter, Peg Marko, Robin Pitcairn, Mary Dee Hanson, and Kate Morrissey at AthletiCare, Exeter Hospital in Exeter, NH
Lauren Richards at Rehabilitation Services at Plaistow in Plaistow, NH
Cristin T. Zaimes at Oceanside Physical Therapy, LLC in Portsmouth, NH
Nutrition: I'll admit, I was initially very skeptical that nutrition could have any effect on my postpartum pain. However, between my gastrointestinal issues that I had been battling for years and my desire to bring my general inflammation levels down to a lower baseline, I decided to look into it further. My chiropractor, Dr. Courtney Brooks Neill (see above), does a form of food intolerance testing called applied kinesiology, which is a non-invasive approach to determine what foods might be aggravating the body. There is a substantial body of research suggesting that applied kinesiology is an effective technique for determining musculoskeletal and neural issues in the body, but it has not been well studied in its application to dietary concerns. However, a recent pilot study (small, exploratory study) 19 of 21 (90.5%) suspected food allergies found during applied kinesiology testing were later confirmed by serum blood tests; hopefully more research will emerge on this topic. In the meantime, I can say that cutting out gluten, corn, and coconut-- the three foods picked up during my applied kinesiology testing-- has virtually eliminated my IBS (irritable bowel syndrome... gosh I wish they would pick a cuter name for that!) symptoms and seems to have also helped with my pain flair ups, especially the flair ups that seem to be associated with menses. Specialists in dietary concerns for chronic pain are listed below:
Acupuncture: I did not seek acupuncture for my own personal postpartum issues. However, there is some research that suggests that acupuncture can reduce chronic pain. Sometimes when your body has been in pain for so long, it comes to expect it in a sort of self-fulfilling prophecy "pain feedback loop." If you have chronic postpartum pain that is not related to a specific anatomical issue, was not ameliorated by postural correction and exercises, and did not respond to chiropractic, acupuncture may get you to the next level of pain relief. Unfortunately I cannot recommend a specific local acupuncturist, but I recommend calling a few in the area and asking about their services and experience with postpartum women.
MotherTend's Postpartum Functional Fitness Service! Now that you know a little more about my background in fitness and my journey to functional postpartum wellness, I'd like to introduce a service that is new to MotherTend: Postpartum Function Fitness. This service is part of the general postpartum doula package, but can also be utilized separately. During these visits, I will go through all the exercises with you to ensure that they are being done correctly, help you progress to more advanced exercises, and retest your function as we go. Let me help you achieve a full postpartum recovery!