By Amy and Nick

Amy says;

“We all know that the first few years of parenting can be hard yakka. The sleepless nights, the responsibility for a little life, the tantrums, the nappies, the sheer relentlessness of it all. I’ve had 4 babies over the last 6 years so I know all about the highs and lows of parenting the little people. It’s been well over 6 years since I had a really good night’s sleep or a lie in. But you know what, if I could wave magic wand and change one thing about my parenting experience, it wouldn’t be what you might think. Yes a few thousand hours more sleep would be nice, but what I really wish had gone differently (and I’m still trying my best to change) is I wish I’d had a whole lot less physical pain to contend with, particularly the dreaded disc spasms and acute back pain.

After a fair bit of trial and error and the support of my very patient and long suffering in-house physiotherapist (Grant), here’s what I’ve figured out.

What causes it/ makes it worse? 

• Breastfeeding – particularly breastfeeding in non-ergonomically optimum positions (like slumped in bed).
•  Staring at a new-born baby for hours on end and stroking their cute fluffy little head, while breastfeeding in the non-ergonomically optimum position.
•  Carrying a baby in a front pack or sling for hours (and days) on end. Particularly when the sling / front-pack is not correctly fitted due to slapdash approach / general hurry to get the screaming infant into the sling and calm.
• Carrying a baby in a sling (probably in an uncomfortable position as mentioned above) and then attempting to conduct a variety of ill-advised tasks that might range in craziness from pushing a toddler up a steep   hill in a pushchair to attempting to lift the toddler with arms outstretched so as not to wake the baby.
  Rocking a baby to sleep. Many times. Many, many times. Often in the middle of the night or whilst attempting to perform another task simultaneously.
• Lugging a sleeping toddler up stairs after they have fallen asleep in the car and doing this repeatedly every day despite having a sore / weak back and too many steps for this to be a good ‘every-day’ kind of idea.
• Hefting a 10 tonne pushchair in and out of the car, often under extreme stress because the baby is overtired and really needs the car engine to start immediately on being strapped into their car-seat and yet the pushchair wheels have locked and the darn thing won’t fold.
• Getting down on hands and knees at least 5 times a day with a dustpan and brush to sweep a mountain of food from under baby’s highchair, partly because you believe in letting them experiment with finger food, and partly because in a moment of short-sighted desperation to keep them in the highchair for a few moments longer you gave them a plate of rice to mess around with.. and this moment of desperation strikes after every meal because you have all the other small people to clear up after (yes there is no logic to this plan – it’s why they call it ‘nappyy brain I think).
• Lunging to grab a toddler who decides to step out into oncoming traffic, or just step out in the wrong direction, or throw themselves to the floor and refuse to step out at all.
• I could go on, this list is endless.

You might read the above and identify with it. Perhaps it will even bring a smile to your face. Or you might read it and tut tut to yourself thinking, well of course she has a sore back and there’s an easy way to fix it – stop rocking, stop carrying, stop with all that endless breastfeeding and just stop.. parenting? Hmmm , well this blog post isn’t about parenting choices – clearly I’m doing all this stuff because after 6 years at the coalface it still all seems like the best way to me – madness and all and I know from talking to others that I’m not alone. So the question is, how can we minimise the impact of these parenting choices on the back (neck / shoulder etc)

What helps?
Most importantly, strengthen up your core. If you are a mum and you haven’t started to strengthen your core, and you’ve experienced back pain then you’ll probably feel a bit annoyed to read this sentence. The kind of annoyance that comes when you read something that you know is important and you’ve heard many, many times but failed to act upon it. The annoyance is with yourself / your circumstances / whatever you perceive to be stopping you from undertaking some regular core stability exercises. Most of all the annoyance is with the irritating smug person telling you to ‘do your core stability work’. I am very familiar with this annoyance. It took me nearly 6 years, 4 kids and 3 episodes of really acute disc pain that literally wiped me off my feet, to make core stability training a real priority in my life. And I live with a physio who constantly chirped in my ear over the importance of core stability (which was very annoying at times let me tell you). So I know it’s hard and you literally have zero time to build it in to your day and you’re so damn tired when all the kids go to bed that you really can’t face anything more taxing than a large wine or a slab of chocolate and some low-brow TV. I know that feeling. But if your back is weak and you’ve had your stomach muscles stretched, possibly sliced through, maybe stitched back together , possibly multiple times and then you try and pull all kinds of strenuous lifting moves then something literally has to give and it may well be your back… and if it really gives badly then it is the most utterly miserable thing.   Now, after 5 months of doing 10 minutes of Pilates based core stability exercises every single night then my back is beginning to feel stronger. It’s slow and it’s hard work and I don’t think there are any shortcuts. But it’s only 10 minutes a day and when I think about all the other tedious things I spend 10 minutes on through the day (sweeping rice up of the floor perhaps, making toast?) it’s really not a big deal. Plus I’m encouraged by the thought that I’ll be much less likely to be needing any of the products that are usually advertised by smiling women in their 50s who need a little extra ‘padding’ when they laugh or pick up a child or ride over a bump in the road. That’s got to be a good thing because after 4 kids I reckon I’ll have had enough of nappies for one lifetime.
–        Try and minimise stress and anxiety. When you’re stressed and anxious   you hold yourself awkwardly (shoulders up round your ears anyone?) and just generally feel heavier and everything is more difficult and you make ill-thought through lifting decisions using bad technique and funnily enough the aches and pains and spasms come thick and fast. I don’t know the science of it (although sure the physios an explain it) but I do know that all my ‘episodes’ of pain have hit during times of stress. Reducing stress as a parent is a very personal thing, there’s no getting past the stress that comes with the responsibility for caring for the kids. Their utter dependence on you for every single thing is exhausting in itself without factoring in the sheer work involved. For me personally (and for many others I’ve spoken to) then the thing that often tips the stress from manageable to unmanageable is the sense that somewhere in the midst of all the parenting that you’ve completely lost your sense of self. Your soul has been stolen by a rouge Wiggle and you just aren’t sure you can take another breath without falling apart. It’s that kind of stress that it’s quite possible to do something positive about by reclaiming a little bit of something in the world for yourself, somehow . Hopefully   you know what will make a difference for you and it’s just a matter of making a bit of a plan. It’s easy to put yourself at the bottom of the pile as a mum and convince yourself that there’s no way you can fit in time for a walk (haircut, wander round the shops, coffee with a friend.. whatever it is) but the domino effect of stress and anxiety is so great then it’s worth trying to reverse it.
–        Don’t be a martyr – know your limits. For me the hardest thing on my back is getting up and lifting in the middle of the night. That’s kind of tough and  I do feel bad about it,  but it’s just something we’ve had to figure out at our place. My back just isn’t strong enough (yet) to lift too much cold and it isn’t going to help any of us if I put it out again trying to be a hero.
–        Know that it will get easier. I’m not sure that parenting overall gets any easier as the kids get older but I’m pretty confident that the early years put the most pressure on your body.”
Nick Says

“I think there is a general perception amongst mothers that pain, discomfort, weakness and tiredness are in the job description (and they are, but how much is not clear). It seems to me when you are preparing for your first child there is some shared experience from other mothers, but a lot is left unsaid. Older mothers, like expectant grandmothers,  have not had the recent experience to remember the day to day pains, and they come from a different era with different cultural norms. For example, they didn’t have to bend, twist and reach over the back seat to put the kids’ seatbelts on. I think most women probably accept more PDWT than they should simply because they have no idea how much is normal and no one has explained that it doesn’t have to be this way. I can’t think of too many families who wouldn’t function better if Mum was feeling good. Some time for yourself to do some strengthening or fitness is a must. Everyone will be better for it.

Amy is right on the money with Pilates. The scientific evidence supports the principles of Pilates. Pilates is a low grade core strengthening programme. By low grade what I mean is gentle – the optimum contraction is around 30% of maximum. This is important because you are trying to condition the deep support system of your abdomen and pelvis and the muscles you are targeting are endurance muscles. Endurance muscles contract over a sustained period rather than short quick bursts. You want to train these muscles to retain some activity in the background which gives the spine support to move more easily. Pain, poor posture, fatigue, injury (as in a surgical cut) will inhibit the function of this system. Repeat pregnancies (4 children you must be crazy Amy!), especially if not fully reconditioning between them, will also impair these muscles performance and as with Amy increase your chances of having an unstable back.

The daily tasks Amy describes are all awkward and necessary. They are challenging normally. The only advice I can give here is to understand how you are feeling and when you are tired or sore take short micro-breaks, have stretch, do the opposite of the posture you have been in, and perhaps take a moment to plan how you are going to complete the task. One simple thing you can do is to tuck your tummy in – or tighten your pelvic floor – whilst you are completing the task. Again you are thinking about 30% of the hardest contraction as an indicator. For example if you are bending, emptying the washing machine, you can turn these muscles on as you start the task and keep them engaged until you have finished the task – don’t forget to breathe though. With a 30% or less contraction you should be able to breathe freely and easily using your diaphragm.

One thing I spend a lot of time working with patients on is posture. With Pilates there are three basic ingredients: breathing, gentle contraction of the core muscles and working around neutral postures. A muscle works best in its mid position. If a muscle is stretched there are few individual muscle units overlapping and they muscle fibres cant develop a lot of tension. When they are compressed the individual units are so overlapped they have no room to contract. It’s a bit like a bell curve where most strength (the high point of the curve) occurs when the individual muscle unit is in the mid-position between fully stretched and fully squashed. In practice this is having good posture. The best way to start to fire these muscles is to stand, sit and live in better postures. When you stand in a nice tall position you can feel some abdominal muscles. Try standing side on to the mirror. Most people will see their tummy protruding forward of their chests (breastfeeding mums might have to adjust this a little). To resolve this tuck your bum under – or rotate you pelvis backward. At the same time lift your top button up and forward. You should now see your chest and tummy in the same line or your chest forward. Now this usually feels incredibly strange but if you look in the mirror for a moment you’ll see that it actually looks quite smart and you can feel your tummy working away. Try to do this using the least amount of effort.

As Amy has highlighted ,every mother is time-poor. It isn’t easy and your body does face big challenges. But Amy also highlights nicely that little strengthening steps completed daily will take a few short weeks to improve conditioning. I think we all need to face the fact that maintaining a level of fitness is just part of life and during some periods we need to prioritise it more than others.
Anyone for more kids…….. “