Where are the moms?

October 1, 2018 Posted in Back Pain  Health & Fitness  Musculoskeletal  Pregnancy  Womens Health Loading Likes...

In my line of work I see a lot of musculoskeletal pain. My typical day consists of sedentary folks, weekend warriors, professional athletes, and retirees. One population that does not get enough attention are moms during and after pregnancy. There may be several reasons this population tends to be overlooked. I am not aware of any specific studies but I thought I would share my experience with you.

“I thought that the pain would go away but then it didn’t.”

I think that there is an expectation of having pain while pregnancy and after delivery. Carrying around 20-40 pounds of extra weight for 40 weeks can definitely cause discomfort/pain. However, some moms have a spectacular pregnancy and others really struggle with pain until delivery. I think I can speak for all men when I say I cannot even imagine the toll carrying and delivering a child has on a woman’s body. It is so traumatic that I think anyone would expect to be in pain at least for “a couple” months after delivery. However, in the clinic I often hear that they thought the pain would go away and then it just did not. Unfortunately there is reliable way to know when pain should go away or when a woman’s body has “recovered.” Plus, it’s impossible to know what a body should feel like after pregnancy.

“I thought it was normal and that all moms are in pain. I figured it wasn’t worth mentioning.”

I hear this all of the time. I suspect that no one wants to speak up when you are in pain in the mom world. I obviously do not have any firsthand knowledge but I hear things in the clinic, at the playground, online, etc. A little while back I posted a question on Facebook if any of my mom friends had pain after pregnancy. It was like an explosion of discussion! The ones who responded were friends that I knew are generally comfortable with posting and sharing aspects of their lives. However, I know there are a bunch of folks that are just Facebook “lurkers” who do not actively post that probably wanted to say something. Once I saw the response (and maybe lack of response) it kind of made me sad. I wondered if there were a lot of moms suffering in silence and too embarrassed to share their pain.

All parents can agree that having children is a life changing event. However, only moms can attest that it’s a body changing event as well! I see a number of musculoskeletal conditions related to pregnancy and childcare. It ranges from spine pain, pelvic pain, shoulder pain (i.e rotator cuff tendinitis/tendinopathy), nerve irritation (carpal tunnel syndrome, cubital tunnel syndrome), patellofemoral issues, pelvic floor disorders which includes pain, incontinence, and pain with sexual activity. To make things more complicated, there are often multiple musculoskeletal complaints. However medical care after pregnancy is really focused on well baby visits. From the mom’s standpoint, the gynecologist is focused likely on pain related to tearing or incisions related to delivery, lactation, and screening for post-partum depression just to name a few. Now try to cover those topics into a 15 minute visit! It’s challenging for the provider every time. There is also the issue of awareness of musculoskeletal conditions. Primary care providers have been trained in musculoskeletal disorders in their early years. However, they may not be as comfortable recognizing it so far removed from training. You can’t treat what you don’t see. So it’s not just the amount of time but recognition of the condition. Unfortunately the musculoskeletal issues can fall through cracks or fall into the “I’ll mention it next time” category.

Making appointments can be hard! There is hardly any personal time once kids come into the picture! Aside from trying to sleep, eat, and shower you are tremendously busy caring for little ones. It is easy to forget about yourself when caring for others. Even after deciding to see someone about pain think of the entire process.

1. Call to make an appointment to see your PCP or gynecologist. Sometimes you get the operator quickly sometimes you wait 20 minutes. There next appointment is not for 2-3 weeks.
2. Make arrangements for childcare so you can go to the appointment by yourself or decide to bring your child.
3. You get to the appointment but have to wait 30 minutes. You and your physician talk for 8 minutes and then decide to get imaging and they call you back.
4. If you go to a walk in clinic and get an x-ray, it will likely read the next day. Skip to step 6.
5. If you get referred for a MRI, please see step 1 then go to step 6.
6. After the imaging is completed you get a call back about 3-7 days later regarding results. Your PCP decides to refer you to physical therapy or a medical specialist (i.e. orthopedic surgery, sports medicine, physiatry.) If you are referred to see a physical therapist, you will likely be seen within 1 week which is the best case scenario! If you are referred to a medical specialist, see step 1.

Sound familiar? These are all of the steps that need to happen even before treatment is started! The use of telemedicine can circumvent a lot of this headache. Please check out my website for more details.

So I list all of these reasons not to give excuses but motivation to be proactive when it comes to your body. If you do not feel right, say something. Talk with your friends at the very least. Sometimes meeting someone going through the exact same thing is therapeutic and the first step to recovery. As I said, I hate seeing people suffer simply because they assume that it’s normal. But it’s extremely common. So moms, please say something. I know that it’s hard and we can all lose ourselves in our kids. Please know that there are people that can help. I know you have a million things to do but please put yourself at the top of that list. If you have any problems locating a provider in your area please shoot me a message and I’d be glad to help you out.