Physio Myth Busters – Back Pain IS preventable for stay at home mums!

Mums. We’ve all had one. They do an amazing job. This blog is for all those super mums out there, who tirelessly and endlessly love upon their kids and partner, run households, cook dinners, clean houses, drive kids everywhere and give of themselves day in and day out. If you’re a mum, this blog is for you! Firstly, thank you for all you do for your kids! They may not tell you it, but they really value you! Secondly, I want to teach you today how you can keep your back pain-free so you can keep being the super mums you are and need to be.

Statistically speaking, there is an 80% chance, just like every other Australian, that as a mum you will end up suffering from low-back pain. And the stakes are fairly high. If you do develop low-back pain as a mum, among other things, you may not be able to lift your kids, clean the house, or lift the pram into and out of the car. I have seen first-hand as a physiotherapist, the huge stress and pressure back pain can place upon mums, families and most importantly people’s health and well-being. It is therefore, essential that as a mum, you look after and take care of your low-back.

Fortunately, the truth is, that even with all the super mum tasks you perform, you do not have to end up with low-back pain. However, if you are going to keep a pain-free low-back through the child-rearing years, you are going to need to be proactive. Otherwise, if you’re not, your back will tell you about it!

What causes low-back pain:

There are lots of different things that can cause low-back pain. As a general rule, most low-back pain results from an acute (ie. lifting a pram into the car) or repetitive (ie. repetitive lifting of kids) overload of the low-back joints, muscles, discs or ligaments. As a physiotherapist my role is in identifying the key contributing factors to a problem and working out the key risk and predisposing factors to a problem occurring. Back pain at home is rarely one-dimensional, but rather multi-faceted, with a number of factors contributing to a mum developing low-back pain from their motherly duties. It makes sense then that a multi-faceted approach be taken to both prevent and fix low-back pain.

Top 5 tips for mums in preventing (and fixing) low-back pain

So here we go – employ these following tips, and I guarantee your back will thank you for it!

1. Optimise and manipulate your work environment – Analyse the demands of your tasks at home and understand the risks involved. Think about what’s required of you and plan ahead. Change the surface, height, timing and process of things to minimise low-back loading. Be smart with how you do tasks at home, especially lifting and repetitive movements.

How?

• Space out manual tasks ie. Washing, vacuuming and cleaning
• Clean in short bursts, not for 4 hours straight.
• Get your little kids where possible to get on the couch and lift from there, instead of from the floor. This will reduce the low-back load.
• Get help lifting where required – wait for a second pair of hands for heavy parcels or groceries from the car
• Don’t lift and twist while carrying kids or groceries – twisting while carrying a load (ie. a toddler), greatly increases the forces and stress on the low-back structures. Turn your feet, rather then twisting!
• Get a cot with an adjustable side that you can drop right down so you can save reaching over the height of the bar.
• Use trolleys to carry kids at the shops to save carrying them and loading your back.

2. Maintain optimal postures – Life is a series of postures. If you maintain poor postures repetitively, ie. Repetitive bending, lifting and twisting, you can expect a back pain to develop. Think about your posture at home and with how you carry and care for your kids and how you move.

How?

• Maintain blades back and neutral spine when cleaning where possible.
• Use your big muscles – your legs to help lift heavy objects and kids, not your small back muscles to avoid low-back strain.
• Vary your postures and avoid staying bent over picking up kids toys or folding the washing.
• Avoid twisting with the washing basket in hand and repeated bend and twist movements
• Use your legs and keep your spine in neutral when lifting the pram out of the car
• Be careful twisting back in the car to pass something to kids in the back. This extension with twisting while passing something can lead to low-back overload and injury. Pass something back at the lights or when pulled over to minimise risk of straining.
• Avoid long periods of washing the dishes with your head down – it will likely aggravate your neck if you do it for long enough
• Kneel in front of your child while buckling them into their car seat – don’t try and awkwardly strap them in from outside the car and risk low-back strain.

3. Always warm up! – One of the most ‘at risk’ times for your low-back to sustain an injury is when your body and back are not warmed up and after prolonged sitting. Warming up before you move, lift, bend and carry kids, while not always possible, is helpful in preventing the likelihood of sustaining a low-back strain. A warm up helps get blood flowing and muscles warm and increases elasticity in tissues, therefore reducing the risk of over-stretching and straining low-back structures.

How?

• Go for a walk with the kids/pushing the pram in the morning before you do the vacuuming or housework
• Do some stairs at home a few times before you do the washing or lifting at home to get your heart rate up and back warm.
• Be especially careful lifting kids during the night when they wake you up and need to be picked up. Make sure you employ good lifting technique!
• Stretch your hip muscles out before you do housework – make it a game with the kids – get them to do stretch too!
• Join in with your kids on dancing to ‘The Wiggles’, or whatever show they are watching. (No one will ever know you boogied down to the Wiggles!)

4. Maintain good flexibility – Most low-back injuries are a direct result of overload. Where too much load is applied to the low-back joints, discs, ligaments and muscles and eventually strain or injury presents acutely or over a period of time. Maintaining good hip, low-back and thoracic spine range of motion and flexibility is essential in reducing the load placed on your low-back via your work. Stretching is mostly valuable to people who have a ‘stiff’ body type, more so than those who are hypermobile. For hypermobile workers, strength and stability are more required than flexibility in reducing the chances of low-back injury. For mothers during pregnancy and for up to 6-12 months after delivery, the hormone relaxin increases a mother’s joint flexibility. Care should therefore be taken during the times re stretching and usually stability is more important for helping prevent back pain (see point 5). For mothers with kids over 6-12 months old, stretching and flexibility can certainly help prevent and fix low-back pain problems.

How?

• See a physiotherapist and discover your body type – hypermobile (floppy), hypomobile (stiff) or somewhere in the middle.
• Get set up with a stretching and/or strengthening program to help support and de-load your low-back.
• Stretch in the morning and evening (if appropriate) – 2 x day to prevent low-back pain occurrence and recurrence
• Stretch (if appropriate) after you eat at home or if you have done the housework or other physical activity.
• Simple quads, gluts and hip flexor stretches are all easy stretches to do on the go at home with the kids running around.
• Make it a game – get your kids doing the stretches with you – make a game out of it that kids enjoy ie. Who can hold the longest stretch or pull the funniest stretch face
• If you have kids who are can be left on their own for a moment, try and make sure you make space to do your home exercises – lock yourself for 5-10 mins in the bedroom if you need to!
• Tag team with your husband or partner or get some family support to get some moments in the day where you can do your prescribed exercises to help prevent or reduce your low-back pain.

5. Get strong and stay strong – Core and hip strengthening really is the key to both preventing and fixing low-back pain. There a number of ways and methods you can use to strengthen your back and honestly, it doesn’t really matter which one you choose, as long as you enjoy doing it, do it regularly and get the strength you are after. Engaging the right muscles is really important also and this is where your local physiotherapist or personal trainer can help in teaching you how to use your core and hip muscles properly to support your back. Personally, I find with my clients clinical pilates is a fantastic, effective way to build functional core strength for your motherly roles.

How?

• Clinical pilates, swimming and gym programs all provide great tools for core and hip strengthening for mums.
• Mums and Bubs classes for gym work or pilates or yoga are all great options where the baby/little one can come along too.
• Choose a group/gym exercise option with a creche attached for the kids!
• Make sure you choose a personal trainer who knows and understand your back, especially if you have had a history of low-back pain.
• Home-based core exercises – ie. Mat-based pilates exercises including supermans, planks and side planks, are great for stay at home mums and can be done when the kids are sleeping and require minimal set up and pack down effort. Exercise DVD’s can be useful tools also.
• Make time – don’t wait until your in pain to do something about it – plan how you can keep a healthy back through the early years of child raising.
• Choose functional exercises if doing bootcamp style training – use your legs, core and arms in as many exercises as you can. Whole-body training is helpful for mums especially.

In summary:

Don’t wait for low-back pain to start impacting your life and your ability to take care of your kids, home and family. Take action, be proactive and you can prevent and beat low-back pain caused by your your motherly duties. Don’t look back and say ‘I wish I had….’ Instead, love your back – look after it!

If you have presently got low-back pain or have had low-back pain in the past and would like to find out more about how to beat low-back pain, make sure you contact your local physiotherapist.

To having happy backs and happy mums! Cheers!

Jacob Taylor (APAM)

Physiotherapist

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