ObGyn/Pregnancy issues/knee/joint pain

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Question
QUESTION: Hi Helen,
I delivered my baby 5 months and 1 week ago. When I was pregnant with him I had joint pain when bending, etc.  He is my third child and biggest one.  I am petite and so ever since I had him (by c-section) I've had ongoing joint pain.  He is now a heavy baby.  I think carrying him around also causes knee pain and just the fact that I am constantly moving.  But I am now experiencing pain when walking for a long time.  I got my knees/lower legs checked/x-rayed and doctor said to take 3 anti-inflammatories (Ibuprofen) daily for two weeks.  I couldn't do that because causes my constipation and also she gave me some exercises, I have not been too diligent about doing those exercises either.  It is hard with a baby.  What advice can you give me?  The pain seems to move, travels to my thighs and lower legs sometimes.  I hear cracking when going up stairs.  Some weeks worth than others, but every since baby arrived the pain has not gone away.

ANSWER: What exercises were you given?
Do you feel pain mostly going up stairs, or going down stairs?
Are you doing any exercise, like stroller fitness walking?


---------- FOLLOW-UP ----------

QUESTION: 1)stretches,& strengthening she said I am very stiff (my legs)(hold each foot to my back stretch for 30 secs), lying down-one knee bent, other leg pointing up-hold for 30 secs, then switch.  Also another one lying down, one knee bent, other leg up- use belt to pull toward me- then switch.  

2) It is not so much pain, I would say going up stairs, the pain is more when I am very active, doing alot of house work or stuff-running for baby, etc.

3)No, none.  What is stroller fitness walking.
Do you recommend exercise or just rest?

Answer
Mary,
The exercises that were recommended to you are for building flexibility in the hamstrings (back of the thighs). Hamstring tightness does not cause knee pain.
Most likely, you have been dealing with postpartum instability. The hormones of pregnancy lengthen our connective tissue so that the pelvic outlet can expand during labor. But these hormones also lengthen our ligaments. Ligaments are designed to stabilize our joints, so that they move in the proper range of motion.
Joint laxity in the ankles, knees, hips and pelvis is a very common postpartum problem. Most likely, this is the root cause of your knee pain. And this would also explain why your pain seems to move around a bit too.
The good new is that by 6 months pp, most women start to feel that their joints are less loose, and more like their pre pregnancy state.
I recommend two tactics.
First, deal with any swelling that you still might have. You could try the anti-inflamatories with dietary adjustments to prevent constipation. 3 Ibufrofen daily for 2 weeks seems a bit excessive. Try it for 3 days instead.
Second, build up some thigh and glute strength. Weakness in the buttocks is a common cause of knee pain in women.
For the thighs, lie on your back, knees bent, soles of the feet on the floor. Extend one leg straight up, or between a 45 and 90 degree angle. Then lower the leg (knee stays straight) till your heel almost touches the floor. Lift the leg back up with a straight knee. Slowly bend your knee, then straighten it back up, and repeat. Do this move 12 times on one leg, then switch sides.
For the glutes, lie on your side, with your hips slightly flexed, legs straight. This will make a small "jackknife" position in your body. Slowly lift the upper leg about one foot off the floor. Make 8 little circles in one direction with your foot/leg, then reverse direction. Repeat both sides Keep your hips still and your knee straight.
Third exercise, use your lowest step in your house like you would in a step aerobics class. Walk up and down one step, leading with your right foot 16 times, then reverse so that you lead with your left foot 16 times. Repeat this pattern for 3 minutes.
Stroller fitness walking is brisk walking with your baby in a stroller. Great to do every day when the weather allows.
http://befitmom.com/abdominal_separation.html

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Helene Byrne

Expertise

I can answer all questions regarding prenatal and postpartum fitness and exercise. I will not answer any questions that are not related to prenatal and postpartum fitness and exercise. I will not answer questions regarding getting pregnant, or signs or symtoms, only fitness and exercise during and after pregnancy. No due dates, medical problems during pregnancy, signs or symtpoms of pregnancy, pregnancy tests, vaginal problems/smells/discharge, periods or ovulation.

Experience

Pre-and-Postnatal Exercise Specialist ACE certified Personal Trainer Author: "Exercise After Pregnancy: How to Look and Feel Your Best" Book Author: "Bounce Back Fast! Post Natal Core Conditioning" DVD Founder: BeFit-Mom Teacher: Post Pregnancy Exercise Workshops

Organizations
IDEA Health and Fitness Association

Publications
numerous regional parenting magazine

Education/Credentials
Dancing Thru Pregnancy, Pre/Post Natal Exercise Specialist Certification 2000 Resist-a-Ball Core Program, 1999 American Council on Exercise, Personal Trainer Certificate, 1999 Peak Performance, San Francisco, CA, Pilates Instructor Training Program, 1992 Health and Fitness Institute, Cal State Hayward, Personal Trainer Certificate, 1990 American College of Sports Medicine, Group Exercise Leader, 1989 Boston Conservatory, BFA/Dance, 1982

Awards and Honors
´┐ŻBounce Back Fast! Post Natal Core Conditioning´┐Ż, 2005. Winner of the Platinum Award from the Family Review Center, 2007.

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