Could sitting in the car be causing you pain?

The Holidays are coming, which for many of us means traveling.

After sitting in the car for 3 hours (one way) while driving the the Seuss Museum over the weekend and then the thought of driving another 3.5 hours to visit family over Thanksgiving, thoughts of making my travel more comfortable and least stressful on my body came to mind.

Sitting in the car to go to the next town over or several states over can put your body into strange postures.

Car seats are built for safety, not so much for good posture.

What this means is you need to be mindful how you are sitting in the seat, which may include props or modifications.

By sitting in the car in an odd posture for 10 minutes several times a day, 30 minutes a week or several hours all add up to wear and tear on your body.

Good posture in the car becomes especially important during pregnancy and as a mom.

As a mom you are reestablishing your core and have to constantly adapt how you are moving and using your body to take care of your little one(s). Being intentional about your posture will help your body heal, reconnect, and move in a more efficient way. Thus in the long run nourish your body and avoid pain.

During pregnancy, good posture can be harder to find and manage, especially if the seat you're sitting in forces you in to an odd posture.

And since sitting in general during pregnancy can cause your joints to settle leading to aches and pain, it makes it even more important to pay attention to.

When sitting in the car, especially for longer than 10 minutes, your body tends to get tired of sitting in one position when it lacks the support from your core.

Here are some of my tips for sitting in the car.... to travel during the holidays or for every day driving.

Adjust Your Seat First

There are so many ways to adjust seats now, so take advantage of your options.

When you first get into the car play around with your seat position. Explore the different positions you can put your seat in.

  • Does your seat raise and lower?
  • Is there adjustable lumbar support?
  • Does the seat tilt?
  • Can you adjust the steering wheel (if you're driving)?
  • What is the distance you can safely and comfortably be from the steering wheel?

Know What Proper Sitting Posture Looks Like

Adjusting your seat will only be effective for you if you know how to adjust for good posture in sitting.

There are some basics to always follow and then some modifications to play around with.

Here are some basics:

  • Pelvic Neutral
    • You want to make sure your pelvis is not tipped in one direction. Car seats tend to force us into more of a posterior tip, making us sit on our tailbones.
    • You also want to make sure you are not twisting in one direction, by crossing your legs or shifting your weight to one side.
  • Spine Neutral
    • You want to make sure your spine is nicely stacked over the pelvis, not rounded or arched or twisted
    • Car seats lend more to rounding your back because of the concave nature of the seat back.
  • Knees in line with each other
    • This is especially true when you are driving
    • Make sure when you are sitting your knees line up with each other, rather than having one more forward
    • This is typically a twist in the pelvis
  • Neutral hips
    • Avoid sitting with legs crossed, significantly turned out or in, or squeezed together or wide apart

Here is a modification:

  • Hips and Knees should be around 90˚ flexion (or bent)
    • This is when you are a passenger. When you are driving your knees will not be at 90˚ to reach the petals while at a safe distance from the steering wheel.
    • This may not always be achievable in a car based on height of the seat. For example you may drive a sedan and be tall. The seat may only raise up so high to accommodate your long legs. Unlike a SUV that seat is already higher.
    • As your belly grows so does the angle your hips can be at for comfort.

How to Find Good Posture

Now to combine playing around with your seat options and knowing your posture guidelines.

When you first get into the car adjust your seat. Find the position that brings you the closest to the 90˚ at hip and knee, or even around 100˚ hip flexion (think more open between thighs and belly, like opening a book).

Once you've figured that out, adjust the distance between you and the steering wheel if you're driving. I've found that when I adjust the seat height I get too close to the steering wheel.

The rest is based on you.

After adjusting your seat to avoid the common rounded, slouched or closed off position, you have to help your body find the comfortable neutral.

Use your pelvic tilts to find pelvic neutral.

Grow your spine out of your pelvis in both directions, stacking your vertebra, ribs, shoulders and head over your pelvis.

Adjust your seat again, if your lumbar support is too much or little. I find that sometimes the lumbar support doesn't actually align with where you need the most support. Think just above the sacrum or belt line. You should feel your sacrum (widest part of pelvis) and your ribs are softly reaching into the seat.

Look at your legs. Are they neutral or twisted? Are you crossing your legs? Are you shifted to one side, so you can quickly look back at your kiddo(s)? I'm guilty with that last one.

As you settle into your neutral body position and find your good posture, now you can adjust your mirrors to match your needs.

Keeping it up on long rides....

Can be support challenging. Don't feel you need to stay still the entire time you are in the car.

By all means shift and move.

This will keep your muscles from becoming stiff, your joints from settling, and boost your overall awareness of your posture.

If you rode with me you'd see me doing pelvic tilts, pelvic circles, glutes squeezes, neck rolls, deep breathing with core coordination, leg shakes and more.

This keeps my body awake, but at the safe time relaxed and more comfortable, avoiding very common aches and pains in the low back, pelvis and hips....especially when you transition out of the car to standing.



Pubic bone pain stopping you in your tracks?

During my second pregnancy I have experienced pubic bone pain more often and with more severity than during my first pregnancy.

There have been several times that it was so intense I could barely walk.

If you've had pubic bone pain you'll know what I'm talking about. The sensation that the front of your pelvis is grinding together and ripping apart. It's not pleasant.

But why do some of us experience pubic bone pain during pregnancy and sometimes even into postpartum?

Pubic bone pain is a very common pain syndrome during pregnancy. It is associated with Symphysis Pubis Dysfunction. The symphysis pubis is the joint that connects the two halves of the pelvis in the front. Your abdominal muscles, pelvic floor muscles and inner thigh muscles attach to the pubic bones.

There are four main causes of pubic bone pain, these can happen exclusively or more commonly in combination:

1. Posture

Your spine and pelvis is designed to be held in a particular position in relation to each other.

You have natural curves through the spine that allow forces to be translated efficiently and safely through the joints.

During pregnancy your posture tends to alter these natural curves because of your growing belly shifting your center of gravity forward and a stretched & weaker core.

When this happens your lower back curve increases and your pelvis tips forward, in standing. Or while sitting we tend to slouch into curved position. With a weakened core it's harder to pull out of this position.

This puts more weight on the symphysis pubis, that it is not meant to have to bear, straining the joint.

2. Alignment

Our pelvic joints go together likes puzzle pieces. There is one way they fit together, any other way is like jamming the pieces together.

Picture how painful that could be.

This is more commonly considered Pelvic Girdle Pain. Issues in the sacroiliac joints (back of the pelvis) that translates to the symphysis pubis.

Your joints are more susceptible to not fitting well during pregnancy and during recovery because of relaxin, estrogen and progesterone, which soften the ligaments and connective tissue that support and stabilize the joints.

When your joints are not "put together" they no longer efficiently manage forces, putting more strain on them.

3. Muscle trigger points or spasms

Trigger points and muscle spasms are locked up, dehydrated, sometimes over-worked muscle fibers. They tend to get stuck in a pain cycle of communication until "unlocked."

During pregnancy and  postpartum, with weaker core muscles, other muscles work harder to stabilize the pelvis and spine.

When muscles repeatedly work harder they form trigger points and muscle spasms.

These trigger points and muscle spasms can effect the joints they are attached to, referring pain  or causing imbalances in the joints.

4. Weak core

Without being extremely mindful as well as diligent with corrective exercises your core muscles will weaken, loose natural reflexes and disorganize function.

When this happens they no longer support and stabilize your joints and body.

So every time you move, like getting up from sitting or rolling in bed. Your joint are able to manage the forces going through them and your body responds with pain.

For me it has been a combination of old injuries causing alignment issues and trigger points reducing my body's core coordination. This all happened after two incidences:

One while lifting and moving too many boxes and furniture without asking for help.

The other after slipping on wet leaves covering my shed's ramp while doing yard clean up after a big storm. The caused me to tense up to avoid a full on split.

Both certainly not my finest hour, but I was able to get resolve pain fairly quickly with self care I've learned over my pelvic health years that I know work for my body.

If you answer "yes" to the following questions then it's time to listen to your body and ask for the help you deserve....

1. Do you experience pubic bone pain when you role or shift in bed?

2. Do you get pubic bone pain when you walk?

3. Are you several months postpartum and your pubic bone is on fire?

4. Do you want to have a natural birth and wonder how you'll manage because of your pubic bone pain?

There are simple tips and tricks to reduce your pubic bone pain.

Top tips....

Take smaller steps while walking...

Stand and sit tall keeping your pelvis and spine in neutral...

Warm up your pelvis with pelvic tilts before standing up...

Keep your legs together and roll like a log when moving in bed...

And lastly....

Set up a breakthrough call to learn what your body needs.

Sleep during Pregnancy

As I drove to work this morning I listened to a podcast by Katy Bowman, a biomechanist, about SLEEP.

If you've never heard of Katy, she is a proponent of nutritional movement and varying our movement in our daily activity for optimal physical health. Our beliefs align on so many matters, which is why I enjoy listening to her podcasts.

This morning was no exception.

The style of this particular episode was answering questions from listeners and the first listener was an expecting mom.

Thus, the reason why I'm sharing my thoughts to all you lovely ladies.

To paraphrase this moms question,

"should I sleep on my left side?"

She is generally a very mobile sleeper, but had heard that during pregnancy she should sleep on her left side. She however, feels that this is causing one side of her body to be "overworked" and the other side to be "underworked."

To be honest, I didn't completely agree with Katy's answer, which was essentially, "I don't know."

But she did have some good insight, especially since she did some digging into the research to see if there was any evidence to support this position while sleeping during pregnancy.

This is what she found....NOTHING!

There is no research to back up the very commonly prescribed, sleep on your left side during pregnancy.

However, there is evidence to show that if a mom lays on her back for long periods of time it can slow down blood flow to the fetus. This is because of the weight of the fetus within the uterus pressing back onto our large blood vessels in our gut that shunt blood back to our heart.

The cool thing is our bodies will tell us by becoming light headed, nauseous or uncomfortable, or the baby will slow her movements.

Then typically all we have to do is roll to our left side, because the vessels are predominately on the right side of our spine. Or sit up.

How does this relate to sleeping then?

Hopefully for most of us we are sleeping for at least 7 hours. Of course during pregnancy this may be altered because of discomfort, our bladder, hunger, or just being restless.

But if we are sleeping for longer than 1 hour stretches, this is a long time for our body to be in one position, right?

So the theory is, if you start on your left side during pregnancy, you are reducing the compression on your vessels.

Then through the night if you find yourself in other positions, it's okay.

Remember, your body will let you know when to move.

I am a mobile sleeper and am constantly in different positions, there was no exception during my pregnancy. But I didn't stay on my left side the whole time.

I respected and listened to my body.

The other thing to consider is if you are laying on your side to reduce pressure on your vessels, then wouldn't laying on an incline also provide this relief?


So if you are at all worried about having to always be on your side, but it's getting super uncomfortable, there are ways around it.

This can be said for any sleeping position, if it's uncomfortable, maybe there are ways around it or modifications you can do, or activities you can do prior to bed to provide relief.

The big take away is to honor your body and listen to what it is telling you. Take the time to vary your movement and stretch through out the day to reduce restlessness and improve your body awareness over all.

Happy Sleeping!

Breastfeeding...Tips to Reduce Upper Back Ache

My first experience breastfeeding was in an ER.

My delivery was pretty by the book. I went into labor Friday night, I was able to sleep between the contractions, we were up by around 7:00 am and two hours later I was to the point I couldn't stay home anymore.  We arrived at the independent Birth Center by 9:00 am.

I tried the was that hot and not for me...even though I LOVE water.

But clearly my body was saying, nope and I respected that.

Instead I climbed into the queen sized bed and pushed on my hands and knees.

Everything was going well, as far as I could tell...even though I joke with my husband that I only dropped the f-bomb once, he chuckles and says if you say so.

But even though I was in pain I was riding the waves of it, resting in between and in a total state of euphoria.

It was REALLY hard work, but I have a hard time describing just how painful and hard of work it was even just 3 years later.

Mostly, I remember things being in a haze around me, the midwives encouraging me, my husband by my side, my mom helping me stay hydrated.

But then, everything changed.

The midwives had me flip onto my back. They insisted I get my baby out.

So after a few pushes her head emerged.

This is when things really get blurry.

Apparently, unlike other circumstances when the umbilical cord is wrapped around a newborns neck it can be removed or does so on it's own during decent.

This was not the case for our little one.

I was strangling her with every push and if I had kept going she may not be here with us today.

This is why the midwives think it took me as long as it did to actually get her head out.

So instead of being able to keep her cord connected as long as possible, as my plan intended, they needed to cut it even before she was fully delivered.

I had 30 SECONDS to get her out after they cut the cord!

Well let me tell you there was no amount of time you could have told me to get my baby out if I knew her life was on the line.

Needless to say with that last push, she was born and I tore.

They placed her on my belly and told my husband and I to rub her vigorously to try to get her to cry.

This didn't work.

They removed her from my belly and had to perform rescue breathing on her to get her to breath.

It has been 3 years and I still tear up thinking about how our vivacious, head strong, wonderful daughter may not be with us, if my awesome midwives hadn't been on the ball.

Within minutes the ambulance came to pick her up and bring her to the hospital.

I was not able to go with her because I tore and needed stitches before I left.

So last I saw her was partially limp, but breathing on  the bed next to me.

My husband followed the ambulance and my mom stayed with me as I was cleaned up.

When I arrived at the hospital, the nurse at the ER desk didn't seem very concerned that there was a newborn infant waiting for her mother in one of the rooms and it felt like eternity to get me back to her.

My midwife was not impressed and rather cross.

When we finally arrived, my husband had our daughter all bundled up and was letting her suck on his finger with sugar water.

The whole time I was being cleaned up and driven over to the hospital and then waiting to be reunited, I was petrified that I wouldn't be able to breastfeed because we had been away from each other too long.

I climbed into an ER bed, in a dark room tucked away from the hustle and bustle of the other goings on and my daughter was handled to me.

When I held her to my breast, it felt so awkward and she seemed so tiny that I was fumbling. But my midwives again encouraged me my daughter latched.

It was a miracle.

We were fortunate that we had no issues nursing, after I was so terrified that I wouldn't be able to.

We went on an nursed for 2 years.

I can't say that through those 2 years it was all sunshine and roses though.

Hello teething!!!

She never really bit, but holy cow her suck became so strong to sooth those tender gums.

But the trickiest part for me was finding positions that wouldn't hurt my neck and back.

She was a nurse to sleep kind of girl.

And sometimes, she would stay nestled in my arms for hours and any time I moved she would scream.

So if I wanted her to nap, I needed to stay put in my rocker.

Fortunately, we found a super comfy glider, rocker combo with ottoman, but even that wasn't enough.

I had pillows galore and would stuff them in all the crevices to get me from slouching down to meet her.

This helped, but still my muscles would ache.

Of course being the physical therapist that I am, I was determined to stop the ache.

This meant not only making sure my posture was in good alignment or that I switched up the position I was in so I wasn't always using the same muscles but I stretched.

I stretched my neck, chest, upper back, hips and buttocks after every feeding.

But stretching isn't enough to make sure you don't slouch. Our core plays a HUGE roll in our posture. After pregnancy and birth our core muscles have to heal, shrink, and remind themselves what their roll is.

Most of the time, they need our help.

This meant when I was sitting or lying down or standing while nursing I did sets of pelvic floor and core exercises.

Some of you may question me when I say exercise, when I not breaking a sweat.

But exercising a muscle does not always require us to be jumping around or moving our whole body to gain benefit.

Actually, in the postpartum period smaller, slower, more intimate exercises will help you heal and get back to those more intense, vigorous exercises without long term issues.

So to recap my tips:

  1. Make sure you are in good posture while breastfeeding. This means if you are sitting - not sitting on your tailbone, bringing the baby to your breast and supporting with as many pillows as necessary. If you are lying down try to switch up the sides you lay on and again prop baby until she is big enough to not need support. If you are standing, the easiest way to breastfeed a newborn without a carrier is in football hold.
  2. Stretch. Tight muscles will lock in the chemicals that help our muscles to work, but over time this build up and constant shortening and pulling on the joints will cause pain. So balance out your muscle by stretching those that are most shortened while nursing. Try out these!
  3. Work on your Core. Starting simple and easy with breathing exercises is the best way to reacquaint yourself with your core. If you had pelvic floor trauma or a cesarean this reconnection may take longer and you may need help from a specialist to figure out what muscles your are targeting and if there is anything may be inhibiting your reconnection, like scar adhesions. Check this video out!

To find out more about proper nursing postures, postpartum stretches and reconnecting to you core sign up here for your free consultation with a maternal pelvic health specialist.