Category: Weekly Tips

Categories
Weekly Tips

Mental Health During Postpartum

Did you know that nearly 1 in 4 new mothers experience clinical depression after having a baby? More than that, nearly all women experience emotional highs and lows in the challenging weeks after adding a new addition to your family. We know you love your squishy little baby more than anything in the world! And we know you are happy to have them! That said, it is okay to admit you are sad or overwhelmed. It’s okay to admit not every minute is butterflies and rainbows. These early days, weeks, and months are HARD. And you are not alone! If you are feeling sad, overwhelmed, overly teary, or any other extreme emotions, don’t hesitate to talk to your doctor. There are many great options out there to help you, including exercise!  Don’t let another moment go by where you are not at your best and your happiest! Your baby needs you to be your best version of yourself!

Here are some symptoms to look out for:

  • Reduced quality of life
  • Anxiety
  • Lack of life interest
  • Tearfulness
  • Insecurity
  • Inappropriate obsessional thoughts (i.e. that your baby will stop breathing if you do not monitor them constantly)
  • Irritability
  • Fatigue
  • Guilt
  • Fear of harming the baby
  • Reluctance to breastfeed
  • Difficulty processing birth or birth trauma

If you are not sure if your feelings warrant evaluation, click this link and take this simple quiz! https://psychology-tools.com/test/epds. It is only 10 questions and will provide you with a score. If you score anywhere from 10-30, we recommend you talk to your doctor! 

You may also want to talk with a spouse, partner, or close friend/family member and to ask if they have noticed a change in your mood. Sometimes, a loved one may recognize a change in mental health before you do.

https://www.who.int/mental_health/maternal-child/maternal_mental_health/en/

Cox  JLMurray  DChapman  G A controlled study of the onset, duration and prevalence of postnatal depression.  Br J Psychiatry 1993;16327- 31.

Gráinne M. Donnelly GM, PT, Brockwell E, Rankin A, Moore IA. Beyond the Musculoskeletal System: Considering Whole-Systems Readiness for Running Postpartum. J Wom Health PT. 2022;46(1):48-56.

© WKU {2022} All rights reserved.

Categories
Weekly Tips

Women’s Health Physical Therapy for Pregnancy

Your body is supporting and growing a child.  It is essential you are at your best in order to carry to term, deliver, and care for this life.  A WHPT understands the needs of women and the changes that occur during pregnancy, labor and delivery, and postpartum.  During pregnancy a women’s health PT can help address the pains associated with your changing body. These include but are not limited to lower back pain,, pelvic pain/pressure, neck/shoulder pain, bladder and bowel issues (leaking, constipation), and abdominal wall concerns (e.g. diastasis recti).   Although many attribute these as “normal” conditions, these are issues that are manageable and treatable!  A women’s health specialist can improve your quality of life through the pregnancy, prepare you for delivery, and prepare you to care for your new baby postpartum.

A Women’s health physical therapist (WHPT) is a licensed clinician trained to evaluate and treat neuromuscular conditions related to pregnancy, postpartum, and pelvic pain. We commit ourselves to learning and caring for women in all phases of life. 

Written by Women’s Health Physical Therapist: Dr. Emily Davenport, PT, DPT, WCS

© WKU {2022} All rights reserved.

Categories
Weekly Tips

Women’s Health Physical Therapy for Postpartum

You have taken care of yourself to deliver your baby.  Now, let’s talk about how to take care of you!  Your body has changed over the last 9 months and will continue to change over the next 6-18 months.  While many physical changes are very common after pregnancy and delivery (for example, leaking urine), they are not normal and you do not have to live with them!  Urinary incontinence (leaking urine for any reason) is considered normal for 2 weeks after delivery, as well as some pelvic heaviness and pressure (prolapse).These symptoms should progressively improve over the first 2-3 weeks postpartum.

 If these problems persist after 2 weeks, a physical therapist can help with exercises and lifestyle/behavioral modifications to reduce and potentially reverse your issues.  They can also help with the aches and pains associated with childcare activities including: neck and back pain, wrist and hand pain, impaired posture, and/or numbness and tingling in arms, legs, or pelvic area.  Other issues that can occur are diastasis recti (separation of abdominal muscle) and pelvic pain with vaginal penetration (sex, speculum exam by your doctor, tampon use when your menstrual cycle resumes).  It is important to address these symptoms early so you may return to your previous activity level and care for your baby without interference or pain. 

** A Women’s health physical therapist (WHPT) is a licensed clinician trained to evaluate and treat neuromuscular condition, including those related to pregnancy, postpartum, and pelvic pain. We commit ourselves to learning and caring for women in all phases of life.**

Written by Women’s Health Physical Therapist: Dr. Emily Davenport, PT, DPT, WCS, & Jenny LaCross, PT, DPT, PhD(c), WCS, ATC, CLT-LANA

© WKU {2022} All rights reserved.

Categories
Weekly Tips

Returning to Exercise After Delivery

When can I return to exercise after delivery? That seems to be at the top of most people’s list of questions for providers.

A typical 6 week postpartum visit with your OBGYN or midwife is simply checking to see if your cervix is closed and any stitches are healed. This is not a full examination of muscle recovery and function. Even if your birth experience wasn’t traumatic, there is still a level of trauma that occurs to the body, especially the core and pelvic floor. Six weeks postpartum isn’t a magical healing time for these muscles. This is where working with a pelvic floor physical therapist for a pelvic floor exam and a qualified postpartum trainer to help guide you back into the movements you love will really transform your recovery and future progress.

Some areas to consider with postpartum exercise:

– Stress

– Diastasis recti

– Hormone changes

– Pelvic organ prolapse

– Incontinence

– Breastfeeding supply

– Fatigue

Fatigue and Stress

Exercise has many known health benefits. However,  when your body is already deeply stressed from birth recovery, lack of sleep, learning how to parent a new baby, and navigating adding another human to your household, adding more stress on top (even if it is “good” stress like exercise) could do more harm. In times like this, slowing down and prioritizing rest need to be key components of your fitness plan. This can look like prioritizing flow and mobility work, adding in rest days, increasing the rest time between sets, or decreasing the number of high demand movements within a single workout. This is one area where you will want to really lean in to listening to your body. Issues such as adrenal and thyroid dysfunction and hormone imbalances can sneak up on you during postpartum with the combination of hormone shifts, fatigue, and stress.

Exercises You Can Do Early Postpartum

You can return to fitness postpartum with the appropriate modifications and strategies. These four exercises are a great way to start rebuilding your foundation and get you back to the activities that you love.

Breathing

  • Breathing is the foundation to your postpartum recovery and strength building process.
  • Try 360 degree breathing

Kegels

  • Not just a squeeze, a kegel is a contraction with a lift of the pelvic floor.
  • Note: Depending on the amount of birth trauma, these may not be recommended. Consult with your doctor and request a referral to a pelvic health physical therapist to determine the appropriate pelvic floor exercise for you!

Mobility Work

  • It feels good to move your joints after spending so much time sitting to hold and feed baby, especially after 9 months of growing that baby. Focus on shoulder and hip mobility with movements such as wall angels, good mornings, and shin box flows.

Walk

  • Start with short trips around your house and progress to short trips around the block (Week 1= in/around the bed, Week 2= around the house, Week 3= around the block/outside). Gradually build distance and time.
  • Feeling symptomatic when walking? Sometimes changing to walking on a slight incline can help your body get into a better position.

Gráinne M. Donnelly GM, PT, Brockwell E, Rankin A, Moore IA. Beyond the Musculoskeletal System: Considering Whole-Systems Readiness for Running Postpartum. J Wom Health PT. 2022;46(1):48-56.

Deering RE, Christopher SM, Heiderscheit BC. From Childbirth to the Starting Blocks: Are We Providing the Best Care to Our Postpartum Athletes?. J Orthop Sports Phys Ther. 2020;50(6):281-284. doi:10.2519/jospt.2020.0607.

Casey Thomas-Hardesty, MS, NTP & Jenny LaCross, PT, DPT, PhD(c), WCS, ATC, CLT-LANA

© WKU {2022} All rights reserved.

Categories
Weekly Tips

What is a Kegel?

A kegel is an important exercise to do both during pregnancy and postpartum. This pelvic floor contraction can help strengthen the pelvic floor muscles, support the pelvic organs (uterus, bowel, and bladder), and help reduce the chance of pelvic floor disorders such as incontinence and pelvic organ prolapse. However, 1 in 2 women do not know how to perform a kegel correctly even if given verbal directions. This is why seeing a pelvic health physical therapist is very important, as they will assess your ability to activate these muscles and provide individualized coaching to help optimize your muscle performance and eliminate/prevent symptoms.

The kegel is a two-fold exercise of contraction and relaxation; both are equally important. To do a kegel, you’ll want to contract and lift the pelvic floor, try longer holds of 5-10 seconds and shorter holds of 1-2 seconds, then fully relax.

When contracting and lifting the pelvic floor, here are a few do’s and don’ts to help you get it right.

Do:

– Do be sure you lift the pelvic muscles up and in. If you place a flat hand under your perineum (the space between the vagina and anus) either directly on skin or over your clothing, you should feel the perineum pull away from your hand. When you relax, you should feel the perineum gently rest back into your hand with the same amount of pressure you felt before starting the kegel exercise. 

– Do fully relax at the end of the kegel

Don’t:

– Don’t contract surrounding muscles like your glutes, abs, or thighs

– Don’t squeeze as hard as you can. More isn’t necessarily better.

– Don’t do kegels while you are in the middle of urinating or having bowel movement unless specifically prescribed by a pelvic floor physical therapist

Having trouble with targeting the correct muscles?

– Visualization can be helpful. Imagine picking up a blueberry with your vagina. Strange, I know, but this can help you target the lifting action of the kegel as well as reminding you to lift gently.

– Check yourself. As long as you are comfortable, you can check yourself internally as you perform a kegel. Simply insert 1 clean finger into your vagina. As you perform a kegel, confirm that you feel both a contraction and a lift of muscles around your finger and that the contraction happens equally all around. Don’t feel comfortable inserting a finger? That’s OK!! You can follow the same steps over your underwear with a flat hand and fingers on your perineum (the space between the vagina and the anus). You should feel this area lift away from your hand/fingers as your squeeze and feel it fall back into your hand as you relax. Still uncomfortable? You can also check this using a hand held mirror with your underwear off. Instead of feeling, you will be watching in the mirror to see the perineum pull up and in on the squeeze and return to the starting position on the relax.

– Schedule an appointment with a pelvic floor physical therapist. They can do internal and external checks to ensure you are properly performing a kegel as well as prescribe specific kegel exercise patterns as needed.

Casey Thomas-Hardesty, MS, NTP & Jenny LaCross, PT, DPT, PhD(c), WCS, ATC, CLT-LANA

© WKU {2022} All rights reserved.

Categories
Weekly Tips

Healthy Snacks for Pregnancy

Everyone loves a good snack. Here is a list of healthy snack ideas to keep you full and satisfied as you go through your day. It is also important to eat a snack before exercising or prior to attending a physical therapy session.

  • Hard boiled eggs
  • Apples and nut butter
  • Smoothie
  • Chia pudding
  • Full fat greek yogurt with berries
  • Edamame
  • Carrots and string cheese
  • Raw vegetables and yogurt based or hummus dip
  • Grapes and cheddar cheese
  • Orange and pumpkin seeds
  • Guacamole and bell pepper
  • Whole grain crackers and cheese
  • Pineapple and cottage cheese
  • Dark chocolate and nuts

Casey Thomas-Hardesty, MS, NTP

© WKU {2022} All rights reserved.

Categories
Weekly Tips

Smoking and Your Pregnancy

Pregnancy is a great time to quit smoking. Not only will it have a positive benefit on your long term health, but quitting smoking (and reducing your exposure to second hand smoke) will also greatly benefit your baby as well.

Risks of smoking during pregnancy

  • When you smoke, the toxins from the cigarette (and e-cigarette) pass through the placenta and keep your baby from getting the proper nutrients and oxygen that they need.
  • Smoking during pregnancy can lead to long term health risks for your baby, including an increased risk of colds, lung problems, ear infections, and growth restriction.
  • Smoking during pregnancy can lead to a preterm delivery.

How to quit smoking

  • Many states offer free smoking cessation programs that pair you with a dedicated coach for increased accountability and support.
  • Have a support team that you can reach out to whenever needed.
  • Set a quit date – and stick to it!
  • Talk to your OBGYN or midwife about available local resources to increase your chance of success.

There are resources and support persons out there to help you quit smoking. You don’t have to do it on your own.

Casey Thomas-Hardesty, MS, NTP

Two Peas Wellness

Long term health risks

https://americanpregnancy.org/pregnancy-health/smoking-during-pregnancy/

Smoking cessation programs

https://chfs.ky.gov/agencies/dph/dpqi/cdpb/hpdocs/QNKFactSheetPregnancy.pdf

© WKU {2022} All rights reserved.

Categories
Weekly Tips

Postpartum Meal Planning

Nutrition is an important part of postpartum recovery, but no one has time to plan elaborate meals. Below are some easy meals that can be made ahead, frozen, and reheated as needed, making them perfect for the fourth trimester.

Soups

Soups and stews, especially those made with bone broth, can be both a comforting and nutritious part of postpartum recovery. Try various forms of vegetable soup, chicken noodle, or a beef stew.

High iron foods

Iron is an important nutrient for postpartum recovery. Increase your iron intake with lean red meat in dishes such as slow cooked pot roast, meatloaf, or pork carnitas. Pair with fresh, canned, or frozen vegetables and roasted potatoes or rice for a complete meal.

Fast foods

When you need quick and don’t have time to defrost prepared meals, think fast foods. Things like:

– eggs, whole grain toast, and berries

– snack plate with whole grain crackers, snap peas, baby carrots, sliced apples, turkey lunch meat, and string cheese

Note: For food storage safety guidelines, click here.

Casey Thomas-Hardesty, MS, NTP

Two Peas Wellness

Bone broth-  https://www.twopeaswellness.com/post/bonebroth

Iron – [link nutrition and postpartum recovery]

Pork carnitas- https://www.twopeaswellness.com/post/carnitas

Click here-   https://www.foodsafety.gov/food-safety-charts/cold-food-storage-charts  

© WKU {2022} All rights reserved.

Categories
Weekly Tips

Important Nutrition Tips for Pregnancy

Are you really eating for two? While you are definitely providing nutrition for two, you do not need that many more calories during pregnancy than your normal intake. The first trimester does not require additional kilocalories – 340 kilocalories are required in the second trimester and 450 kilocalories are required in third trimester for those at a healthy pre-pregnancy weight/BMI (Academy of Nutrition and Dietetics, 2023).

When assessing nutritional needs during pregnancy, it is important to maintain a balanced plate in terms of macronutrients (protein, fat, and carbohydrates) but vary the macronutrients regularly to help ensure intake of various vitamins and minerals.

Macronutrients for pregnancy

You could get into percentage breakdowns, but the easiest way to plan your meals is by using the plate method. This assumes:

  • ½ your plate is non-starchy vegetables
  • ¼ of your plate is protein
  • ¼ of your plate is carbohydrates

Where is the fat? Many foods play double (or triple) duty and fall under more than one category of macronutrients. Such is the case with fat. Your fat intake will generally be included with your protein source, cooking fat like butter or olive oil that is used in vegetable preparation, and dairy that may make up a portion of your carbohydrates.

While the plate method is the preferred and easiest way to track macronutrients in pregnancy, it is important to note that many women drastically underestimate their protein needs. If you’re counting or weighing, 71g of protein per day is a good guide for the first half of pregnancy while increased need does not occur until second and third trimesters. Protein needs depend on weight — 1.1 g/kg of body weight, so some women may need more than 71 grams. If you’re struggling with protein due to meat aversions, see the below list of good sources of protein for alternatives (Academy of Nutrition and Dietetics, 2023).

Food Serving Size Protein Content

Lean beef: 3 ounces, 22 grams.

Chicken breast: 3 ounces, 26 grams

Salmon: 3 ounces, 22 grams.

Eggs: 2 eggs, 12 grams.

Milk: 1 cup, 8 grams.

Greek yogurt: 6 ounces, container 16 grams.

Northern beans: ½ cup, 6 grams

Peanut butter: 2 tablespoons, 7 grams

Meeting protein needs in pregnancy is relatively easy. Good sources include lean beef, chicken, seafood, dairy foods, beans and nuts. Keep in mind that a 3 ounce portion of meat is only about the size of a deck of cards, or the palm of a woman’s hand (FoodData Central, 2023)

Good sources of macronutrients

Protein

– Eggs

– Lean meat

– Greek yogurt

– Beans, peas, and lentils

– Chickpeas

– Nuts and nut butters

– Fish

– Protein powders

Fat

– Avocado

– Nuts and nut butters

– Pasteurized cheese

– Full fat yogurt

Carbohydrates

– Fruits and vegetables

– Sweet potatoes

– Rice

– Quinoa

– Dairy

– Whole grains

Casey Thomas-Hardesty, MS, NTP

Two Peas Wellness

Reviewed and edited by Heather Emerson-Payne, RD, PhD, 2023

References

Academy of Nutrition and Dietetics. Nutrition Care Manual. Comparative Standards, Gestational Diabetes Mellitus. https://www-nutritioncaremanual-org.wku.idm.oclc.org/topic.cfm?ncm_category_id=1&lv1=5517&lv2=18188&lv3=273833&ncm_toc_id=273833&ncm_heading=Nutrition%20Care. Accessed July 12, 2023.

Academy of Nutrition and Dietetics. Nutrition Care Manual. Comparative Standards, Normal Pregnancy. https://www-nutritioncaremanual-org.wku.idm.oclc.org/topic.cfm?ncm_category_id=1&lv1=272980&lv2=26918&lv3=268758&ncm_toc_id=268758&ncm_heading=Nutrition%20Care. Accessed July 12, 2023.

FoodData Central. U.S. Department of Agriculture, Agricultural Research Service. https://fdc.nal.usda.gov. Accessed August 14, 2023.

Institute of Medicine. 2005. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Washington, DC: The National Academies Press. https://doi.org/10.17226/10490.

© WKU {2022} All rights reserved.

Categories
Weekly Tips

Nutrition for Postpartum Recovery

Nutrition can play an integral role in your postpartum recovery. Below are some important nutrients for the fourth trimester.

Iron

Iron is ultimately responsible for transporting oxygen throughout your blood. This is an especially important nutrient to consume after blood loss. Managing your iron levels can also help battle fatigue.

Foods that are high in iron: red meat, liver, spinach, and lentils

Omega 3 Fatty Acids

Omega 3 fatty acids (especially DHA) are important for both mom and baby’s brain function. So even if you aren’t breastfeeding, it’s important for you to nourish your body with this nutrient. 

Foods that are high in omega 3 fatty acids: salmon, eggs, grass-fed beef, walnuts

Fiber

Fiber is essential for maintaining normal bowel movements

Foods that are high in fiber: raspberries, apple, green peas, quinoa

Zinc 

Zinc is important for immune health as well as the production of proteins in your body. Zinc has also been shown to be beneficial for wound healing.

Foods that are high in zinc: oysters, pumpkin seeds, lamb, cashews

Choline

Choline is essential to brain development and is especially important for breastfeeding moms.

Foods that are high in choline: eggs, fish, chicken, kidney beans

A note on breastfeeding. Breastfeeding is said to burn an additional 500 calories per day. At least in the beginning, I recommend listening to your hunger cues to make sure that you are properly fueling your body for breast milk production. If the reduction of calories for weight loss is desired, this would be something better adjusted after you have recovered from delivery and have a firm handle on breastfeeding. 

Casey Thomas-Hardesty, MS, NTP

Two Peas Wellness

© WKU {2022} All rights reserved.