What’s Best for Baby Isn’t Always Best for Mommy


What is Post-partum Back Pain?

Post-partum back pain, or post pregnancy back pain, is pain many women experience after pregnancy and childbirth. It is most common in the lower back but some women might experience it in their shoulder and neck area. This pain can be described as dull or stabbing. A woman might feel as though her muscles are just tight. They could also feel the same sensations as a pulled, strained, or a sprained muscle.

Post-partum Back Pain Can Actually Start While a Woman is Still Pregnant

The term post-partum or saying back pain after delivery can make people assume that these sensations start strictly after the baby is born, but this is not the case. In many cases, these pains start while a woman is still pregnant. Sometimes they start as early as the first trimester.

While it is common for a woman that does not experience back pain during pregnancy to feel back pain after delivery, almost all mothers that are already experiencing back pain during their pregnancy will continue to have it post-partum as well. Having back pain is a sign of an injury. An already injured back is easier to hurt further leading to even more pain. This is why women that have back pain in pregnancy often report the pain getting worse after the baby is born.

Why Do Women Have Post Pregnancy Back Pain?

While pregnant, women go through a lot of hormone changes. To have a healthy pregnancy which leads to a healthy baby, a woman’s body produces an excess of estrogen, progesterone, and relaxin. Together these hormones cause a woman’s muscles and ligaments to relax and become easier to stretch. They also allow the joints, especially those attaching the hips to the spine, to loosen.

A woman’s body does this to allow her to stretch and make room for her growing baby and uterus as well as allowing the baby to be delivered in the easiest and safest manner. The abdominal muscles, for example, need to be allowed to stretch outwards to support the uterus. The hips need to stay loose so that they can open up during delivery to allow the baby to pass through the pelvic opening.

Although these things are great for the baby, they are not so great for the mother. Because these hormones cause the muscles to relax, a woman loses some spinal control during her pregnancy. Her spine will be less stable because the muscles used for spinal control, such as the abdominals, are compromised from taking on differing roles like holding the weight of a baby.

These changes start as soon as a woman becomes pregnant and get more and more noticeable as the pregnancy continues. Women are often forced to shift their center of gravity as the pregnancy goes on and there is an increasing amount of weight in front of them. While this shift is essential for the pregnant woman’s balance, it changes their posture and can even change the curve of their spine. The increasing weight also puts more pressure on the joints of the lower back and hips.

After a woman has delivered, her hormones start the process of evening out and going back to pre-pregnancy ranges. This will eventually cause her muscles and ligaments to harden back to their original state. This is a slow process, though.

During these post-partum changes, many women will experience hypermobility in their spine making injury easier. The muscles will be less toned and the ligaments will stretch easier which together allow your spine to move in ways it shouldn’t causing injury.

Doing any repetitive motion can cause an injury. Most moms are picking up their baby and possibly older siblings, holding their baby most of the day, and picking up baby gear such as strollers, car seats, and high chairs multiple times per day. Doing these motions over and over again combined with hypermobility makes post-partum women more susceptible to back injury which in turn causes pain.

These Same Injuries Can Happen to Anyone

Although women who have just given birth are more likely to have these injuries causing back pain, it is not limited to just them. Often other caregivers such as dads, grandparents, adoptive parents, and child care workers have this same pain. It is easier for a woman to hurt herself after giving birth because of hypermobility but the reason she gets hurt is the repetitive motion. Any person that is the main caregiver to an infant or small child will perform these same motions over and over again which will cause injury and pain.

Can Back Pain After Delivery Be Reversed?

Post-partum back pain is caused by injury. The best way to not experience the pain is to never have the injury. To avoid a back injury while pregnant or post-partum, women should concentrate on their posture. The belly button should be pulled back towards the spine. This will engage the abdominal muscles responsible for spinal stabilization.

Moms also have the tendency to rush through tasks. They should take their time while lifting and make sure their lower body is doing the lift, not their back. While lifting the back should be straight to avoid injury.

These will also help with established back pain but it should be noted that these injuries took a long time to happen, and can take longer to reverse.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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