FTV Postpartum Back And Knee Pain Fixes

Did you know that back and knee pain are very common post partum?

Back in 2023 I recieved an email from a listener and that's what this week's show is all about;

"I recently joined your program after reading your article about the connection between Diastasis Recti and lower back pain. After a few days of your workouts, I'm already feeling a difference. Your explanation of core breathing was a breakthrough for me.  

 I'm currently 10 months postpartum and had an elective c-section back in October. I've been experiencing significant lower back soreness, particularly at night and in the morning. It's uncomfortable to turn over in bed and stand up especially getting out of bed in the morning - it feels like things are compressing downwards when I do. Glute bridges are also painful, requiring about 10 minutes of mobilisation before I can fully perform them. Although my suspected annual tear from January has improved, I still feel twinges during glute bridges, which I suspect are related to the lower back pain due to Diastasis Recti.

 Additionally, I've been having a sharp pain in my left knee during reverse lunges, while my right knee is fine. I also have a painful coccyx which seems to only hurt when I stand from a sitted position.

 Despite all this, I'm determined to get stronger. I would greatly appreciate any suggestions you might have. "

So I'm going over everything; Why the corebreath makes such a difference.
Lower back-pain and the feeling of it compressing downwards,
Why she needs soo much mobilisation before being able to do glute bridges.
Back twinges during glute bridges.
The sharp knee pain when doing reverse lunges.

And the disturbing lack of post-partum care for this woman as all of this stuff is fairly easily sorted.

Here's a link to the blog about kneepain which includes the Yoga video.

And here's a link to the corebreath video 

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Transcript

Vault Intro And Q And A Invite

Peter 0:00

Hey, welcome to the Healthy Postnatal Body Podcast with your postnatal expert pickle up. And as always, will be me. This is the podcast for the 10th of May 2026. And time flies when you have a fun. Last week I did uh I did a new one, so today it's from the vault, and today I am talking about knee pain and back pain again. Um in response to an email. This originally came out in 2023, and uh I get questions about this quite a lot, so you know I thought I uh I thought I'd repeat this one. Um speaking of questions, Peter at healthy postnatal body.com. If you have any questions or comments, uh next week we're doing a uh what's it a QA? So you know that's always nice to get your questions in. I've got one or two already, but you know, more are always welcome. Anyway, so that's it for the video. Knee and back pain. Here we go. Hey, welcome to the Healthy Post Native Podcast. Uh, this is the podcast for the 27th of August 2023. And I'm answering one email. I hope you're well, by the way. I hope you're doing well. I hope everybody's happy you've gone back to school and all that sort of thing. Kids are back if you're in the UK, most kids are back to school, and order has been restored. Um, we're basically talking postpartum back in the pain after an email I received from somebody that covers an awful, awful lot of bases. So a little case study, that's uh pretty much what you're getting today. If you have any questions yourself, um any comments, Peter at healthypostnatalbody.com. That is what I'm here for, right? You send an email in, whether you're a healthypostnatal body.com member or not, doesn't matter. I always get back to people. Nice. So let's get into this. Hi Peter, I recently joined your program after reading your article about the connection between diastasis rectile and lower back pain. We'll get to that as well. Um, after a few days of your workouts, I'm already feeling the difference, uh, a difference. Your explanation of core breathing was a breakthrough for me. That's the second thing we'll cover. I'm currently 10 months postpartum elective C session back in October. I've been experiencing significant lower back soreness, particularly at night and in the morning. It is uncomfortable to turn over in bed and stand up, especially getting out of bed in the morning. It feels like things are compressing downwards when I do. Glute bridges are also painful, requiring about 10 minutes of mobilization before I can fully perform them. Although my suspected annual tear from January has improved, I still feel twinges during glute bridges, which I suspect are related to the lower back pain due to diasensis recti. Additionally, I've also been having a sharp pain in my left knee during reverse lunges, whilst my right knee is fine. I also have a painful coccyx, which seems to only hurt when I stand from a seated position. Despite all this, I'm determined to get stronger. I would greatly appreciate any suggestions you made you might have. So as you can uh as you can tell, there's there's a lot happening there, right? So I'll just break that all down a little bit. Um starting with why the core breath makes such a difference. Um when it comes to feeling better and how fast you feel the difference. The core breath, as I explain it uh on the little YouTube channel, and I will link to the video, I'll link the video to the I'll put it in the podcast description and all that sort of stuff. This is why I prefer the core breath. Understanding how your muscles should feel and how you should try to contract your muscles during breathing, whilst it's during during the postpartum recovery stage, and after that, it should hopefully be automatic, is key to quickly healing your diastasis rectile. If you're not breathing correctly, if your muscles aren't active, and by breathing correctly, I mean your muscles aren't contracting in the right order when you exhale, then you're going to find that your recovery will take longer. Uh, this is why I'm not a big fan of diaphragmatic breathing and and and all that sort of stuff. Well, this is the core breath is simply the better way. Like I said, I will link to the YouTube video. But basically, what it boils down to is making sure the lower part of your core contracts before the upper part of your core does. Too many people collapse in on themselves when they exhale, especially when they exhale sharply, and that bit below your belly button, those muscles don't contract when uh when they exhale. That's a problem when it comes to healing diastasis rectile. So that really is the way you want to breathe. Um, you know, and I know people disagree with me on this. I know Anthony Lowe disagrees with me on this. Um, he says that breathing always involves certain muscles, and I fundamentally uh, you know, I know it doesn't. Yes, it's keeping you alive, but it doesn't mean that um the right muscles are firing at the right time. He and I both agree that diaphragmatic breathing is not the way to go. Um lower back pain, right? So, like I said, after a few days of work, I was uh blah blah blah. The connection between diastasis rectile and lower back pain. Now, I've I've touched on this before. Um the link between diastasis recti is and lower back pain is clear as day. It really is. I I have linked to many, many, many, many, many studies, and I've written about this before, um, where that show a clear link between people who have diastasis recti and uh people who have uh lower back pain. So postpartum women suffering from lower back pain and postpartum women suffering from diastasis recti, there's a there's a huge overlap in that in that Venn diagram, in that Venn diam diagram. So, you know, that is quite clear. So I've said this before, anybody who claims there isn't a link is is not really 100% correct. And by not 100% correct, is you know, I mean, they're wrong. The feeling of it compressing downwards, so this lady, as she said, she's 10 months postpartum, had an elective C-section back in October, she's been experiencing significant lower back soreness, uh, particularly at night and in the morning, and that's stiffness, isn't it? Uh and stiffness can very quickly turn into soreness, by the way. If stiffness in certain muscles mean that other muscles aren't doing their job, or other muscles are overcompensating, uh, or sorry, um, certain muscles are overcompensating, such as your lower back muscles overcompensating for a weak core, and everything seizes up a little bit overnight because those muscles are tired and they're just exhausted and they've been doing too much. Especially they've been doing things that they shouldn't have been doing. Um, that's gonna hurt overnight. Um, it's uncomfortable to turn over in bed and stand up, especially getting out of bed in the morning. Again, completely normal. It's not right, but it is very common. Let me put it that way. It feels like things are compressing downwards when I do. Yeah, that is not again, that is mainly because uh, and we'll get to this in a little bit. Glute activation is an issue here, and um as in the glutes not working properly, and therefore things starts to pull. Things things start to pull, Jesus English speaker, things start to pull. Um, and that's why it feels like it's it's all downward and it's saggy. Your core isn't doing the thing it's supposed to do, your glutes aren't doing the thing it's supposed to do, and everything feels like it's it's it's pulling downwards or collapsing on itself. Um, so why does she now she sit here? Um it feels like things of compression always want to do. Glute bridges are also painful, requiring about 10 minutes of mobilization before you can fully perform them. And that's an interesting one because that's fascinating. First of all, glute bridges shouldn't be painful in your lower back because the lower back isn't involved in in glute bridges. When healthy bodies perform a glute bridge, it's the glutes doing the work, right? Clue very much in the title there. And most people feel uh most people with diastasis rectile, most people with lower back problems, and any most people who don't anyone postpartum really tends to feel them more in their hamstrings and sometimes their lower back. The reason uh this lady is feeling them in the lower back is because everything is just a little bit um a little bit more complex, right? The lower back is overworking, it's doing way too much of the work uh during the day, and that's why you then need 10 minutes of mobilization before you even fully get up. The back is just shattered, it's just tired. So the solution to that, because obviously, you know, I've obviously already responded via email, right? The the reason she has to move about for 10 minutes before doing any glutteur, just doing 10 minutes of mobilization, is because everything is just tight and overworked, right? Completely normal. The glutes aren't activating, are are nowhere near activating enough. Um and that shows you the importance of glute activation stuff in the first four to six weeks of your postpartum program. Now, if you remember, if you're if you're a member of HPMB, then then you'll already notice the first four to six weeks are what I call the activation stage. Um and the more active you are prenatal and during your pregnancy, the easier, the shorter this postpartum period will be, this postpartum activation, muscle activation period will be because everything is still firing up properly. But for a lot of people, that's not an option or wasn't an option, or you know, the postpartum now in your way are, right? So that muscle activation bit can be quite quite tricky in the beginning. And if your glutes aren't activating properly, your hamstrings are overworked, your lower back is overworked, and it causes a lot of problems. So if you look at our HP and B program, the first four weeks, the first home routine, is um what does that consist of? Some core the core breath, obviously. Uh then you go into, and this is top of my head, right? Um, go into glute bridges. I think from then on you go into that's double leg glute bridges, so very basic, straightforward things. Um, then you go into heel slides. Is there a side plank in there? It might be side plank with dips in there, um, some sort of oblique thing. There usually is when I do stuff with people, and then you have some squats and reverse lunges, and then you go back to core breath. I think I'm right when I say that that is it. It's been a while since I've looked at the first uh the first four-week thing. Um, so that's a lot of glute stuff because squats and reverse lunges are also uh a glute exercise. The glutes work in a different way during a reverse lunge than do they do than what they do during a squat. But we have of that lot, you have uh as buddy snores in the background, you have of the six exercises, three or four involve the glutes in one way or another. So, and very few of them directly involve TVA type exercise, and uh, and I've spoken about that last week or the week before as well. You know, you don't have to focus that much on the transverse abdominus when uh when you exercise postpartum in the beginning, is much glute activation is much more important because it teaches the body to use the right muscles at the right time, right? That is all this is about. So the feeling of glute bridges being painful in the lower back or glute bridges being painful in the hamstrings and all that sort of stuff, and the the back requiring that much mobilization and the back hurting and being stiff and sore and all that sort of stuff is all linked to the glutes not doing what they're supposed to be doing. The more glute work you do, the less back pain you have. In this particular case, right? When you're postpartum, the more back pain you have, the more glute work you need to do. But it's all different glute work, and it's all nice and steady, it's all about teaching the muscle to fire up again. And I know again, and other physios have disagreed with me in the past, they think that if you can perform a certain movement, by definition, you're using the right muscles. Um, such as if you can do a squat, then by definition your glutes are doing what they're supposed to be doing. I completely disagree with that, and all the evidence I think is on my core in my corner on now. As in the body is really good at just getting you moving up and down. I know people that can do squats all day long and they never use their glutes once. Uh there is no feeling of their glutes, there's no no their glutes are not being worked as much as say their quads or hip flexors and all that sort of stuff are. And postpartum, we're looking at the glutes. I care extremely little about people's quads, the muscles at the front of your legs, um during postpartum period. We're squatting, and therefore you're using them, but I have never come across anyone that has had quad problems, postpartum, all glute related. That's where the fan sits. So that's what you have to work. In in this lady's case, it's going to take a while, but four to six weeks and that'll feel a lot better. This is why I always talk about uh postpartum back pain of this type not being a permanent thing, it's not a permanent uh problem at all. You fix that by doing the right exercises. In this case, like I said, I expect her postpartum, her back pain to almost be completely resolved in six to eight weeks' time, and then it's just a case of strengthening everything up so that the muscles that are functioning properly. When I say completely resolved, I shouldn't have said that. Uh it should be significantly better, right? 70-80% better, and then the last few twinges you get rid of that by doing you know, strengthening work and all that sort of posture work and all that sort of thing, which funnily enough is stage two of the HP and B program. Right? It's almost like I know what I'm doing. Um, additionally, so oh sorry, so she said, although my suspected annual tear from January has improved, I still feel tringes during glute bridges. Yeah, that can happen. It can be really, really tight down there for a while if you have a tear, um, which I suspect I related to lower back pain due to diastasis recti. Um, well, lower back pain, obviously, pulse and all that sort of stuff. We covered that. Additionally, I've been having a sharp pain in my left knee during reverse lunges, whilst my right knee is fine. Yes, and I wrote about this quite a while ago. Um postpartum knee pain is remarkably common, and I will again I will I will link to that particular uh blog post as well for those of because I know a lot of you are suffering from postpartum knee pain, and again, people tend to say when you go to your GP, um you go to your GP and say, I have knee pain. They send you to a physio, and they don't necessarily relate that to uh anything that happened postpartum. Now, okay, so what causes the hip pain? Uh so what causes what causes the knee pain? Sorry. Um now knee pain can be caused by many things, and I'm kind of taking this off my blog because otherwise I'll waffle for ages. And uh, you know, I spent hours writing a blog, so I kind of uh why not? For those of you who don't like to read, you know, you know, right, so knee pain can be caused by several things. However, unless you bang your knee on something, it's hard hardly ever actually a problem with the knee, right? Um, technically it could be persitis, you know, and you get some um ibuprofen, uh or some anti-inflammatory and and some and some rest and all this other stuff. Um, but I find most postpartum knee pain is mistakenly diagnosed as persitis or as the weight gain can cause inflammation. I've heard this a lot um from healthcare professionals where they say, Oh Pete, I I just assumed that when women come to me with knee pain postpartum, it's it's the weight gain, uh, the excess pressure on the joint for you know three, four, five, six months, because it's weight gain, because it's pretty constant, that that have um, and then that causes the inflammation. The strain is just too much on the joint. Um I kind of again, I kind of disagree with that. Um I do link to a little guide from um which which will help with your bursitis recovery in in the post, so that'll be in the podcast description below. If you do have bursitis, then that'll help. Um, but as I say in one of right, if you've been relatively active during pregnancy, uh, you know, without doing anything silly, there's no reason why your joint can't handle a bit of weight gain, right? You can you can there's a ton of people that gain two or three stone over the course of their life, and their knees are completely fine. There is no reason why you can't gain pregnancy weight and uh and that would without your knees hurting, right? Your joints are okay with that. I do, by the way, for people who are exercising prenatal, I always recommend doing a lot of squats and doing a lot of core work, uh, especially rotational, anti-rotational movement, uh, such as wood choppers, downward wood choppers, and core presses and all that sort of stuff. Again, you'll find those exercises on the YouTube channel, right? Um there is no reason at all why the squats, especially, by the way, during the pregnancy, the squats come in really handy when you give labor. Trust me, squatting helps. Um, anyways, the the joint can definitely um can definitely handle a bit of extra weight. The human joints are are phenomenally strong, um, especially if you have some muscle protecting it, right? So the knee pain I come across a lot is indeed this sharpish knee pain that um that this lady refers to, right? A sharp pain in my left knee during reverse lunges, whilst my right knee is fine. So, as I as I as I said, knee pain I come across a lot is that sharpish pain, which is not chronic. It just feels like it's behind the kneecap, usually to the inside of the leg nearer to the top of the kneecap rather than at the bottom. So basically, it usually happens when you put a fair bit of pressure on just one leg. Well, funnily enough, reverse lunges. Right? Uh, you might feel it during exercises like step ups, but it tends to be fine during a squat. Again, that's so, like I said, there in it's fine when you're putting pressure on one leg, such as a lunge or a step-up or reverse lunges or whatever, but it's fine when both legs are working together. Nine out of ten times this is caused by weak glutes or hamstring issues. Hey, we're back to the glutes. Funnily enough, it's always the glutes. And um, you know, if you've written with any of my other blogs, this is why I bang on as much about the glutes as Jessica Murray Roseleggio bangs on about the SOAS. It's always, always, always the glutes where you start. So, how you fix that is because that is of course the main thing, right? How do you fix that knee pain? Do your glutes and hamstring exercises. Right now, the HP and B sessions are full of them, like I said, um, but you might need to focus on them more for a little while. Um, so that means when you get to the four-month point of the HP and B program, so just the point where you start paying for it, um, you should choose the leg routine over the posture and core home routines. Always. So, for those of you not members of HPMB, how the program basically works the first three months of free uh for everybody, and not the standard postpartum recovery program, which, like I always say, should be free for everybody in the world. So you sign up, HPMB, uh healthyplasinsabody.com. You sign up, and on day one, you get 12 months, uh, 12 weeks, 13 weeks, sorry, three months, completely free access, anyways. Even if you cancel on day One, you'll still have three months of completely free access, right? And that includes emailing me, asking questions, and me having stuff to talk about on the podcast. Yay, from me. Um, and roughly at the four-month point when your postpartum recovery from a core perspective, diastasis rectile perspective, and most people who had normal pregnancies and have a normal postpartum situation, you should kind of be finished. You should kind of be done. You cancel your membership, you say, Yeah, Pete, I'm done. I'm finished. Thank you very much. It didn't cost me a penny. I am on my merry way, and I'm going to go back to the gym or going to go back to running club or whatever it is. For people who want to stick around, they can split uh because they have other things to work on, or they want to stick around to do whatever. Um you can choose three different areas to focus on. Uh, one is the legs, the other is the posture, and one is the core stuff. And they all so it all splits up, the whole program splits up a little bit. Um at that stage. So you choose what you work on. So if you have knee pain, even at that stage, then you choose the leg routine instead of the posture and the core home routines. Um, for those of you that don't know, obviously you can you can use all of them, right? You can I say it splits up, it gives you options. You can use all of them, you have access to absolutely everything, and you can jump in between them. And the program runs for like 10 months or a year or God knows how long. Uh, how much how many months are throughout? So basically you have three years uh worth of exercise routines out there if you jump between stuff. Um anyways, it doesn't matter. That's just a quick explanation. So you start focusing on the strength part of the exercises, so start dropping the number of repetitions a little bit, start increasing the resistance. So if you're doing resistance band glute kicks, you start using a heavier band and you kick a few fewer times. If you're doing bodyweight exercises like bodyweights like squats or lunges, start adding some weight and really focus on the muscle whilst you're doing the exercise. This is I'm I'm really big on this. This mind muscle connection connection is huge. So on the way, and and I know again somebody else disagreed with me on the podcast, they say it doesn't work. I haven't seen the study, uh, I haven't seen the study. They said there was a study, I I've looked at the study and they said other cues are better. Yeah, sure. I believe other cues are better. Um I'll go with that. But I also believe that these muscles aren't automatically used, and we need to find a way. So, whatever cue you use, as long as you focus on that muscle, I don't really care. Uh where you squeeze out glutes or house things or the quotes as hard as you can every single rip, uh, single rep, then that's great. Should your hips feel really tight, then you can do some more stretchy stuff. Um I I used to employ a yoga uh instructor, my corporate client, and she was phenomenal. She recorded uh a couple of yoga flows, uh, but she didn't because she had quite a strong accent, I had to narrate the whole thing, so it was a bit of a nightmare. But the first yoga flow is up and is linked to in that um in that blog post. Right, and it's an excellent, excellent routine, by the way. An excellent yoga routine. Um that will help. There's also a stretching uh playlist on our YouTube channel. Again, you know, it's just there, so just use that. Um just make sure everything is really activating. You know, if you can't feel your glutes working when you're doing a jump lunch, you go back to basics and do exercises such as glute producing it. And this is quite easy to forget. You know, the temptation that we have is to get through a program and you do X for four weeks and then you jump onto the next for four weeks, and then the next for four weeks, and you stick to that. However, if you're feeling like you're not getting something right, you take a little bit longer. Especially with HP and B. If you think it's gonna take me longer than three months to get through that first three-month free trial, you copy-paste the exercises, right? There is no there's no reason why you can't. And again, my IT guy will hate me for saying this, but fundamentally that's what you can do. You can copy-paste the first three months, and if it takes a while longer, then you still cancel your thing. You'll still that way you still have access because your the YouTube videos are just on YouTube, right? Uh, I haven't hidden them on like some other Pells Python programs. Um, I haven't hidden them on a special uh private setting that you can only follow if you are a member and all this other stuff. You have access to all that stuff. So don't go too fast too soon. There's no need for it. Um if after three to four weeks you can't feel any improvement, that's when you get a referral to a physio, as you might just need somebody to to um move things around a little bit, manipulate a bit, uh press on some um on some bits and pieces. Uh and it usually hurts. Um but fundamentally that is all it is. The movement, doing the right exercises will help. And that postpartum knee pain will go away with some targeted exercise. And I always say you've I forgive it three to four weeks. That really is all you need, and you will feel and you will get results every single time. Um was there anything else I needed to cover? No, I think we're good. I think that is absolutely everything we covered from through uh through Latino. So, like I said, there's a lot, right? So the core breath really matters. Start by doing the core breath. Get that right, and make sure you understand the core breath. It is the single biggest thing that you can do for your postpartum recovery is understanding how to breathe. Um and secondly, work on the glutes. Any sort of back pain, any sort of hamstring pain, any sort of knee pain. Make sure your glutes are doing what they're supposed to be doing. Um because nine out of ten times that is your solution to that type of stuff. Anyways, Peter at healthypostnatalbody.com. If you yourself have any questions or comments or whatever you want to disagree with me, also fine. If you want to come on to the podcast, uh you know, have the same email address. If you know anyone, I'm I'm going to send some more invites out to people uh that were suggested. But if you know anyone that you'd like to hear from, you know, send me an email. Uh I can always try to get people on. It might take a little while before people come on. But you know, we've been running for long enough that I can get some interesting guests on um that you know it's not it's not as dinky little a show anymore as it used to be. Um that's it for this week, guys. I'm going to go. I have no idea what I'm doing next week yet. I had an interview planned, but uh that didn't happen. So we'll see. Send me an email, Peter at healthypostnatal buddy.com. Give me something to talk about for next week. Um you have a tremendous, uh tremendous week, and I'll check in on you next week. All right, bye now.

SPEAKER_00 29:50

Look at all your pieces,