I have a special interest in antenatal and post natal osteopathic care and have been working in this field for nearly 20 years. During that time I have been a lot of new mothers and more often than not, at some point during the first year of their child’s life, treated them for what I know as Mother’s shoulder.  I have also seen fathers with the same complaint , so maybe it should be called parent’s shoulder?

Typically they complain of pain under the shoulder blade and in the base of the neck, sometimes with pain further up the neck and / or into the upper arm. If it is very bad they can get pins and needles and / or numbness into the arm as far as the fingers, or if it is the neck, they can get bad headaches. It is usually on the side opposite their dominant hand and come on gradually and continues to worsen.  It usually takes the form of a dull ache under the shoulder blade, like a tooth ache, and nothing really seems to shift it.  Massage can help for a while but the pain returns. Often I hear of people pushing their mid-backs up against door frames to try and self-massage the knot of muscle that builds up by their shoulder blade.

After ruling out anything more serious, very often what is left is a musculo-skeletal strain pattern that I know as Mother’s Shoulder. This involve a jamming of the joints between the ribs and the spine and the resulting muscle spasm that builds causes all the symptoms. To cut the story short, basically what happens in that the ribs jam up due to the mechanical strain on them but the body still wants them to move (hey, we still have to breath). Two different muscle groups battle it out, one saying to the ribs “Move”, the other saying “Stay still”. They tussle and wrestle with each other and then get their mates involved, and before you know it the whole shoulder and neck musculature is involved. This can be very painful and cause nerves to get squeezed (thus the pins and needles / numbness that can occur). I have found that until the mechanics of the ribs are corrected the pattern will continue, and this is where I as an osteopath can help.   Patients have often reported great improvements soon after treatment.

Why? What?

The reason this all comes about in the 1st place is due to the combination of several mechanical factors at a time when the mother is undergoing great change. In the post natal period the mothers body is having to adapt to not being pregnant any more. All those postural changes during pregnancy have to be “undone” and the body has to re-organise, and all of this whilst raising a child.  This is a very physical task and mothers tend to carry their child over the shoulder of their less dominant hand so that their dominant hand is free (to write, use keys etc etc).  Another, and I think the most important factor is what mothers do when they feed their child, and what happens is very similar for both breast and bottle fed babies.  Mum sits down to feed, gets herself and her baby nicely positioned using pillows and alike and starts to feed. All is well but then mum, as we all would do, looks down lovingly at the bundle of joy in her arms. She spend the whole feed doing this but in doing so she places a postural and mechanical strain into her neck and shoulder (if the baby is feeding from say they left breast then looking down at it places a strain through the muscles on the back right of the neck into the right shoulder blade and mid-back – try mimicking this posture and see if you can feel what I am talking about). It is this, along with the increased lifting and carrying that the mother does that kicks off this pattern. Bear in mind that all of this is happening at a time when the mothers ligaments are still soft as a result of the hormones in her body from when she was pregnant.  This is especially the case for breast-feeding mothers as the ligaments stay softer for longer in breast-feeding mothers. If the ligaments are softer then the muscles have to work harder to support the joints, and this can exacerbate problems like this.

So what can be done about this?

Don’t get me wrong, I am not saying don’t look at your beautiful child, I am saying be aware of your posture when you do this and do some gentle shoulder rolls and stretches to keep your shoulders. Flexibility is important, keeping the mid-back and shoulders mobile with greatly reduce the likelihood of this complaint.  Find a mother and baby yoga class to go to as here you will learn fun and safe techniques that will keep you moving, and be great for you baby as well.  If you start to suffer then some osteopathic treatment may well help. If you would like to see an Osteopath then please consult http://www.findanosteopath.co.uk/ to find your local Registered Osteopath. In treating complaints like this it is often a case of helping manage the situation.  Parents can’t stop being parents, so it is a case of offering treatment for the mechanical factors whilst advising on “lifestyle” changes that reduce the chance of it happening again.

If you have any questions about this, please do feel free to contact me using the form below. However, please note that this article describes a pattern I often see, but that this may not be what you a suffering from if you have these or similar symptoms. Please seek an appropriate medical opinion rather than consider this article definitive advice as there are other reasons why you could be suffering these symptoms and these will need to be ruled out.

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Pregnancy Massage (Antenatal and Postnatal): is of wonderful benefit to treat and relieve the muscle tension and joint discomfort that can accompany pregnancy. Massage helps improve circulation with draining strokes and kneading eases muscle cramps, whilst oils help with regulating hormones and together provide nurturing and relaxation for mother and baby.

Reasons for massage in pregnancy:

• Backache often accompanies pregnancy, especially lower backache due to the increased weight of the baby and the changing shape of the body which increases the lumbar curvature of the spine. Lemon and Lavender essential oils

• To de-stress mind and body – stress increases all anxieties about a pregnancy and can lead to premature birth in some cases. Frankincense and Neroli essential oils

• Constipation and digestive upsets (indigestion) can occur due to intestinal displacement by the growing foetus. German Chamomile and Sweet Orange essential oils

To identify and reduce tight muscles e.g. postural muscles, primary and accessory respiratory muscles – to bring awareness to breathing and posture. Sweet Marjoram essential oil.

Aromatherapy in pregnancy

Aromatherapy accompanying massage is highly effective and Aromatherapy is even more important when the heightened sense of smell during pregnancy is taken into consideration. If there are reasons contraindicating massage as above, essential oils can be used in different ways:
Insomnia and fatigue can be eased by vapourising oils or using such as Roman Chamomile and Lavender in carrier oil in massage.
Morning sickness can be treated with 4-5 drops of Ginger or Spearmint on compress over the abdomen or on a tissue.
Oedema – swelling of the hands and feet – caused by a rise of oestrogen in the body can be relieved with a foot bath with 4-5 drops of Lime and Grapefruit in 1tsp full fat milk.
Hormonal changes produce an ever fluctuating emotional state for most pregnant women. Even when a pregnancy is planned and welcomed women may experience mood swings and many anxieties. Geranium and Rose
Stretch marks can be prevented by applying an oil blend (consult a professional aromatherapist) of avocado oil with jojoba wax, Neroli and Frankincense.
Varicose veins can be alleviated or prevented with gentle massage in upward strokes to the legs using an oil blend including Geranium and Cypress
Aromatherapy in Labour (consult a professional aromatherapist)

Aromatherapy can be used in labour to calm anxiety and facilitate easy breathing. Vapourise 4-5 drops of Rose and Neroli.
Some essential oils strengthen and deepen contractions – uterine tonics – and ease the pain of childbirth. Lavender and Jasmine.

Post natal Care

Breasts may be sore and nipples can crack. Avoid essential oils on the nipples, use a calendula infused sweet almond oil instead.
Episiostomy/tearing. Healing Lavender (3 drops) and Cypress (2 drops) essential oils neat in a sitz bath.

Post Natal Depression

Uplifting Bergamot, Anti-depressant Rose, Anxiolytic Frankincense – essential oils can help on all levels.
Reasons to avoid massage in pregnancy: *
Deep vein thrombosis – essential oils in a footbath, or in a compress may help, cardiac disorders (heart or pulmonary problems), chronic hypertension, severe anaemia, abnormal foetal heartbeat, lupus erythematosus, bloody discharge, continual abdominal pains, diabetes

Jenny James
Aromatherapist BA (Hons) PGCE NYR MIFPA
Email: jennyjamesiom@yahoo.co.uk
Mobile: 07931 349 125

*Always consult a trained aromatherapist before applying home blended essential oils. Never apply essential oils neat.

**Jenny is a member of IFPA (International Federation of Professional Aromatherapists) and trained with Neal’s Yard Remedies in Holistic Aromatherapy & Essential Oil Science, Advanced Massage Techniques and Advanced Pregnancy Massage.
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After providing antenatal care the team at Chelsea Natural Health strive to continue to provide help and support to postnatal mothers, their babies and the rest of the family. For instance, Cranial Osteopathy with Philip Waldman, Craig Coman can be very helpful in helping both mother and baby overcome the stresses and strains of birth and acupuncture can help resolve constitutional issues. Massage is wonderful for everyone, especially mother and baby, adn all of our massage therapists have a special interest in ante and postnatal care. Jenny James is on hand to teach baby massage, acupuncture with Craig  can be very helpful in recovery period after giving birth, as can reflexology with Jenny, Shiatsu with Jan and nutritional therapy with Halina.  These are just some example of the treatments and care on offer at Chelsea Natural Health.

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