Women's Health: Lauren Niimi's Story
Debunking an Age-Old Pregnancy Myth
Lauren Niimi with physical therapist Suzanne
Badillo, Dr. Colleen Fitzgerald and Niimi's sons
Eli and Ben
Lauren Niimi thought her back pain was a normal part of pregnancy. After all, she thought, pregnancy is bound to be uncomfortable. But pain during pregnancy, while common, is not inevitable. Through the Women's Health Rehabilitation Program at the Rehabilitation Institute of Chicago, mothers-to-be and new moms can find relief from pain and, like Niimi, play with, run after, dance with and fully enjoy caring for their children.
Niimi's pain began as a sharp stab in her lower back during a routine climb up the stairs when she was about 20 weeks into her first pregnancy with Eli, now 3. Despite her attempts to "take it easy," the pain got progressively worse, until she could barely walk. She assumed she had no other option but to endure it.
Almost worse than the physical discomfort was the fear she felt. "How am I going to care for a baby?" she worried. "How am I going to pick him up, keep him safe? Am I going to have this pain with me forever?"
When she mentioned the pain to her obstetrician/gynecologist at Northwestern Memorial Hospital, the doctor immediately referred her to Colleen Fitzgerald, M.D., director of RIC's Women's Health Rehabilitation Program. Dr. Fitzgerald recognized the problem as inflammation of the sacroiliac joint where the spine and pelvis meet, a common condition among pregnant women. "She understood almost immediately what was wrong and how to take care of it," says Niimi. "I knew right away I was in the right place."
For Women, By Women
"The right place" for Niimi, and many women like her, was the Women's Health Rehabilitation Program. Through the program, professionals specializing in female-specific musculoskeletal problems such as pregnancy and post-partum pain, pelvic floor dysfunction such as incontinence, and post-breast cancer issues such as lymphedema. The staff includes four board-certified physical medicine and rehabilitation physicians and more than 20 specialized women's health occupational and physical therapists. Women's health rehabilitation is offered at all of RIC's outpatient facilities. Niimi initially received care at the flagship's outpatient location in downtown Chicago and later transferred to an outpatient clinic in suburban River Forest.
Dr. Fitzgerald referred Niimi to Suzanne Badillo, a physical therapist and clinical director of the Women's Health Rehabilitation Program. Badillo started her on a twice-weekly therapy regimen that included gentle stretching exercises to realign her joints and mobilize her pelvis. "When I started, I was so stiff I could hardly do anything," reports Niimi.
Finding Her Inner Strength
During pregnancy, hormonal changes cause the joints, especially the pelvic joints, to become "lax" — more mobile and flexible — to accommodate the baby's growth and delivery. While these changes are normal and beneficial, in some women the amount of movement is excessive, and the result is pelvic and back pain. Niimi's situation was complicated by the fact she has artificial hips and some arthritis, the result of childhood leukemia treatments that caused serious damage to her joints.
Badillo taught Niimi a self-correction technique and encouraged her to do it at home whenever she felt her back getting out of alignment. This simple exercise, which involved sitting on the side of her bed and pushing down on her knee and up on her thigh, quickly became her "best friend," said Niimi.
Lauren Niimi and her older son, Eli. Physical
therapy at RIC has given her the ability to
keep up with two active boys.
"A key component of therapy is empowering the patient to take care of herself at home. As soon as we find something that works, we teach her how to do it on her own," says Badillo. Niimi also was fitted with a sacroiliac belt, which takes pressure off that vulnerable area, to wear during her everyday activities.
Another fundamental skill taught by RIC therapists is proper posture and body mechanics, especially during essential everyday movements such as getting in and out of bed, bending over and picking up a purse. Pregnant women like Niimi practice safely carrying out the additional activities that will occur once the baby is born — getting the baby in and out of the car seat, changing diapers, lifting and carrying the baby and breastfeeding, which all can wreak havoc on the body and stress the sacroiliac joint.
With supervision by Badillo, Niimi learned exercises to strengthen her core — abdominals, pelvic floor, and diaphragm and back muscles — to help stabilize her spine and pelvis. She also worked to regain flexibility in the muscles and ligaments around her hips using therapy balls, stretching bands and floor exercises. "It was like having a personal trainer," says Niimi.
As she became more flexible and her back pain lessened, therapy was reduced to once a week, with lots of handouts, illustrations and instructions on things to do at home as well. Because she was scheduled to have a C-section, Badillo taught Niimi how to massage the scar area to prevent pain after delivery. (Women who plan to deliver vaginally are instructed on positions to prevent injury and minimize pain during labor and delivery.)
Although Badillo had assured Niimi she would be available to help with any postpartum pain she might experience, Niimi reports that any remaining discomfort disappeared immediately after Eli was born.
Returning to the Experts
Two years later and pregnant with baby #2, Niimi was prepared. "I remembered how bad the pain had been, and I knew I didn't want to go through that again. As soon as I felt the first twinge in my back, I called Suzanne," she says. She also used the self-correction technique she had learned as soon as she felt things getting out of alignment.
Because this time the pain was nipped in the bud, her therapy needs were less intense, and sessions were required only once a week. Big brother Eli came along to help Mom learn safe approaches to the day-to-day challenges of caring for a toddler and a baby. Badillo demonstrated safe ways to get down to the floor to play and grab a busy toddler on the go. In the RIC parking lot, they practiced putting the stroller in and out of the trunk and getting the car seat in and out of Niimi's car.
As her due date approached, therapy was reduced to twice a month, and then stopped altogether. "We often don't see women throughout their whole pregnancies, but only until they are at the point where they can help themselves," explains Badillo. "I told Lauren to call me if she needed me, but she took care of the rest of her pregnancy on her own."
Ben is now a year old, and Niimi reports that she is successfully juggling the physical demands of keeping up with two active boys. "I feel I am providing a happy, loving, fun environment for them," she says. "I can run after my three-year-old, play chasing games and dance to our favorite CDs. I can do all the routine day-to-day things, like crouch down on my knees to give them baths. I can be completely hands-on with potty training, which takes a lot of stamina and patience. The three of us go to the park several times a week, and I'm able to keep up with their high energy levels."
For Niimi, the knowledge that she was not alone in her pain was almost as important as the physical relief she felt. "I was amazed to learn there is a place for this kind of pain. I often thought, 'You mean I'm not the only one who's suffering like this? I don't have to grin and bear it?'"
Now, she is eager to spread the news of the relief available through the Women's Health Rehabilitation Program with other mothers-to-be who may also think back pain is an ordinary part of pregnancy. "When I was at home suffering, I thought it was just normal. I don't want other women to feel that way," she says.
"Over the winter, I enrolled the boys in a children's music class at the Old Town School of Folk Music," says Niimi. "Every Tuesday morning, I'd pack up the diaper bag, bundle both kids in extra layers of clothing, load them into the car and make my way up north to Lincoln Park. There were a few wintry, snowy days when I was really 'tested,' but I was always happy and grateful to be able to have the physical ability to enjoy this time with both children. To see their smiling faces each week when the teacher would start strumming her guitar and singing those familiar songs was so, so worth it! Actively participating in my kids' childhoods and making sure they have the best life possible - that is truly what 'ability' means to me."
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