Why do I have knee pain after having a baby?
Updated: May 19
Why you get sore knees after pregnancy?
Many mums suffer from aching painful knees after having a baby.
This pain can either be a dull ache or a sharp pain with certain movements - either way it is no fun to live with when you are constantly getting up and down looking after a baby.
Most people start by looking at the knee itself, to try to find the source of the pain.
You might be surprised to know that the knee joint is more like an early warning light in a car’s dashboard- it lets you know that there is a problem somewhere in the system but is rarely the actual source of the problem (unless you have had a specitic knee injury in the past).
The truth is that your knee joint is a hinge joint (the same as your elbow) and it is affected by what is going on below it with the foot and above it at the hips.
Any instablilty or twisting forces coming from above or below will cause knee pain, so we have to look up and down the kinetic chain in your body to figure out what is going on.
So, what affects the knee joint?
One major factor with postpartum knee pain is pregnancy hormones - specifically the hormone Relaxin.
Relaxin is responsible for loosening your ligaments and allowing the pelvis to widen in order to get ret ready for birth.
Relaxin levels generally remain high in the body during what we call the 4th trimester (the first 3 months after birth).
Breastfeeding will also cause Relaxin levels to stay high, up until about 3 months after you finish breastfeeding. This means that your body is naturally more unstable than it was pre-pregnancy for up to a year (or more) depending on when you choose to wean your baby.
Exercising with high relaxin levels means that you need to be careful with which exercises you choose to do, and be extra picky about using great technique while doing them.
Pregnancy changes your posture over the course of the 9 months. As your baby grows, it is common to start to lift up the front of your ribcage and drop your hipbones forwards and down to make room for the baby. (This is called Rib Thrusting and Anterior Pelvic Tilt.)
Your body can often remember this pregnant or sway back posture and get stuck there, even after we have had the baby.
Anterior pelvic tilt is also often held in Place by tight hip flexor muscles (the ones on the front of your hip) and these can get even tighter with all the sitting you do as mum - feeding, rocking and looking after your baby.
Release your hip flexors by stretching or foam rolling them.
Try to vary your sitting and sit in other postions as much as you can.
Sit on the floor, cross legged or in a deep squat (if it feels ok for your knees).
Being mindful of your posture when you are holding your baby and doing everyday tasks can also be a big help - you need to retrain your body to know what neutral aligment feels like again.
3.Hip Weakness/ muscle imbalances
Your hips are the cradle that you have held Your baby in for 9 months. They have had to work hard to support Your body through the postural changes as well as Widen and loosen to allow for Your baby to be born.
Remember waddling like a duck towards the end of Your pregnancy?
Yup,that was your hips getting ready for birth.
All these changes can leave you with muscle imbalances and hips that are not stable either front to back or side to side.
This means that your butt muscles (the glutes) may not be showing up to do their share of the work, leaving those hip flexors I mentioned earlier to take more of the load and creating the classic flat "mum butt".
Lack of lateral or side to side stability can also be an issue, creating a twisting movement on your thigh bone (and the knees) with each step.
Build stonger butt muscles to help to regain your hip stability.
Do exercises like glute bridges, squats and clamshells to build strength.
Adding a resistance band and doing lots of repetitions will help you get the most out of these exercises.
4.Core Weakness, Diastsis, Pelvic floor issues and Leaking.
This follows on from your hips. The hips are stabilized from above by your deep core muscles (Diaphram, Transverse Abdominals, Obliques- internal and external, Pelvic Floor, Rectus abdominals and the Multifidi in your back) and by the Glutes and inner thigh muscles from below.
Any weakness in these muscles is going to destablize your hips, creating knee pain.
If you have Abdominal separation or Diastasis then Your abs aren't going to work properly, adding onto the load on the other core muslces.
This can show up as pelvic floor dysfuction (like leaking when you sneeze or jump, or increase the symptoms of pelvic organ prolapse) and create a sore back and knees.
Work on building abdominal strength and get all of the core muscles to show up and work together.
Often it is the Transverse Abdominals, your deep corset muscles, that aren't doing theor job. Often they have been stretched out by pregnancy and birth and need some help and attention to help stabilze your hips again.
Try doing exercises such as Heel slides, Deadbugs and Bird- dogs to reconnect to these muscles again.
Knees are also affected by what is happening with your feet.
Postural and weight changes during pregnancy can flatten out the arches in your feet -( this is why some mums find that their shoe size is bigger after having a baby.)
If you tend to walk on the outer edges of your feet or your arch normally drops inwards (as with flat feet), this sends a twisting force up your leg to your knee.
Building foot arch strength helps to stabilze our entire body. Your feet are literally the foundation for your posture and all movement..
Start by practicing to re-establish you foot arch using the tripod foot stance:
Press your big toe firmly down onto the floor.
Your toes should be spread out wide and you should have equal weight from the ball of you foot to the ouside of your foot.
Your weight should also be equal from your big toe and ball of your foot back to your heel.
Now engage the arch of your foot.
Once you have the the tripod foot set up, you can load it to build strength by balancing on one leg as you hold your arch in Place.
Spending time barefoot will also help to build your foot strength, as you feet muscles work more without the support of shoes.
Many mums find that their pre-pregancy postural habits and imbalances are now heightened after having a baby.
With the correct attention to rebalancing, retraining and building strength in the right places, knee pain can often reduce or disappear.