Doing EC with an injury: Some thoughts on modifying EC while healing from any injury (and preventing EC-related injuries, too!)

Doing Elimination Communication with an injury can be a daunting task. Taking your baby to the potty can feel overwhelming or impossible when you are hurting, healing, and perhaps limited in your mobility.
Since I am currently healing from an injury, I wanted to talk about this today and offer some helpful tips to get you through your healing period without making your injury worse...and most importantly...without losing track of your EC practice with your baby. Because when we're hurting, and we're a little bit depressed about being hurt, and we're trying to heal, EC can often go completely out the window. We don't want that to happen.
Quick story. I was a few months pregnant with Twyla and walking down the old (and very hard) wooden stairs in our farmhouse, carrying Branson who was 18 months at the time, and I missed a step. In order to save me, the baby in my belly, B, and Cooper (3 at the time and walking down the stairs in front of me), I took one for the team.
I landed as upright as possible and caught my entire body weight on the area around my big toe...and I heard a pop. I didn’t know it at the time because it was misdiagnosed, but I had broken the tiny little bone under the ball of the foot, snapped it in two, and I wasn’t able to take care of myself then, so I compensated for 19 months until I decided to fix my posture with the Alexander Technique. The pain returned, and now I’m on a self-directed healing plan...that will take 6-12 months.
So what of EC then? What of carrying my babies down the stairs and putting them on the potty? How do I do things like make breakfast, exercise, chase 5 kids around? What shall I do?
Let’s just say that I have a plan in place for myself, with the help of an amazing hurt foot fitness trainer I found on YouTube, and while making modifications, I thought to share this with you, too!
Perhaps you have an injury like mine, maybe you have physical limitations that are old or new, or perhaps you have chronic low back pain or carpal tunnel symptoms that you’ve developed while caring for your new baby in the postpartum period.
Whatever your injury or limitation, let’s dive into some tips about managing elimination communication with your baby while you heal.

Get a healing plan in place with support if needed
The first thing I want to suggest is get a healing plan in place with support if needed. This could be from a doctor, or from a specialist in the particular injury that you have, or a professional. If you want to go online and find yourself an online professional, that's fine too.
It's very important to make a healing plan to put yourself first, because if mama or daddy is not okay, and you're the main caregiver of your child, your baby is going to have a harder time. We want to get you healthy. Get a healing plan in place first and foremost.
Equip yourself with the right healing tools (braces, boots, orthotics, compression, etc.)
Second is equip yourself with the right healing tools. This might be a brace, a boot, or orthotics. I made my own. I got special shoes for my foot injury. This might be compression socks, a knee brace, whatever it is that you're dealing with. Get yourself the right healing tools.
Be serious about your treatment
Next thing I want to mention is just to be serious about your treatment. I am saying this twice now because this is so important, and I know that, specifically, we moms put ourselves last when caring for our family and our kids.
So put yourself first, be serious about your treatment, figure out a plan, and stick with it. Otherwise, your injury will linger like mine. Hello: 19 months later, still dealing with something that I should have dealt with back then!
Get a second opinion if needed
The next thing is to get a second opinion if needed. Now, the podiatrist told me that I needed surgery. I am also a dancer, currently converting my garage into a dance studio and office, and there's no way I'm going to let somebody take a bone out of my foot!
So I got a second opinion that happened to be found on the internet. You should totally do that if you don't agree with whatever professional you've got a healing plan with has said. Get second and third opinions if you want to. Make sure you're in the right hands, including your own.
Ask for help with your baby, day-to-day
This is for whoever is staying with the baby full-time. Speaking to those of you who happen to be moms, day to day it's really hard for us women, in particular, to ask for help.
I want you to ask for help with your baby.
Ask somebody to bring your baby to you so you can potty them if the other people in your household don't potty your baby.
Ask for someone to bring the baby to you after a nap - my baby is in a crib upstairs, so every morning I ask my husband, “Honey, please go get the baby and bring her down” because, even though I could just go up the stairs with or without my orthotic shoes...I shouldn't! And I nurse her side-lying in bed.
So, I am calling on help from other people, and you should do the same.
Get a top hat potty and use it while sitting (instead of using the sink)
I would also recommend you get a top hat potty. You can get that at my Tiny Undies store if you don't have one.
If your baby is about 12 months old, we want to offer the potty while sitting down. If we've been using the sink, we definitely want to transition to doing it in-arms over a top hat potty while staying in bed or on the couch.
Use a low stool to use the big toilet
The other thing we can do, especially if your baby is too big for a top hat potty, is to use a low stool to potty on the big toilet. You're not going to put your baby on the stool, you're going to put yourself and your bottom on the stool and sit down on it. Sit up straight. Hold your baby in the EC hold in front of you over the big toilet.

If you're holding baby onto the toilet seat, you could do that as well instead of using a mini potty if you can't get down and up off the ground very well right now. Or if you have shoulder issues and you can't lift them very high, you’ll want to use a top hat potty or mini potty low to the ground.
If you're more so dealing with back issues or foot issues, use the big toilet and sit yourself on a stool in front of it. It works wonders!
Take advantage of this time and do naked or modified observation time
The next thing I really want you to do is to take advantage of your healing time. If you're going to be on the outs for a while, use that as a wonderful opportunity to slow down life and do naked or modified observation time.
If your baby's mobile, you're going to use something like Tiny Trainers, which also can be found at tinyundies.com, because you can see immediately when they're wet or you can do sumo style diapering just to see immediately when they're wet.
But you can do naked or modified observation time. Grab my observation log below and just start learning your baby again. See where you're at right now. Take advantage of the downtime. It's a blessing!
Download my free EC observation log here:
Take advantage of this time and sloooooow down, cherishing the time you get to sit still with your baby and be present
Cherish the time that you get to sit still with your baby, whether your baby is still or not. You can sit still on the carpet while they play around you, and be present. It is so wonderful!
Leave your phone far away on the counter and just sit there and be with your baby.
When I learned that I still had a broken foot after all these months, I started to feel depressed. Then I realized, looking all around me, I have these amazing children right here, and just laying there with them, doing my stretches and my exercises at home and letting them crawl all over me, has been quite a joy. I would recommend the same.
It might increase your positivity and help with your mood a little bit, because having any injury, you guys, is a grief process! It's definitely not easy to have your body not working the way you would like it to.
Consider transitioning from in-arms to a mini potty or the big toilet
You might consider transitioning from in-arms holds to a mini potty or the big toilet like I talked about earlier. If holding your baby in-arms is hurting or hard, then you have to transition.
I have a podcast on moving from in-arms to the mini potty, also another podcast on mini potty to the big toilet.

Use a back-up during this healing time to reduce your stress
Using a backup during this healing time is something that you might want to do. If you're feeling stressed not catching as much because you're not mobile enough to take your baby potty right now, then use a backup, like a diaper, a cloth diaper, or a disposable biodegradable diaper like the ones I get from DYPER.
If you've been using undies or just pants, use Tiny Trainers. That can help you reduce stress and really take care of yourself during this healing time.
But, if you've completely ditched the diapers, I would not go completely back to diapers. I would just use some kind of padding if you're having a lot more misses since your injury.
Get easier on- and off- clothing
If you currently have any snappies at all in the whole range of everything, best to get long t-shirts and elastic-topped regular pants. The easier you can get the clothing off while sitting there or being limited in your mobility, the better.
And...the easier to get it back on, the better, right? Obviously!
Keep a mini potty in the play area
I also want to encourage you to keep a mini potty in the play area or the area where you chill with your baby while you're injured and healing. It's important to have a mini potty nearby.
Sometimes for babies...if it’s out of sight, it’s out of mind. Also for moms and dads! Out of sight, out of mind.
If the potty is right there with you, it's going to be easier for you to use.
Stay positive
I just said this, but I'll say it again, I want you to stay positive! Caroline Jordan over on her hurt foot fitness YouTube channel has shared some really great positivity talks with her audience...because you can easily get down in the dumps, especially if you're a really active person and you're floored by an injury.
It's important to stay in a good mindset for your baby as well.
Keep (or begin) exercising!
I want you to keep exercising or begin exercising. I know so many moms I've talked to recently who have not started exercising at all postpartum, and they're like 9, 10 months into the postpartum period.
It is very, very important to start exercising to keep our bodies active and energized even with an injury, doing things that you are capable of doing without hurting yourself more. Turns out with a hurt foot like mine, I can do a lot more things than I ever thought.
I just downloaded the floor barre technique from this German guy, Stephane Dalle, Floor Barre for Beginners. It's so cool if you're into barre workouts, and ballet. I actually can do everything in the video and it makes my whole body feel a lot better (bonus points: my foot's been feeling better, too!).
I talked to a physical therapist first to see how I should be careful and what I can and can’t do. She gave me a whole list of exercises I can do. Now it's up to me to actually do it.
We talked about habits a few weeks ago, atomic habits. All I have to do is set up my laptop, open up glo.com, and get my foot-injury-friendly yoga playlist up, or I can get my Stephane Dalle floor barre up.
All I need to do is open my laptop and sit on the ground - that is the habit I've been cultivating to get daily exercise.

Consider pelvic floor therapy (if you have low back issues)
If you haven't started exercising, consider pelvic floor therapy. It's a good place to start to see where you're at after having a baby. After having five babies myself, I finally went to pelvic floor therapy at the physical therapist office nearby and learned tons about myself!
I've had low back issues for a really long time, especially when I'm pregnant and postpartum. Apparently, pelvic floor strength, tone, and health is directly related to low back issues, as are foot injuries. It's all connected.
If you're going to start exercising, a pelvic floor therapist could tell you what's safe and whether you have diastasis recti or not. So definitely consider that.
Consider the Alexander Technique to restore your body’s balance after healing the injury
After you have healed the injury, circle back around and really try to get your body back into balance. The number one thing I can recommend for this, in my own experience, is the Alexander Technique. Google it. Look it up. Get a book on it. Try to find somebody locally who does lessons on it.
It usually takes many, many lessons to really understand it. It's not really a technique as much as a way of life - for example, I'm learning to hold my head back further and to find my core in a way that takes the least effort.
Alexander Technique is all about how to have good posture with the least amount of effort possible to bring your body into balance and completely heal the root cause of your injury...just by getting your body back to its original state of balance. It’s all about cooperating with gravity!
How to prevent an EC-related injury
- Keep your wrist straight while doing anything with your baby - nursing, feeding, pottying - during the first three months postpartum. It's very important to keep your wrist straight. If your wrist is crooked while you're holding your baby, you still have a lot of relaxin hormones in your body, and you are probably going to develop carpal tunnel symptoms. What I want you to do is keep your wrist straight.
- Use a low stool at the big toilet if it helps, no matter where you are, to prevent hurting your back.
- Check in with your own posture while pottying your baby in-arms. I have a few notes about this in the upcoming revision of my book. Also on my Instagram I have some photos of me checking in with my posture.
But basically, you want to have shoulders back and down. You want to do a Kegel, “pull the marble up” with your labia, and really pull the whole core up and tighten. If you don't know how to tighten your transverse abdominals, it's a good thing to learn from a pelvic floor therapist.
And as you do all of these things, you are rising up, so your rib cage is lifting up. It's a really important thing to have your core engaged in a very comfortable manner while holding your baby in-arms and pottying, especially if they are heavy.

- Check in with your own posture while you're carrying baby. Is your head forward all the time because you're constantly on alert? Are you relaxed and your head is in a normal position? Are you slouching? When you're nursing, are you looking down at your baby so much that your posture is suffering? Poor posture while doing anything with your baby can cause an injury.
- Make sure that you're using the correct baby carrier, if you're using one. If a baby carrier hurts you, consider using a stroller. Go to a local natural baby store if you have one nearby, or go online and find out which carrier is the best one for you - if you have any issues or you want to prevent a sore back.
- Engage your core and breathe, and learn how to do these basic things that we as new moms rush around and forget to do. Breathe! Be strong!
- Be sure you're exercising in the postpartum. We already discussed this, but staying fit will definitely help prevent injuries.
- Consider pelvic floor therapy. Again, this can strengthen you from the inside which literally adds an additional layer of protection against injuries.
I haven't heard of anyone getting injured from doing EC...however, by holding their baby in these new positions and not having their wrist straight, or not having a stool underneath them to support them, or just having a really weak pelvic floor, some moms have experienced difficulties in doing EC. It's kind of silly to think that just by holding a baby and walking around incorrectly you could cause yourself an injury...but you can!
Okay, let's not be paranoid about it, but let's definitely take care of ourselves, moms and dads and everything in between.
Have you done EC with an injury or physical limitation, and what tips do you have for us? Or let us know if you have any questions! Please mingle with us in the comments below.
PS - here’s the video version of this episode in case you prefer to YouTube it. ;)
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After delivering my third baby I got a prolapse, which means I shouldn’t lift anything heavy, so I try to do my exercises (one set) when I hold baby over the sink. I guess that means I’m using EC as a healing tool?? (By the way, I highly recommend Michelle Kenway’s blog, it’s got plenty of information and safe exercises.)
Also, before I knew about EC, because I didn’t want to wash more cloth nappies than necessary, I’d hold my first and second babies over the toilet, like you show in the photo where you use the stool, but I’d also sit on the toilet, and rest my wrists on my thighs, which allowed me to maintain good posture with less effort :)
It’s awesome that you did EC instinctively with your kiddos, using the potty definitely cuts back on laundry. It sounds like you figured out a great way to offer the potty without hurting your body. Such a great idea to build your recovery into your EC practice! I hope you are recovering well! xx Andrea
I have one hand and practice part-time EC with my baby (who is now 1, ah!). It’s definitely requiring lots of creativity and patience on my part, like everything in my life, but there’s nothing we cannot do if we keep experimenting! Having one hand puts a great deal of strain on my “good” side – my full hand is used 2X as much and gets exhausted often. Things like holding my baby while pulling down his pants over the potty, holding him over the toilet, holding him and wiping him, pulling up underpants, it’s all slightly challenging, but worth it (most days…. some days, like everyone, I say “screw it!”) I realize my experience may not be super relevant to most, but felt compelled to share that despite challenges, with creativity and persistence you can overcome a ton. Your mind is always your greatest hurdle. Sending EC love to all!
Hi Meghan! Thank you for sharing your story. Your experience is likely relevant to more people than you think. It is so great that you found a way to make EC work for you! You are absolutely right, you can do anything with patience and perseverance. All you need is to decide it is important to you and find a way to make it happen. xx Andrea
So glad you brought up Alexander Technique! I am an Alexander Technique teacher and am often thinking/teaching about how important it is to notice our use when holding a baby over a potty (or even the non EC daily things like picking up a baby or nursing). These repetitive tasks can really take a toll on our bodies if we are not aware. Caretakers are often tired as it is, which puts us in a slump to begin with. We can always use our toddlers as beautiful models on how to use ourselves better. Such an important topic, thanks Andrea!
Thanks Jill! It is so easy to forget your posture going about daily life. Once you start paying attention it makes such a huge impact on how you feel. xx Andrea
I’ve really been struggling with my 4th to even feel like I’ve started EC. I’ve tried at different points in time in almost every version from a newbie to 5 months. This kid fights it so much since a few days old (absolutely no in the potty catches yet), and he is a big baby (6mo size at 4 months), which doesn’t help with my full body injury. I have hypermobile joints, so every strain and lift is taxing on my joints and body alignment. The best I’ve been able to do with him is signaling when I know he’s going, before I change him completely and to change him often. My third kid was fairly easy, but this kid mixed with my worsening joint issues really pushes my limits….but I keep trudging on. He often lets me know he either pottied or he’s about to potty at least. I’ve been showing him pictures of babies on the potty and potty storybooks. I know he’ll eventually get there, but I can only do so much with both whole body pain and a potty fighter. Maybe he’ll be my early no more diapers kid 🤞 Even my EC kids took longer than I had hoped for… I wasn’t an EC kid and was potty trained before 2 (mostly on my own, hated to be wet and tore off diapers) so I had that expectation. My stubborn kids didn’t care about my expectations. …sorry I think this turned into a vent, but kids can get really frustrating.
Hi Kassie! It sounds like you are doing a great job navigating potty learning and your injury. Changing him right after going is a great way to keep him aware. You may find that once he’s walking you can just ditch diapers and do full time EC then. In the meantime it may be that he doesn’t like the potty situation. You can try changing it up, a mini potty, a seat reducer, etc. Shake things up a bit and see if it helps. xx Andrea
I have a chronic condition that limits my ability to hold my baby over anything for longer than a minute. I do have the Baby Bjorn Smart potty, but she seems to really hate being propped up on it. For reference, my baby girl is 10 weeks old and on the more petite side. Needless to say, I am not expecting her to sit on it; I am just hoping to rest her on it a little bit to save my arms and back. I am still holding her legs. She is resisting this and when my husband hold her over the party in the classic EC hold, she does a little better, but is still fighting. Any tips for our situation? We just started EC with her this week. We are using cloth diapers, and while I don’t know all of her signals yet, she sure hates being wet and lets us know, which is very helpful.
Using a top hat potty can help save your back and arms! With the top hat, you hold the potty between your legs, you can then position her legs in the classic EC hold to help her go. You might even be able to sit back, well supported and be able to potty her over it. It came in very handy during those early months. You could try the same technique using the insert of the Baby Bjorn Smart Potty. At least that way you don’t have to hold her up over a receptacle.
Omg this is me! 7 1/2 pregnant and broke my foot – avulsion fracture. Was on a boot for a week but couldnt deal with not accomplishing anything for my family. Hate that it takes at least 6 weeks to heel. Mama’s got lots to do!
It is rough! During this time, lean on your partner or trusted family/ friends to help along your ec journey. It can be so hard to feel like we’ve accomplished anything when there are physical restrictions put on us, but I encourage you to slow down a bit and focus on healing well while you near the end of your pregnancy. Remember, You are doing great momma!