Erin Brady thought it was no big deal to carry her then-13-month-old son Kyle across a parking lot so she could show him off to a friend.
But the next morning, her back hurt so much that the 37-year-old stay-at-home mother made an emergency visit to a chiropractor. Her husband, a computer programmer, ended up taking two days off from work to care for Kyle while his wife lay immobilized.
"I know now not to push myself," said Brady, of Owings Mills, who is pregnant with the couple's second child.
Kyle is 21 months old now and fortunately needs less carrying. But Brady is wary of getting hurt again. "I have a feeling this is something that is going to be a problem for a while," she said.
It's an unexpected problem for many parents - especially the growing number who are waiting longer to start their families.
Larger babies and the stress they cause to women's bodies during birth also contribute, said Hollis Herman, a physical therapist and co-author of How to Raise Children Without Breaking Your Back.
Wonder how a mom or dad can get hurt just taking care of children? Let us count the ways:
Bending over to change diapers, putting kids in the car seat, in the stroller, in the high chair. Folding the stroller and hoisting it into the minivan. Twisting to separate tussling siblings. Giving piggyback rides. Stepping over the safety gate while carrying children and groceries. Nursing the baby on one side, day after day. Lifting the toddler out of his crib, carrying him on one hip while you twist to stir the spaghetti sauce. Hoisting the first-grader out of the car to keep from waking him up. Practicing baseball in the back yard with your Little Leaguer.
Statistics on the prevalence of parental injuries are hard to come by. But chiropractors, orthopedic surgeons and physical therapists say problems are common as the age of parents creeps up.
"There are movements people make every day with a child, with an infant, that you don't think about, but done over and over again can cause overuse injuries," said Alan Sokoloff, a Glen Burnie chiropractor who also treats members of the Ravens football team.
Add to that the fact that parents are getting older. While the birth rate declined for women younger than 30 between 1990 and 2002, it rose during the same period for older women - from 80.8 to 91.5 births per 1,000 women age 30 to 34, and 31.7 to 41.4 births for those age 35 to 39, according to the National Center for Health Statistics.
Dr. Nicholas DiNubile, a Philadelphia-area orthopedic surgeon who specializes in the problems of baby boomers, said that for many in their late 30s and 40s, parenthood can aggravate dormant problems.
"You're bent over and you're moving in ways you shouldn't, because you're chasing someone around who's 2 feet tall," said the 51-year-old father, whose children are ages 3 and 7. "You never do it with proper biomechanics."
The problems often start during pregnancy, when many women experience carpal tunnel syndrome and sciatica. Hormones weaken the joints and stretch ligaments. Weight gain throws the body off balance, stretches out the abdomen and weakens the back muscles.
Prolonged bed rest, often prescribed by doctors concerned about complications of pregnancy, also can reduce muscle strength.
"The pregnancy and all the missteps [women] can take during the pregnancy is all but inviting a problem in the lower back," said Jerome McAndrews, a former president of the Association of Chiropractic Colleges and spokesman for the American Chiropractic Association. "The older the woman is - and we don't have a study on this - I would say the more likely it is she's going to have problems."
Angie Rafferty, who stays at home to care for her 11-month-old daughter Madison, struggled with sciatica during pregnancy.
Recently she's had muscle spasms in her shoulders. One day, she twisted her back so badly trying to lift 23-pound Madison out of her car seat that she had to get help from a neighbor.
"I just avoid picking her up as much as I can," said Rafferty, 30, of Essex. "I spend a lot of time trying to teach her how to climb."
Susannah Wolf, 35, a stay-at-home mother, noticed pain in both wrists starting when her son, Samuel Gauck, was 5 months old. She's twice gotten cortisone shots to relieve the symptoms. Doctors told her she has De Quervain's syndrome - also known as "washerwoman's sprain" - and that it often strikes new mothers.
Before she knew what was wrong, Wolf, of Cedarcroft, said, "I was really scared that I wasn't going to be able to care for him." She has since tried to remember to support Samuel, now 14 months, from underneath to ease the stress on her wrists.
Jan Howells, a physical therapist in Timonium, said she frequently sees parents carrying infants in basket carriers that snap into car-seat bases - a move that throws off the center of gravity and strains elbows and wrists.
Howells runs a "therapeutic Pilates" class for new mothers and mothers-to-be at Megan Rich Physical Therapy to help prevent such injuries.