Returning to exercise after giving birth is often a priority for women, and here on the Northern Beaches of Sydney that is no exception. I get asked about returning to exercise post-baby on a regular basis and so I thought that it was time to dedicate a blog article to it. 

Returning to exercise after giving birth is such a massive topic with many many considerations…….so apologies if this is a bit of information overload! Ultimately I hope that it guides you to make good decisions and allows you to look after your body both now and in the future.

Some women seem to have the ability to look fit, like they have never been pregnant, and others are trying to workout, but struggle with leakage, abdominal separation and niggling injury. But why? This seems so unfair. 


The reality is that some women are doing all the right things to rebuild their deep core and pelvic floor function, and others are not….and the likelihood is that this is not intentional……after all, what you’ve never been told….you simply don’t know, and I believe that there’s a huge lack of information and education on this subject. Most guidelines are vague, and unfortunately there isn’t a one size fits all answer as everyone is individual and affected in different ways.


Let’s look at the main complaints for women following pregnancy and birth…..


INCONTINENCE

Leaking when you cough, sneeze, jump and run is not normal….and certainly not something that you have to live with now that you’re a mum. 

PROLAPSE

This is when your pelvic organs start to descend in the vagina from their original position. It can cause a heaviness in the vagina, discomfort, painful sex and difficulty passing urine/bowel movements. 

ABDOMINAL SEPARATION

This can change the appearance of your tummy after birth. Some women make it through pregnancy without abdominal separation, others recover relatively quickly, and some need to work hard to close the gap and regain good functional core stability.

So how can you prevent these symptoms? 

Having a good understanding of the following will help your journey of returning to exercise:

Safe return to exercise will depend on:

PREGNANCY

How was your pregnancy? Were you able to exercise and stay fit throughout, or did you have pelvic pain that meant you were stuck in bed? Did you have morning sickness and vomit regularly? Did you have any other complications during pregnancy?

BIRTH

Did you have a vaginal birth or cesarean? How long were you pushing for? Did you have a forceps delivery? Episiotomy? Tear? How big was your baby? 

PELVIC FLOOR RECOVERY/DYSFUNCTION

Do you have the feeling that everything down there is a little bit lower than it was before pregnancy? Are you experiencing vaginal heaviness? Do you leak when you cough or sneeze? Or can’t get to the bathroom in time? Is sex painful?

ABDOMINAL RECOVERY

Do you have abdominal separation? How is your wound healing?

GENERAL ENERGY LEVELS

The reality for many new mums is that they are sleep deprived, which can cause fatigue, reduce energy levels, and challenge motivation to exercise. Is your baby sleeping and feeding well?…..or are they feeding ‘too frequently’ and needing cuddles to be settled to sleep?

EXERCISE GOALS

We are all individual. For some women, their goal is to get some fresh air, walk the dog and take their baby in the stroller. For others it’s pilates, yoga, the gym….and for others it’s crossfit or high impact sport. All these activities challenge the pelvic floor and abdominals to different degrees, which is why it’s important to seek advice from a physio with a special interest in Women’s Health who can provide you with safe guidance as you return to doing the things you love.


Medical clearance

It’s always good to get medical clearance from you GP or Obstetrician before returning to exercise, but did they ask you what your exercise goals are? Did they test your pelvic floor strength? Were you told that you have a slight prolapse?….or that you should strengthen your pelvic floor? 

Where do you start? How do you know if you are doing your pelvic floor exercises correctly? A physio has significantly more time during your appointment for assessment, education, exercises and goal setting…….which is why:


All new mums should have an appointment with a Women’s Health Physio

At Activate Physio for Women we recommend that your postnatal assessment is around 6 weeks postpartum or at least 2 weeks after your bleed has stopped and will include:

  • A discussion about your pregnancy and birth history, general medical history, current symptoms and exercise goals
  • A thorough assessment of your pelvic floor and deep abdominal muscles to understand how well they are functioning, how strong they are, what level of protection you have from prolapse and what type of exercise is safe to return to
  • Teaching you how to correctly activate your core muscles (pelvic floor and deep abdominal muscles)
  • Individualised home exercise program
  • Individualised management and advice regarding any symptoms you may have
  • Guidance on your safe return to exercise 
  • Guidance on exercises you should avoid
  • Booking a follow-up appointment to track your progress


Key factors as you return to exercise

Understanding that you should not experience heaviness in your vagina, leakage, pain or abdominal doming when exercising. These are common, but not normal and your women’s health physio can help you with these.

Listen to your body – go slow and steady. Your return to exercise should be gradual depending on how your body responds. Returning to exercises which are too high intensity/impact too soon can damage your body as it recovers from pregnancy and birth.


Allow yourself 9-12 months to recover. Do not compare yourself to others and how quickly they have ‘bounced back’. Look after yourself and be kind to yourself.


If you have any questions about recovering from pregnancy and birth; returning to exercise; abdominal separation or pelvic floor concerns…..please feel free to contact me. You are not alone, we can work together no matter how long ago you had children to get you back in control and doing the things you love!


Have a lovely day

Kelly

Physio

(02) 9948 0004

welcome@activate.care

To see a womens Health Physio book online here.