When and how can I start exercising again?
That million dollar question so many mums have… When and how can I start exercising again!?
I’ve decided to write a post on this because there is so much variance in the information about what is right/wrong, safe/unsafe, good/bad when it comes to getting back into exercise after you have had a baby. The amount of times I hear my patients coming to me so confused about what they should or shouldn’t do is endless and it does not need to be so confusing! My aim by you reading this is for you to be more informed as to what me as a physiotherapist in the area of women’s health is thinking when I am considering your return to exercise.
I must first I apologise in advance and say I am not able to give you an exact week post delivery that it is now ‘safe’ to return to your exercise regime. I often hear that people attend their 6 week GP check and have been given the all clear for returning to your pre baby exercise regime. Unfortunately this is not always the right way to go about it (depending on what your exercise regime was like). The return to exercise path varies from person to person depending on your particulars. What I can do is increase your awareness of these particulars and what I am thinking about when I am considering if someone is ready to commence a particular exercise.
THE PARTICULARS (The things that can impact what types of exercise would be best for you to start with)
1. Your labour and birthing experience
- Did you have a vaginal or caesarean delivery?
- If vaginal- Did you have to have an intervention such as forceps or ventouse to help your baby out? Did you push for over 2 hours?
- Did you get an perineal injury or an episiotomy? If so, how big was this tear (graze, first, second, third, fourth degree tear)? Has this healed well? Do you still have pain?
- How much did your baby weigh?
- How many babies have you had and has your body recovered between these pregnancies?
As you can see so many factors of the labour and birthing experience can impact your return to exercise (I will expand on the impacts these things can have in a blog soon, stay tuned).
2. Pelvic floor health
Have you done your pelvic floor rehab? I cannot highlight the importance of completing pelvic floor rehabilitation after your delivery (yes those that have caesareans this includes you too). It is so important you are able to both contract AND relax your pelvic floor when you are exercising to reduce your risk of having or developing pelvic floor issues.
Have a think about how is your pelvic floor going since your delivery? Are you having any symptoms of weakness such as urinary or bowel incontinence or urgency?
3. Abdominal wall recovery + core strength
To ensure we give our abdominals the best chance to recover it is important we know how to correctly turn on our core muscles (pelvic floor, transverse abdominus, and diaphragm) and use this in our exercise. We don’t want to put extra pressure or force through your abs if you don’t have a strength to protect the area. This can lead to pelvic floor weakness and it can also hinder the healing of our abdominal stretching (recuts diastasis).
4. Your previous exercise tolerance
A simple one the people often forget.. you have just been pregnant so it is likely that your overall fitness has reduced.Think about a rugby player that has been out for a season after a knee surgery- they don’t just suddenly start playing a full game first day back.The return is a gradual process.
5. Any current pain or history of pain with pregnancy
The general recovery post delivery differs for all, I see mums who feel ok a few weeks post delivery then I see mums who feel ok months and months post delivery. Remember there is no right and wrong, each of you have had your own pregnancy and birthing experience so we cannot compare ourselves!
6. Breastfeeding status
The hormonal changes associated with breastfeeding has an impact on softening in the ligaments throughout the body. The role of ligaments is to support our joints and also holds our pelvic organs (ie. your bladder, uterus, and bowel) in their correct place. We need those organs to stay where they are designed to be! This is another reason the return to exercise should be a gradual, gentle one.. to avoid these organs shifting downwards.
As you can see this is why it’s not as simple as reaching a certain week post-delivery then commencing exercise. In saying this I do not want to scare you or make you avoid exercise. Exercise is absolutely fantastic and we all know the benefits, I just want you to do it in the smartest way!
So how can you know if an exercise is appropriate for you??
One of the most effective ways is to firstly be in tune with your body. I know this sounds a little ‘wish washy’ but as females we are generally quite good at knowing our bodies. Let’s now fine tune this and link it to our pelvic area and more specifically our pelvic floor. I want you to be aware of what you are looking for in your body if you are doing too much too soon! Sometimes you don’t need someone to tell you what is right and wrong you can feel it in your body, you just need to be self aware.
If you experience any of the following symptoms when exercising its likely you are doing too much too soon. This is your body saying ‘hey, give me a chance to recover and rehab some more!
1. Any form of pelvic floor issues
this means any incontinence (urinary or bowel), suddenly needing to urinate, or even not being able to control your wind.. Yes our pelvic floor should have enough control to stop all of those things from happening. And no its not ok even if ‘OH, but it’s just a little bit..’ Rule no. 1 We should not leak with exercise!
2. You feel any feelings of… heaviness, pressure, lumps, bulges, dragging, something coming down in the pelvic area during or after exercise. As I talked about above the ligaments holding your bladder, uterus, and bowel are still soft in the post-natal period (particularly with breast feeding). If you do too much too soon these organs can descend or move south if that makes it easier to visualise. You can feel this as a pressure or heaviness type symptom. If you feel this note the exercise you are completing, stop completing it, then when you get home have some flat or rest time. If the symptoms continues seek advice from a women’s health physiotherapist or your gynaecologist for an assessment.
3. Any pain issues
this is a given, we don’t need to push through pain. We have already won the medal with birthing a baby remember.
4. If it just generally does not feel right.
Again, you may have been ok completing the exercise pre baby and you might be ok later down your recovery.. but currently your body is not up to completing it! Listen to it.
I hope this gives some insight as to things to consider in the journey to returning to exercise post baby. Of course as a physiotherapist in the area of Women’s Health I do think it is a great idea to have a consult to complete an assessment so we can be the most accurate. If you want to book an appointment for this reason you are wanting to ask for a post-natal assessment or return to exercise check.
Like always, if you have any questions feel free to email me directly at firstname.lastname@example.org or call the lovely reception team at on (07) 5535 5667