In this article, we address common questions and concerns for new mums considering returning to exercise after pregnancy, particularly in your child-bearing year.
Have you ever wondered what the research says about exercising after you have had a baby?
Have you wondered when is the right time to start exercising again?
Have you ever wondered if sit-ups are helpful to restore your abdominal muscles after pregnancy?
Have you ever wondered when will sex feel the same again?
1 in 3 mothers will experience prolapse symptoms such as vaginal heaviness or a dragging sensation and 1 in 3 women leak when they exercise. This can be related to the type of birth you have had, the length of certain parts of your labour and also the weight of your baby.
Within the past 12 months, a set of guidelines were released by UK based physios to help health professionals globally to determine the answer to questions about a return to exercise for each of our individual clients. The type of exercise that this relates to includes running, fitness classes, hiking and any activity that involves an element of impact.
Prior to these new recommendations being released, the main international guidelines that we had to go by were documents that referred to ‘Pre and Postnatal Exercise’. However, almost all of these guidelines contained 90% information about pregnancy modifications and precautions, and a little token paragraph at the end about a postnatal return to exercise.
Previous advice relating to returning to exercise after birth had included strategies such as:
“Wait until your medical clearance to return to exercise”, “Start exercising after 6 weeks and listen to your body with regards to intensity”, and “Take care with high impact exercise”. However, there was rarely, mention of the fact that vaginal prolapse is often asymptomatic and can progress to a point that the organ/s are near the vaginal opening. If the only advice we give to women is, “listen to your body” then you may inadvertently worsen a prolapse without realising.
Our new women’s health information not only explains why your medical clearance (by a GP or obstetrician) is inadequate for return to running but guidelines heavily promote getting a vaginal exam performed by a specialist physiotherapist as well as a whole-body assessment of your strength, balance, fitness and endurance.
Safe return to exercise not only requires good pelvic floor recovery but also take into account whole body strengthening and conditioning specific to the activity that you wish to return to. In fact, as a result of these new guidelines, in Australia, the health department and Physiotherapy Association is in the process of considering free postnatal physiotherapy and pelvic floor screening for women in their postnatal period.
Criteria that a women’s health physiotherapist will assess between 6-12 weeks (or later) include the following:
– Recovery of the deep opening of the pelvic floor muscles (Genital hiatus). This should be returned to less than 7cm to prevent a prolapse moving downwards through the opening with impact activities.
– Strength of the pelvic floor: length of time you can hold, the strength of squeeze pressure and also your ability to ‘lift’ or elevate the pelvic floor.
– Lower extremity and pelvic girdle control including the ability to hop on one leg.
– Fitness and endurance goals such as walking or hiking for extended periods of time prior to commencing higher impact work.
– Balance relating to moving out of your base of support in a variety of directions as well as maintaining control when standing on 1 leg.
– The integrity of your abdominal wall. This can sustain stretching and weakening due to hormonal changes and baby position during pregnancy.
All of these criteria are individual to each woman and their birthing story. A women’s health physio can assess your pelvic floor as well as your general fitness and endurance levels. They are also experts in treating any continence or prolapse conditions that may be identified.
In the long term, not every woman who has a prolapse or incontinence will require surgery. There are many recommendations, strategies and types of equipment to help women safely return to exercise. This rarely requires avoiding exercise but it usually always needs an individualised program and targeted plan. Prevention is always better than cure! Learn more about our Women’s Health Physiotherapy treatments.
At Nordic Balance Abbeville Road we offer a wide range of treatments for the entire family.
June 22nd 2022
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