A step by step guide to returning to exercise post pregnancy from one of London’s leading Women’s Health Physiotherapists.

After pregnancy, it’s not uncommon for women to be in a hurry to return to exercise. Although this may sound like it could be beneficial, too much, too soon or the wrong type of exercise, can cause serious long-term problems.

In fact, studies have revealed that the majority of mums will take three years to return to their previous fitness levels.

We’re not sugarcoating it – returning to exercise after pregnancy needs to be undertaken gently and carefully. The body has just undergone a huge amount of strain, which will have significantly reduced its function.

Remember that it’s OK to take your time getting back into exercise. Don’t put undue pressure on yourself or push yourself too hard, because the risks certainly outweigh the rewards.

In this article, I’ll be giving you my step by step guide to returning to exercise, explaining the importance of specialist guidance and outlining specific advice for each point of the post-pregnancy period.

The invaluable help of a specialist

The best way to return to exercise safely, in a way which enables growth without risking your health, is to follow the advice of a specialist.
What constitutes a ‘safe return to exercise’ varies from person to person and depends on pre-existing fitness, as well as the conditions of your pregnancy, labour, and delivery.

It is recommended that you see a pelvic health physiotherapist from 6 weeks post-partum for a Postnatal MOT/Assessment. During this assessment, the specialist will establish the function of your core, abdominal and pelvic floor muscles and give you a tailored guide to return to exercise and sports safely.

Postnatal Exercise Recommendations

The following recommendations are designed to suit specific phases in the post-pregnancy recovery period.

This provides a helpful guide to returning to exercise, but remember, the information may not suit your particular circumstance.

Many factors may influence your ability to exercise after childbirth. These can include altered sleep patterns, breastfeeding, hormonal changes, energy levels, pain and dysfunction.

Further modification of exercise plans may be required if you have had a caesarean section, have any existing pelvic joint or back pain, rectus diastasis or have any additional risk factors, such as assisted delivery (forceps, ventouse), a long second stage (pushing over 1 hour) and a baby birth weight of over 4kg.

If none of the conditions above applies to you, then these simple phases of gradual exercise may work well for you. You can follow these points at home in your own time and use them to rebuild your strength and fitness gradually.

Recommended exercises for 0-6 weeks postnatal:

– Short walks
– Belly breaths
– Gentle postnatal core and pelvic floor exercises.
– Recommended exercises for 6-12 weeks postnatal:
– Recommended exercises at this stage include:
– Walking
– Swimming or low-intensity water aerobics classes (once the bleeding stopped
– Postnatal abdominal and pelvic floor exercises
– Low impact aerobics or a postnatal class
– Gym programs – maintain posture, use light weights, no breath-holding.

Note: It is recommended that you wait until your 6-week postnatal check with your pelvic health physiotherapist before commencing a group exercise program, returning to the gym or personal training. A check-up is particularly important at this stage, as the specialist will need to check for abdominal muscle separation and pelvic floor dysfunction.

Advice for the 12-16 weeks postnatal stage:

Abdominal and pelvic floor muscle testing should be done before returning to higher impact exercise, running or sports, and especially before commencing regular abdominal exercise programs.

Before progressing further with higher resistance, intensity or load exercises, you should have no pelvic floor weakness symptoms and good core control. You should not experience any back pain, pelvic or vaginal heaviness or urine loss during or after exercise.

If you experience any of these symptoms, immediately slow down and reduce your intensity level, then see a pelvic health physiotherapist for advice.

Nutrition, Hydration and Environmental Considerations

– Dietary intake is very important, especially when exercising. It is essential that you stay hydrated before, during and after exercising, regardless of whether you are pregnant or breastfeeding. Take particular care when doing exercises in a heated swimming pool, as this can dehydrate you further.
– Exercise and lactation are safe in the postnatal period, providing adequate calories are consumed, and hydration is maintained.- Breastfeed, where possible, before activities.
– Wear non-restrictive comfortable clothing and a good supportive non-underwired sports bra.

Postnatal MOT

Following your 6-week postnatal review with your GP, we recommend a Postnatal MOT (Assessment) by a specialist pelvic health physiotherapist before returning to abdominal or high impact exercise and sports. This is suitable for women who have symptoms of pain, pelvic floor or abdominal problems, and those who just want a check-up with advice and information.

During the Postnatal MOT, we can assess:

– Pelvic floor muscles and bladder concerns
– Pelvic organ prolapse
– Diastasis Recti or Tummy Gap (abdominal separation) and core control
– Scar assessment (of c-section or episiotomy scar)
– Return to sports and exercise
– Assessment of any musculoskeletal issues you may have

Treatment may include creating an individualised pelvic floor program, abdominal and core strengthening, treating any musculoskeletal issues found, scar tissue management and advising on returning to sport, nutrition, posture and ergonomics.

Women’s Health Physiotherapist

Farhana Sonday is the Pelvic Health Lead Physiotherapist at Nordic Balance.

Fara has worked in various NHS and private clinics in London, including The Princess Grace Hospital, Little Venice Pilates and Physiotherapy, and 108 Medical Chambers.

Fara has extensive experience and training in women’s health, pre and postnatal care, pilates and hydrotherapy.

To receive personal guidance about returning to exercise post pregnancy from Fara, get in touch with Nordic Balance at either the Abbeville Road or Wimbledon Village clinics.