by Trish Gipson, Registered Physiotherapist at Envision Physiotherapy
One of the main reasons new mothers come to see me at the clinic is because they are eager to get back to some sort of exercise or sport but want to do it safely.
Usually women are given the “go-ahead” by their health care provider to return to activity around six weeks post-partum. But what does this mean? Is it safe to start running? Boot camp? Playing volleyball?
The truth is it depends on the individual. Not all pregnancies are the same, not all deliveries are the same, and not all bodies are the same.
So how do you know when and how to get back to your desired level of activity?
The first thing to consider is your level of activity during pregnancy. Most women decrease their activity level over the course of their pregnancy and, as a result, some deconditioning likely occurs. So jumping back into pre-pregnancy activities at that six-week mark may be a bit overzealous and may put you at risk of an overuse injury.
Secondly, you need to consider your delivery. Tearing of the pelvic floor can affect the ability of the core muscles (the pelvic floor, the diaphragm and the deep abdominal and back muscles) to function improperly which can lead to hip, back, knee, or pelvic pain if not properly rehabilitated. These symptoms may not become evident until the load is increased, such as with exercise. A caesarean is a major surgery, and must be treated as such; you wouldn’t start skiing again right after a knee surgery without at least a few months of rehabilitation, so I would suggest the same diligence with rehabbing after a C-section.
Also important to consider is the amount of change that a woman’s body goes through over the course of a pregnancy. Her posture changes, her movement patterns change, certain muscles get more active and other muscles tend to atrophy. These changes don’t revert as soon as she gives birth; her body has taken forty (give or take) weeks to adapt to the growing baby and is going to take time to readjust. And sometimes our bodies need a bit of help along the way.
That’s where a women’s health physiotherapist comes in. I recommend that all women who have delivered a baby see a women’s health physiotherapist six weeks after giving birth. Your physio will assess your posture, your movement patterns, your abdominal wall and your pelvic floor to determine if all is functioning as it should or if there are any areas that need attention.
Because every situation is different, there is no “cookie-cutter” approach for getting back to exercise or sport post-partum. But here are some guidelines to follow:
- For the first six weeks, honour your body and what it’s just been through. Consider that tissue that has been torn or cut takes at least six weeks to heal; over stressing it too early could compromise that healing process, but not moving at all can be equally detrimental.
- Diaphragmatic breathing, very gentle pelvic floor contractions and deep abdominal contractions help with recovery; see a women’s health physio to learn how to properly perform each of these.
- As soon as you feel comfortable doing so, start doing some daily walks. They don’t need to be fast, they don’t need to be far, but bundle baby up and get outside. Gradually increase your speed and distance as tolerated, and vary the terrain (concrete, track, grass, hills, etc).
- Once you’ve hit the six week mark (and you’ve already made your appointment to see your physio, of course), seek out classes or instructors that cater to new moms; yoga, stroller fitness, etc. Have a chat with the instructor so that they know the circumstances of your delivery and where your body is in its recovery. If anything doesn’t feel comfortable to you, then perhaps it is not appropriate for where your body is right now.
- Increase your activity level slowly and steadily. The six week mark is a very common time for pelvic organ prolapse (which is when one or more of the pelvic organs descend and remain sitting lower than they should) to occur because many women rapidly increase the load before their tissues and the muscular support systems (the pelvic floor and deep abdominals) are ready. However, if you gradually increase your activity level and the intensity of exercise over time, your body will adapt to match the increased load.
Your body has ways of telling you that you need to slow down. Listen to it. The following are some signs that your body may not be ready for whatever activity you are doing:
- bleeding increases or resumes
- pain anywhere in the body
- leaking urine, feces, or gas (even a little bit!)
- heaviness in the pelvis or on the pelvic floor
- bulging of the abdomen with certain exercises or movements
- something “just doesn’t feel right”
- excess fatigue
If you experience any of these things it doesn’t mean you can’t ever do that activity, just not yet. It may just take time, or you may need to seek the help of a health care practitioner.
Remember that movement, specifically exercise, is an integral part of our health and well-being. But remember that, as a new mom, it is imperative to give your body time to recover, heal, adapt to the changing load, and get strong. Growing a baby is a process, as is returning to your desired level of activity. Be patient, set goals along the way for motivation, and don’t be too hard on yourself. You just grew a human, super-mama!
Trish Gipson, BHKin, MScPT, FCAMT, CAFCI.
Trish graduated from SFU with a Bachelors Degree in Kinesiology, and from McMaster University with a Masters Degree in Rehabilitation Sciences (Physiotherapy). She is certified as a Fellow of the Canadian Academy of Manipulative Physiotherapy, and has taken post-graduate courses in acupuncture, pre- and post-natal care, pelvic and perineal re-education, and running injuries. She has also completed the Clinical Mentorship in the Integrated Systems Model with Diane Lee. She has experience working with people of all ages and fitness abilities but has a special interest in treating pelvic floor disorders, and working with new moms and moms-to-be. In her spare time Trish enjoys running, biking, playing volleyball, doing yoga and snowboarding, and spending time with her family. Trish has completed numerous half and full marathons, and has also laced up her hiking boots to walk the Inca Trail in Peru and climb Mount Kilimanjaro in Tanzania. You can reach her at www.envisionphysio.com.