GUEST POST BY: EMILY HUNTER, PHYSIOTHERAPIST
Post natal exercise: A guide for easing yourself safely back into fitness
Firstly, congratulations Mama on making it through the marathon that is childbirth. Just like every pregnancy journey differs, so does everyone’s readiness to return to exercise. Straight after childbirth is not the time to throw yourself back into the local Bootcamp. Start slow & steady, appreciate what your body has been through and focus on letting it heal.
Exercise is a great tool to:
- Reduce stress
- Reduce back pain
- Assistance with continence & abdominal separation
- Improve sleep quality
- Enjoy social interaction
WHAT IS SAFE TO DO IN THE FIRST SIX WEEKS?
The first 6 weeks after birth should be a sleep-deprived blur of beautiful & delicious newborn moments, without having the unnecessary pressure of ‘bouncing back’.
During pregnancy & delivery, be it a vaginal birth or cesarean section, strain occurs to the pelvic floor and abdominal muscles. Added factors such as the use of forceps, large bubs or prolonged pushing can lead you to be more susceptible to pelvic trauma and potential pelvic organ prolapse. Likewise, a cesarean is major abdominal surgery affecting multiple layers of the abdominal wall. So, initially, you need time to heal and rehabilitate these muscles.
- Pelvic Floor Activation
Hopefully, you have been told of the importance of completing pelvic floor activation after birth, however many don’t realise that your lift is only as good as your relaxation. Focus on feeling a gentle scoop and lift of the hammock of muscles at the base of the pelvis, as if you are trying to stop urinating midstream. Start with a quick lift & relax and slowly add 1-2 seconds to your length of hold each week. You can perform these in all sorts of positions and try to co-ordinate an activation prior to sneezing or coughing. It is imperative that you do not experience any pelvic pain or bearing down whilst doing these.
- Deep Abdominal Activation
By the third trimester of your pregnancy, you would have experienced separation of the rectus abdominal muscles called a diastasis. This occurs in order to allow room for your bub to grow. Closing the gap isn’t necessarily the priority; the most important thing is gaining the ability to engage your deeper abdominal muscles and tension the area in between. Start with gently activating your lower stomach by thinking as if you are trying to put on a tight pair of jeans. The activation should not be a big brace of the upper tummy muscles more a gentle pull in below the belly button. You can do these whilst you lift & carry bub to prevent placing any further strain on the diastasis. By completing this gentle draw in, you will prevent your stomach from going “pointy” and putting further strain on the diastasis.
- Walking & Mobility
Slow and steady is the best way to start getting back into walking. Start with 5 minutes and see how you feel, ensuring you stop if you feel any vaginal heaviness, bleeding or scar pressure. Each day slowly increase a few minutes each day. Stretching through the upper & lower back will assist with any muscular soreness from feeds and can also help with early c-section scar mobilisation within pain limits.
WHEN CAN I RETURN TO BOOTCAMP?
Your 6-week check with your doctor will mainly assess how any wounds are healing and how bub is managing. It is during this appointment that you will often be told you are safe to return to exercise. So, what does that mean? Straight back into high impact exercise? This medical clearance doesn’t necessarily assess your ability to activate your pelvic floor, if you are having difficulty relaxing, incontinence issues or what exactly you can and can’t do. Returning to Bootcamp prior to your pelvic floor being ready can leave you more susceptible to incontinence issues or prolapse later in life.
Did you know that when verbally instructed 1 in 2 people will incorrectly lift their pelvic floor? Seeking a vaginal examination with a Women’s Health Specialist Physiotherapist will allow you to be taught exactly how to activate and let you know what is safe for your pelvic floor. They will provide you with an individual exercise program tailored to achieving your goals as when it comes to this it is not a one size fits all approach.
WHAT SORT OF EXERCISE IS BEST?
Low impact exercises such as Pilates or Yoga is a great starting platform to get you on the right path to achieving your exercise goals in a pelvic floor friendly way. Participating in postnatal exercise classes run by experienced physiotherapists such as the ones offered by FitRight are a great way of safely improving pelvic floor strength, abdominal separation, and any other ache or pain. An added bonus is FitRight offers volunteers who look after bub in the same room whilst you exercise! For more information on where to go for your post-natal assessment find a list of Women’s Health Physios on www.fitright.physio or chat with your GP. Women’s Health Physios are here to help empower you to be proactive and not reactive with your pelvic floor recovery!
** Disclaimer this advice is for general recommendations, for individual advice speak to your local Women’s Health Physio **