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Returning to exercise after baby — pelvic floor first

By Pim Sereika, Physiotherapist —Waterfront Health Studio

Exercise is so important for every new mama; we all know its benefits in lifting mood, creating a sense of wellbeing and connecting with yourself mentally and physically.  Simultaneously, we all know the pressure women can feel in the early days to be on top of everything; the mental load of caring for your new tiny human, potentially organizing other small people, the pressure to fit back into your pre-pregnancy clothes, the sleep deprivation, oh, the sleep…!

Whilst it can be tempting to rush back into high-intensity exercise, nurturing your body, and especially your pelvic floor is so important after baby arrives. It is a time when it is important to exercise for the weakest link: even if you do not have any symptoms (such as leakage), exercising too strenuously, too soon can cause further damage to this important muscle group. Allowing your body the time to heal your pelvic floor first will ensure that it will be strong enough to withstand the downward pressures that you challenge it within the longer term. 

It is important to check with your doctor, midwife, physiotherapist or continence professional before you return to exercise. A pelvic floor and postnatal abdominal check is highly recommended and can provide you with the most effective and individualized plan. But, these guidelines which are based on normal tissue healing will provide you with a starting point to plan your postnatal fitness: 

  • After delivery, walking, gentle core bracing and pelvic floor exercises are the best ways to reintroduce activity. 
  • Group exercise classes, swimming, light weights and graduated abdominal exercises should be avoided until after your six week check-up with your health care provider. 
  • Once you recommence exercise, avoid exercises which excessively increase your intra-abdominal pressure. This means making sure you are not pushing down on your pelvic floor by straining or holding your breath. 
  • Impact exercise and exercises which significantly increase your intra-abdominal pressure, including heavier weights and more intense postnatal abdominal exercises are normally safe to introduce from the 12 weeks. 

As a guide, if you are able to maintain a controlled pelvic floor contraction throughout an action, it is probably safe to return to it. If you experience any back pain, vaginal heaviness or urine loss during or after exercise, please seek further advice from a health care professional. 

Other factors to consider and ways to care for your pelvic floor:

Being a new mama can be exhausting and demanding. Fatigue and overexertion can cause an increased risk of injury, so listen to your body and how you are feeling. It is a time when it is important to listen to warning signs and pain! 

In the early postnatal days, providing your lower abdominals (which work as a team with your pelvic floor) and perineum with a little extra support will assist you with stressful actions such as coughs and sneezes. This is where your Active Truth mama tights or the extra core support from regular tights might come in handy! 

Activities that put increased pressure through your pelvic floor when it is still recovering should also be avoided. These include:

  • Straining to pass a bowel motion. Drink plenty of fluid and consume a high fibre diet to stay regular as well as giving yourself time to go to the toilet. 
  • Excessive coughing: if you are asthmatic for example, please see your doctor to ensure you are managing this optimally
  • Lifting anything heavy: this could include weights, your toddler, your baby in a capsule as well as a loaded up nappy bag from the car. Think creatively of ways you may be able to lighten your load or make a second trip. 

You should be doing your pelvic floor exercises three times daily, and your technique matters. If you are unsure, follow up with a continence professional or pelvic floor physio. Congratulations on your new arrival, and happy exercising!