For many women, the prospect of returning to exercise postpartum is an exciting thought. At The Injury Clinic we believe returning to exercise is important for postpartum women, but we also know it is important the return is gradual and guided. Currently, there is a distinct lack of consistency when it comes to advice around returning to exercise in the postpartum period.
After reviewing the available literature, practitioners at The Injury Clinic feel there are three key points for all post-partum women to consider in their return to exercise;
At The Injury Clinic, we recognise that there are many changes that occur to your body during pregnancy. Unfortunately, the body does not automatically default straight back to functioning how it was pre-pregnancy. It is therefore important to see a Physiotherapist for a functional assessment to ensure your muscles (pelvic floor, abdominals, diaphragm and global muscles) are functioning effectively. This is the safest way to return to exercise and minimise the risk of injury.
Essentially, our goal at The Injury Clinic is to guide you through a gradual return to exercise and ensure you don’t get injured throughout this process. As a rough guide we feel the following is appropriate:
SIGNS AND SYMPTOMS OF PELVIC FLOOR/ABDOMINAL DYSFUNCTION
The signs and symptoms listed below are the main things we look for that indicate there may be dysfunction with the pelvic floor and/or the abdominals. This list is not extensive so there may be other things you are experiencing that are worth mentioning to your primary carer or Physiotherapist. Some signs and symptoms include;
-Leaking urine or an increased urgency to urinate.
-Inability to control bowel movements or an increased urgency.
-A heaviness/pressure/bulge/dragging in pelvic floor area.
-Pain with intercourse.
-Separated abdominal muscles and/or decreased abdominal strength and function. This may include ‘doming’ of the tummy.
-Lower back or pelvic pain.
-Ongoing or increased blood loss, particularly if this is past 8 weeks postpartum. If you do have any significant changes to your blood loss (ie. increased volume, change in colour/smell), make sure you get in touch with your primary carer.
12 WEEKS SEEMS A LONG TIME TO GET BACK INTO HIGHER IMPACT EXERCISE…
While it often seems a long time to wait before returning to higher impact exercise, there are many factors that contribute to this. It is important to remember that throughout your pregnancy your muscles have often had to change how the function and the role they perform. The postpartum period 12 weeks and beyond should be thought of as a ‘retraining and rehabilitation’ period, essentially doing different exercises to strengthen muscles and remind them how they worked pre-pregnancy. Also, the potential worst-case scenarios (ie. incontinence and pelvic organ prolapse) can be significant and cause long term ongoing issues. As always, prevention is always better than a cure and it is therefore always better to have a gradual return to exercise following pregnancy and childbirth.
IN SUMMARY…
At The Injury Clinic, we recommend all postpartum women see a Women’s Health Physiotherapist for the assessment of their pelvic floor and abdominal function. Once you have received clearance from your midwife or obstetrician to return to exercise, an appointment with one of the Physiotherapists at The Injury Clinic would be beneficial to assess your general musculoskeletal function and to discuss your exercise goals.
If you’re interested in booking an appointment with one of our team members, contact our clinic today and we’ll be happy to find time for a consultation.
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