After having a baby, many women are understandably keen to return to high impact exercise; whether that be running, netball or jumping on the trampoline with their older children. While this is an entirely reasonable expectation, returning to this type of exercise is rarely discussed or planned.
If we, for argument’s sake, do an injury to one of our knees, we would normally seek treatment, follow a management plan and gradually return to running. Once we are confident running, we might trial playing a netball game. If that went well, we might look at gradually continuing to increase our load until we are back to ‘normal’. A lot of people would see a physiotherapist to help guide their return to netball.
Why don’t we look at returning to netball after having a baby in the same way?
While post partum women technically aren’t ‘injured’, majority of women will have some degree of deconditioning that occurs over their pregnancy, particularly as movement becomes more and more restricted in the third trimester. It is also widely understood that the pelvic floor will have some degree of damage or dysfunction after pregnancy, even in women who have a caesarean delivery.
I HAVE STARTED WALKING BUT WANT TO DO MORE, WHAT NOW?
Regardless of how long ago you had your baby, it is important to have a gradual increase in load. This is the same advice we give to anyone who is returning to higher impact exercise after a period of reduced load. The aim is always to:
- Ascertain any strengths and weaknesses or areas that need to be worked on specifically. (This may include a consult with a Women’s Health Physiotherapist)
- Gradually introduce different types of load in a controlled environment.
- Gradually introduce plyometrics.
- Gradually introduce running.
- Gradual return to sport or high impact load.
At The Injury Clinic, we are quite conservative when we guide women in their return to higher impact exercise in the post partum period. This is because:
- Majority of women have been through a period of relative rest during the late stages of pregnancy and early post partum period. This often leads to some degree of deconditioning.
- As your baby grows, you lose your ability to use your core and develop other strategies to stabilise your trunk and enable movement. In the post partum period you need to retrain these muscles back to your ‘normal’ strategy.
- We want to make sure you don’t develop an injury as you return to higher impact exercise. Not only is it disappointing but it is tough to look after a baby or child with an injury.
WHAT ARE SPECIAL CONSIDERATIONS FOR POST PARTUM WOMEN?
- A consult with a Women’s Health Physiotherapist. This is something we strongly recommend to all post partum women, even those who have no symptoms and have been cleared for return to exercise by their primary carer.
- Sleep deprivation. While we all have that friend who’s child sleeps through the night, the reality is that majority of children need some reassurance during the night, often until they are pre-schoolers. This means that sleep deprivation is often a part of life as a family with small children. While this is unavoidable, it is important to remember not to be too hard on yourself. Sleep is when we recover so make sure you listen to your body and have rest days as needed.
- Hormones can play a significant role in how your body will operate in the post partum period. Tissue and joint laxity can remain higher than normal for up to six months post partum, which means it can be more difficult to have good, effective joint control.
- Breastfeeding – Some research has indicated that it can take up to 6-months after you stop breastfeeding for your hormones to return to pre-pregnancy levels.
- The pelvis is particularly susceptible to increases in load post partum. This is for a multitude of reasons including;
- As mentioned above, pregnancy hormones act on ligaments for a significant period after the delivery of your child. As the pelvis relies heavily on ligaments for stability and to function effectively, if this is compromised it is easy and possible for overload to occur.
- The pelvis is essential for the transfer of load from the lower limbs to the trunk. If there is dysfunction in the pattern of loading then the pelvis becomes susceptible to injury.
- Supportive clothing is always important for anyone while they are exercising. In particular, new shoes and sports bras may be necessary if they are old or the wrong size.
At The Injury Clinic, we like to plan a conservative return to high impact exercise with post partum women. This includes an assessment of your trunk and abdominal control and a gradual increase in load until you have returned to your normal, pre-pregnancy load. While there are some special considerations for women in the post partum period, our goal is always to work with you to achieve your goals. If this is something you are interested in, please either book an appointment to chat with one of our physiotherapists or email email@example.com.
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