With the benefits of sport and exercise being so well documented and (hopefully) so well advocated, it is not surprising that so many mums are keen to return to their sporting activities after having their baby.
“When can I start running again?”
“I’m desperate to get back on my bike, is that safe to do now?”
“Can I rejoin my Boxercise class this week?”
These are really common questions from new mums. These activities play a hugely important role in our lives in terms of physical fitness, mental wellbeing, and achieving some form of ‘normality’, when life with a new baby has been turned on its head. These are fantastic goals to work towards but your body has been on a challenging, incredible journey that we must be responsive and considerate to. It’s important to take a graduated, individual approach to your recovery and to your rehab. After all – every mums goal is different, every mums pregnancy is different and every mums labour and birth are different.
So where should you begin when starting back on the road to sport?
1. Consider a pelvic floor muscle check by a specialised Women’s Health Physiotherapist
Our pelvic floor muscles are a layer of muscles that support the pelvic organs (bladder, uterus and bowel) and span the bottom of the pelvis. They act as a type of muscular trampoline from the tailbone (coccyx) at the back to the pubic bone(at the front), and from one sit bone to the other (side to side). The effects of pregnancy and labour mean the pelvic floor is weakened in most women.
High impact activities like running, jumping or skipping demand increased strength, control and coordination of the pelvic floor muscles. The physical force of your foot striking the ground, pass up the limb into the pelvis. The pelvic floor muscles are required to respond to this change in pressure, and support the abdominal contents as they bear down into the pelvis. If the muscles do not have the required strength and coordination to respond to this force, you can become symptomatic (leaking urine, heavy sensations, pelvic organ prolapse, back pain).
It is important that you know how to perform pelvic floor muscle contractions correctly in order to start retraining your pelvic floor., regardless of how you have delivered your baby. This video can help you with the technique for these exercises. A Women’s Health Physiotherapist can assess the function of your pelvic floor muscles, ensure that you are performing the exercises correctly and set a personalised programme for you to ensure you are gaining the maximum from the movements – if in doubt, get it checked out!
2. Core strength assessment
During pregnancy, your abdominal and core muscles are stretched as the baby grows. You may notice a ‘gap’ between these abdominal muscles post birth, which is called a Diastasis Recti. Whilst this is completely normal (almost all women will have one), it is important that the abdominal muscles and the core muscles are able to work well together with the muscles around the hips, back and pelvis in order to transfer the load and control the movement that is required during high impact activity.
It is recommended that an assessment of these muscles is completed by a Womens Health Physiotherapist, prior to returning to high impact exercise, to ensure sufficient strength and control.
3. Gradual load progression
Returning to running ( and therefore high impact activities/sports) is not advisable in the first 3 month post natal period, and beyond this if there are any symptoms of pelvic floor dysfunction ( as mentioned above).
- We recommend that a low impact exercise routine is followed in the post natal period, with a return to impact exercises from 3- 6 months postnatally at the earliest. An example of a gradual load progression would involve starting initially with walking for cardiovascular exercise, then introduction of functional activities (ie squats, lunges).
- The next progression would involve low impact exercises such as static cycling bike, swimming ( if wound healing is complete), power walking, and building on your functional strength programme. Remember, you need to be strong to run – and so consider building up your lower limb, core strength and general cardiovascular strength in alternative ways, until your body is ready to return to high impact activities.
- Once you have gotten the green flag to get back to higher impact activities, consider the ‘couch to 5km’ app for a planned guided return to running and building up your running tolerance.
4. Functional assessment
Quite often it may be close to a year between the pregnancy and postnatal period, before you are feeling able to return to your sport – and so identifying areas that may put you at a risk of injury is key! Functional assessments look at your control and strength in various movements to ensure that your key muscle groups are prepared and strong enough to return to your particular sport/activity.
5. Treat yourself to some new activewear (who needs an excuse for a shopping spree?!)
Comfort is everything when exercising – a badly fitting sports bra or leggings that don’t stay in place can ruin a workout!
You’re body will have changed shape and you may still be breastfeeding. A supportive sports bra that fits correctly is essential for any high impact activity. It can help reduce upper back and neck pain and support your breasts to be comfortable during activity. You may notice that your feet have widened or changed shape as well, so it’s worth considering whether your trainers still fit correctly.
If you would like to discuss your return to sport or exercise or would like to book an Empowered Mother postnatal check, then please don’t hesitate to get in touch!
