Returning to Exercise Postpartum

Getting back into exercising after giving birth can be an overwhelming and daunting task. There is so much information and misinformation out there it can be difficult to navigate what to do and what not to do.

It is important to recognize that every woman’s journey back into exercise is going to be as different as each individual pregnancy and delivery journey. While guidelines such as the SOGC/CSEP Clinical Practice Guideline can be helpful, they may not take into consideration a women’s individual situation (1). For example, what were the woman’s pre-pregnancy exercise habits? Were there any complications with delivery or any restrictions placed on movement in the early post-partum period?

Many women are told: not to run before 3 months, to avoid doing sit-ups, to avoid pulling and pushing heavy objects and to avoid doing any impact activities.

These guidelines are very generic, don’t provide us with much information and may not be appropriate for some women. What is your version of a “sit-up”? What is considered “heavy”? What do you consider as an “impact activity”? Many women might also interpret these guidelines as “don’t do anything for the first 3 months” and once that 3 month mark passes, they may return to activity too quickly.

Returning to activity and exercise post-partum should involve a functional and client-specific approach. This means that the focus should be on building capacity to do daily tasks that are important to you. For some, that may mean being able to lift a stroller into the back of a car, for others, it may mean being able to climb 20 stairs up to a walk-up apartment. Some women have other children at home and need to be able to continue to participate in their maternal role- which may include lifting their 5 year old child.

An assessment with a pelvic floor physiotherapist is an important step to starting out on your fitness journey. Finding a physiotherapist that understands and is supportive of your fitness goals is equally important. Your pelvic floor physiotherapist will assess your movement strategies to determine whether or not you are using optimal movement strategies to perform each particular exercise.

Your pelvic floor physiotherapist will also teach you how to self-monitor when exercising. In other words, they will teach you to recognize when a movement is too difficult and how to modify movements so that you can still participate in exercise.

One important example of self-monitoring is whether or not you have to hold your breath while performing the exercise. Try this out: lie on your back and without thinking about it too much, lift one leg up so that your shin is parallel with the ceiling. Now lift your other leg up so that both shins are parallel to the ceiling. Did you have to hold your breath to lift one leg up? Did you have to hold your breath to lift both legs up? Breath holding is a great indicator that the exercise is too difficult for you and can be a very useful way for you to self-monitor the intensity of the exercises you are doing.

You should also be mindful of symptoms that may indicate pelvic floor dysfunction when exercising. Examples of symptoms include: urinary or fecal incontinence, a feeling of pressure or bulging in the vagina or bulging outward or inward at the midline of the abdomen.

If you are experiencing any of these symptoms while exercising, it is best to see a pelvic floor physiotherapist so you can resolve these symptoms! If you’re looking to get back into exercise but are unsure of how to take those first steps, book in for an assessment with a pelvic health physiotherapist today!

1) Davies G, Wolf l, Mottoba M, MacKinnon C, Joint SOGC/CSEP Clinical Practice Guideline: Exercise in pregnancy and the postpartum period. Canadian Journal of Applied Physiology 2003, 28(3): 329-341.

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