Returning to exercise after having a baby

This is a question I get asked a lot and mums are often surprised with the answer I give. Mums tend to want to jump back into their old exercises regimes/sports they did before falling pregnant and they will see their GP at 6 weeks and get the ok to exercise. But what exercise is ok and what is not?

Several factors affect what you do after you have had a baby. Exercise is so important in a healthy recovery but the correct exercise is even more important to prevent you causing harm to your body. Posnatal exercise should primarly ensure that core function returns to normal. There are several factors to consider. Here are the main things:

Core – diastasis recti

During pregnancy the majority of a woman’s abdominal muscles separate to make room for baby. This is normal and in the early postnatal period the muscles begin to repair and go back together.

Doing the correct exercises to aid recovery is important. While there is a gap there is a weakness and certain exercises, such as crunches or strong oblique work, can make this worse or cause the muscles to pull apart. Some exercises put too much pressure on the core and make the problem worse, press ups for example, or working on your hand and knees. If there is a gap then doing an exercise on all fours whilst working against gravity can be very challenging to keep the right muscles activated and literally to stop everything hanging out.

The aim with postnatal exercise is to bring the abdominals together and ensure that they are doing their job. Sometimes a gap remains but what is important is function that they are not doming when you are lying on your back or hanging out when on a fours.

Pregnancy Hormones

Relaxin is an important hormone during pregnancy as it causes the joints to soften and loosen in the pelvis in preparation for delivery. Sadly relaxin doesn't just effect the pelvis, it effects all the joints in the body and it hangs around after delivery for 5 months oe 3 months after you stop breast feeding.

Avoiding high impact exercise is important as you are more prone to injury as the joints are less stable. Relaxin effects different people in different ways and tend to effect mums more the more children they have had.

When participating in exercise technique is key and it is important that you watch this or have an instructor that can keep an eye on you.

Pelvic floor

During pregnancy the pelvic floor gets stretched as it supports the weight of baby. Delivery of baby can also stress and damage the pelvic floor so it is really important to strengthen the pelvic floor before undertaking exercise. Even if you have a c-section delivery the pelvic floor is effected due to the 9 months of supporting baby.

The pelvic floor is so important as it supports all the organs in the abdomen. Strenghtening the pelvic floor is essential so that it can contiue to do it's important job. It is no fun sneezing and leaking.

Exercises should be performed regularly and it is important to seek further advice from your GP or a woman's health physio if you find that you are still leaking 3 months after delivery. It is not normal to leak and many woman accept this a part of having a baby. It is not and with the right exercises it can be improved.

High impact exercises are not recommended in the postnatal period as it can create more pressure on the pelvic floor especially if it is weakened - this includes running, star jumps, bouncing.

I don't recommend running in the first 5 months (or whilest breastfeeding) , personally I think it is far better to ensure you core and pelvic floor is healed before starting. If you don't you risk incontinence and the risk of pelvic organ prolapse.

The pelvic floor is effected when hormones change during the menopause and if it isn't strengthen correctly you may show symptoms during this time with incontience.

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Prolapse

Prolapse is pretty common but not talked about a lot. This is where organs in the pelvic cavity slip down from their original place - in the worse case situation the can be felt protruding out of the body.

If things do feel different speak to you gp or a woman's health physio - for example if you feel a heaviness or dragging sensation. The right exercise can help and manage a low grade prolapse.

You know your body and if it doesn't feel right seek help from your GP or a woman's health physiotherpist

Breathing

It is also important when exercising to ensure that the intraabdominal pressure is managed and does not create additional strain on the pelvic floor - it is important to breath and not hold your breath. The exercises you are doing shold be suitable for your body and not put it under additional strain.

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Once you have healed your core and pelvic floor, it is important to ensure that the correct muscles are working and functioning with your breath when you are exercising. If this doesn't happen you risk getting injured as your core is not working correctly and developing aches and pains in the wrong muscles which are trying to do the job of the core (superficial back muscles and muscles in the front of the hips).

Caring for a newborn baby is tough, it gets easier as the months go on but it's still tough. Spending time on yourself is important and exercise is a great way to do this if you can get away from baby. Remember it took 9 months to grow a baby, physically it will take a year for your body to return to normal.

Be kind to yourself, take it day as it comes, if you don’t have the energy to exercise that is fine.

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