Here at Body and Birth Physiotherapy, we have the pleasure of being able to work with women with different goals throughout many stages of life. Whether that is before or during pregnancy, early postpartum, or a little bit further down the track after bub. That being said, working with new mums just after delivery to help them achieve their health and fitness goals has to be one of my favourite parts of the job. I love helping mums get back into the activities and exercise they love, and the added bonus of meeting the new little bub they have brought into the world is something that will always brings a smile to my face.
Exercise can be so beneficial for mums in many ways and not just physically! A few are listed below:
It is a key part of restoring tone, strength and mobility to the whole body, including abdominals and pelvic floor
It boosts energy
Great social benefits when done with friends or in group classes
It may be useful in preventing postpartum depression.
It promotes better sleep.
It relieves stress and provides head space.
Great for Mama’s mental health and helps you feel more human!
On the flip side, as part of my role as a Women’s Health Physiotherapist, I not only get to see the wonderful effects of patients returning to exercise, but I can also see the negative impacts on the body that can happen when returning to certain types of exercises too soon. Many women are simply not aware of the impact pregnancy has on the pelvic floor and core, signs and symptoms that may indicate change in the body, how to judge what is normal, and whether they should continue with a certain type of exercise.
Too often we see patients who say “why didn’t anyone tell me this could happen?” after they’ve run into some issues when trying to return to their favourite activities. This is something we want to prevent as much as possible for our ladies and get them back moving safely and with long-term health in mind!
‘So what should I look for?! What are the signs and symptoms?!’ Are very valid questions that you may be asking, which is why I have put together my top 3 mistakes that new mums often make when returning to exercise (and how to avoid them!)
I would love every new Mum’s return-to-exercise experience to be a positive and safe journey, in which they are able to not only reach their goals but thrive during the process.
Whether you love running, yoga, playing football, hockey, Crossfit or Spartan Racing, gym classes, or any sport you can think of, we want you to get back to that safely and feel confident in your body while you do it!
So read on to find out what these 3 mistakes and how you can easily avoid them...
First Mistake - Too much too soon
One of the biggest mistakes new mums make when thinking about returning to exercise is getting straight back into their old pre-baby routine too early. There are many reasons new mums try and get right back into exercise, between feeling pressured to “bounce back” from their baby body, to just needing that freedom and headspace for a short time, or just because they love to be up, moving and active!
At the 6-week postpartum check up, women are often given the all-clear from their doctor or obstetrician to exercise - but this is generally from the perspective of the healing of the uterus and placental scar, not the recovery of the rest of the muscles and joints! Now, there is nothing wrong with introducing movement back into yours and bubs routine (in fact we encourage it!), however, there is a BIG difference between a gentle walk with bub and a 60-minute CrossFit class or 10KM run.
Why It’s a Mistake
No matter which way your baby arrives earth-side, it is such a physically intensive experience and the recovery while looking after a brand new human can be downright exhausting! Aside from the birth, a lot of Mums find they feel weaker and deconditioned from lack of exercise during pregnancy thanks to morning sickness, fatigue, pelvic pain or any of the other lovely pregnancy-related symptoms. This means easing back into exercise is necessary to prevent long-term injury or issues, particularly for the pelvic floor and core muscles.
Your Pelvic floor - After delivery the pelvic floor needs some rest-time. It’s had a gradually growing weight (baby) to support for nine months, it’s been slightly stretched to let that weight out and sometimes it can be injured during the process (for example if there is tearing). After all of that, the pelvic floor is usually tired and most of the time a little bit weak. It needs some time to recover, and when you consider all of the aforementioned stages - it just isn’t ready to support any large downward pressures like the internal forces created during running or 20 burpees. Because of this, if you were to create a lot of downward pressure on a pelvic floor that isn’t quite ready, you are putting yourself at higher risk of injury to the muscle and developing a prolapse, bladder or bowel incontinence, or back or pelvic pain. So easy does it!
Your Tummy - Everybody’s tummy and recovery is different. For some they might not see many changes at all and for other women they may notice that they have an abdominal separation post birth (to read more about Diastasis Recti check out our blog or click here). The size of the separation and how the fascia feels will also determine what exercise is appropriate after delivery. For example, if there is a separation that is causing some coning or bulging, then some abdominal exercises (sit ups, crunches) will not be the most beneficial exercise to complete and can in some cases, make things worse. So best to get your tummy checked before hitting the crunches. Cesarean section scars and tissue healing post surgery is also important to keep in mind and something that should be considered when returning to any abdominal exercise or tasks involving lifting.
Avoid This Mistake - What we recommend
Gentle movement after birth is a great way to assist recovery! This is why in the early weeks, gentle stretching and strengthening with walking and holding that cute little 3-4kg weight (that is now permanently attached to you) can be just the right place to start.
So what happens when you feel ready to do something more? Your mind is good, you feel alright physically and more to the point - your friends have booked you into Zumbalates and you’ve got your favourite maternity/forever comfy tights on! What do you do? How do you know whether you’re ready for the combination of intense jumping and jiving involved in zumbo or the ab workout of pilates?
That is where I can help. The main things I consider when thinking about post delivery exercises are:
What do you want to do?
What is your pelvic floor doing?
What is your tummy doing?
What is your goal? What do you really love and want to be doing again?
If you can’t achieve your goal just yet, there is always an alternative and something you can do to work toward that particular form of exercise. This alternative option is not necessarily forever but it is much better than diving in head first and creating avoidable potential long-term problems.
Here are some options for alternatives:
Walking - walking is such a fabulous, functional whole-body exercise, we have a whole section of it in our free ebook on maintaining pelvic floor and core health. You can do it any time and with baby and it’s a great way to catch up with friends while being active. We recommend starting small, even if it is just 5 or 10 minutes or around the block, then gradually increasing the load or challenge. Do this by building up the distance, increasing the pace, pushing the pram, pushing the pram over grass for more resistance, or even carrying bub in your arms instead!
Spice it up - trying walking up and down some hills while carrying your baby, this can be very challenging and functional
Floor exercises - There are so many great low-impact strength exercises for the glutes, arms, core and legs that you can do while holding your little one or while they get some tummy time. These are great for building the foundational strength needed to get back into more dynamic and intense exercise. Check out the videos on our YouTube channel here for some great options.
Gentle stretching and mobility exercises - you can find some lovely options here: Lower Body and Upper Body.
Mums and Bubs Group Classes - Group group yoga and pilates classes often welcome babies and are specifically designed for new Mums in mind to gradually build that strength and mobility. Just make sure those you book in with are trained specifically in working with postpartum women safely. If you’re local to Brisbane Body and Birth offer Mums and Bubs classes where you’ll receive great guidance from our Women’s Health Physios!
Some other great places to check out postpartum group classes include:
Pear Exercise Physiology in Chermside
Beefit in Ashgrove
Soul Sister Health in Bardon
Mama Know How in South Brisbane
Be In Blossom in Chermside
Bodytrack in Toowong
Exercises we don’t recommend jumping into right away without a proper Women's Health Physiotherapist assessment prior, especially within the first year after baby arrives (not just the first 6 weeks!):
High impact training or sports including jumping, running, skipping, box jumps, burpees, squat jumps - you get the idea
Traditional “core” strengthening - like crunches, sit ups, pilates ‘hundreds’, russian twists, planks, push ups, V-snaps… and so on
Really, really wide squats
Heavy weights and strength training
High intensity interval training
Zumbo-yoga-taekwondo-rollerskatinglates - just too darn confusing for me!
When wondering if you are ready, have a think about these three things yourself, you may not be ready to jump back into zumbalates but you may be ready to do some different body weight exercises instead. Just because you used to do something and your friends are doing it (and you have your comfy tights on) doesn’t always mean that you should jump right in and do it. Take your time, build up your strength and mobility, and work towards it.
Second Mistake - Not listening to your body
Hmm, I’m not sure if this feels right.
This little ache has been there for three weeks now, but it’ll be right.
I am so tired after that walk, and it was only to the post box! And I have planned to walk to pick up the kids from kindy today. Oh well, stop being a wuss and just go, it’s the only way to get fitter!
Ignoring the little signs that your body is giving you to rest and slow down is something that as physios we don’t generally encourage at any point in time, however this becomes particularly important in the postpartum period.
Currently on social media (and elsewhere!) there is a large focus about being intuitive and ‘listening to your body’. Now this is difficult, it takes time and practice and believe me, I can definitely improve in this area as well, however, it is something that I encourage each and every pregnant and postpartum lady to do!
Side Note: Since this is a postpartum piece I will focus on this time frame, however, the same applies during pregnancy and let’s be honest, all components of life. If something is not feeling right and your body is giving you some pretty clear signs that it’s not happy then please listen to them and get yourself checked out.
Anyway.
In this postpartum period your body is under a lot of pressure.
Physically, it’s changing - not having a baby in the belly for starters is a bit to get used to. There are different strength demands on the body (babies are heavy!), repetitive new postures and biomechanics for the lower and upper back (think heavier boobs and breastfeeding) and significant hormonal shifts. Basically, in that first postpartum period (0-6 months) your body doesn’t really know what’s going on. It is changing, accommodating and learning how to move and operate with a little one being outside of the belly rather than in it, and those little niggles are often the body’s way of telling you that.
If walking to the post box one day is enough for you, that is totally fine. You are not weak or lazy. You are a new mum. That’s all there is to it. A bit of patience in this early period goes a long way and can mean that you are far better off in the long run.
Why It’s a Mistake
It is when we push through these signs, that things have the potential to go wrong and the risk is greater for injury to the body and pelvic floor. For example, if when going for a walk you feel a distinct heaviness in the vaginal area, this could be an indicator of a prolapse and is a sign to get checked out and work on an appropriate management strategy. You may find you have some leaking when you sneeze, or your back twinges when you lift your babe or after a workout. If you’re noticing that your tummy is a bit tender with certain movements or you’re noticing some different shapes through the tummy then your body might be trying to let you know of a separation present. If you are simply sore and exhausted after a long day, then this your body’s way of telling you it needs some rest, even if you have a pilates class planned.
Exercise and keeping fit and healthy is an excellent goal and something I think we should all strive towards, however, if you are feeling uncomfortable during or after exercise, it is not something to simply work through. Any of the above symptoms (or extras including bladder and bowel discomfort) can all be indicators of something going on in the body that needs to be assessed and managed, and the earlier the better for your long term pelvic floor and core health.
Avoid this mistake - What we recommend
So embrace your inner Instagrammer - listen to your body and treat it with kindness. If your body is giving you indicators that perhaps it isn’t ready or something isn’t right after bub, the first step is to listen. Listen and give your body a bit more of break, look at the alternatives listed above and start with something a little more gentle.
If you’re experiencing symptoms (see the full list below) we highly recommend a pelvic floor and core check up to assess the functional status and strength of these key areas and how they are working within the whole body. Even better, be proactive and get checked out before returning to exercise so you know if you’re ready.
(Feel free to comment below if you're unsure of something, or you can book in here for a pelvic floor and core check)
This all brings me to my last mistake:
Third Mistake - Not Educating Themselves
This last point is pretty self explanatory really. As I’m sure you have found out by now there is so much information about pregnancy and delivery (and all the rest!) that people simply do not tell you about. As mentioned your body has gone through a heap of change, and many new mums don't take the time to educate themselves on what level of activity and exercises are ideal to start with post delivery, and what the signs and symptoms look like when things may not be right!
Why it’s a Mistake
A lot of this information is absolutely vital for new mums to help prevent long term issues and really thrive as movers and exercisers! This often includes the signs and symptoms to look for when returning to exercise, because despite what Aunty June says - not all things are normal just because you’ve had a baby. Common and normal can often be confused postpartum when talking about the body, and if you’re well informed you’ll be more confident and know when you should seek help if you need to.
Avoid this mistake - What we recommend
Simple one here, get educated before jumping in to exercise! Talk to your qualified health professionals, specifically a women’s health physio prior to getting started so you know what to look out for and where to begin. They can provide insight on what signs and symptoms you may experience, what you may feel, and who you can see if you need help.
You’re in luck as we’ll give you a hand with the signs and symptoms you might experience below! ;)
What to Look Out For
These signs and symptoms may not be present for everyone. You may make the transition back into exercise with ease, grace and nothing but pure comfort (and we hope you do!) However, in the spirit of being alert and not alarmed, these are the things to look for.
Feelings of heaviness, dragging or bulging through the vaginal area either with exercise or throughout the day can be an indicator of prolapse.
Leaking with a cough or sneeze, jump, jog or activity in general is an indicator of incontinence.
Difficulty holding onto wind or a bowel motion while walking or during the day.
Any shapes through the abdomen with crunches, planks, sit ups or simply moving around can be a sign of abdominal separation.
How you feel during the exercise - listen to your body.
How you feel after the exercise - remember that some mild post workout muscle soreness is okay, but if you are getting more than this than take that as sign to ease off and get checked
One last thing to remember - consider your joints and your hormone levels. Remember that relaxin (the hormone that makes you nice and stretchy in preparation for delivery) is still present and the other sex hormones are having a field day. So high impact may not feel right on your joints just yet.
All said - What you can do to avoid these mistakes!
As you can see, there are a lot of things to consider when thinking about returning to exercise and jumping straight back to where you started can sometimes do more harm than good. So now that you know what not to do, what should you do?
Seek guidance from a Women’s Health Physiotherapist at 6 weeks postpartum or when ready to get back into exercise. If you’ve already gone back and something doesn’t feel right definitely get checked!
Start low impact - walking, gentle body weight exercises such as those listed on our YouTube channel here are a good place to start. Swimming can also be a good option, providing you are no longer bleeding and all wounds are healed.
Challenge yourself in different ways - not everything has to be super duper hard and fast to be challenging. Start by adding in some hills to walks, pushing the pram over grass (increased resistance), adding in baby to some strength exercises.
Complement your workout with stretching - all of those muscles that you used to get baby here need some love too. A good stretch session can be just as useful as a walk!
Wearing some tubigrip or supportive garments (such as the SRC shorts) can also be a good way to give your tummy some support while in the recovery phase.
If you are an experienced athlete and would like to get back to training sooner then please speak to your obstetrician and midwife and book in prior to the 6 week mark rather than getting stuck into those sprints and burpees without being checked.
We also highly recommend working with an Exercise Physiologists trained in Women’s Health and postpartum recovery for safe and expert guidance! Esme and team at Pear Exercise Physiology in Chermside, Elisha at Bodytrack in Toowong, or Michelle from Bodysmart in Paddington are great at what they do.
And remember…
Childbirth is an amazing feat completed by the body - give your body some time to heal and get checked properly to avoid any issues in the future.
There are alternate options to high impact exercise and now is the time to use them. ‘Go hard or go home’ doesn’t apply here, ‘How does this feel for my body today’ should be your new mantra.
Listen to the signals your body is giving you and slow down if you need to.
Not everything is normal just because you’ve had a baby or because Aunty June said so. Leaking, pain, instability etc are signs your body is trying to tell you something, a lot of which can be common among mums, you do not need to simply be putting up with these and the majority can be treated! Common does not mean normal.
If it doesn’t feel right, give your brain a break from worrying and get it checked!
We would love each and every new mum to not only recover, but thrive and achieve all of their health and fitness goals. As mentioned there are so many benefits of getting back to exercise and movement and we highly encourage it. We hope the above helped as a guide to some common mistakes we see new mums make and provided some insight on what you can do differently. so you can get back to exercise empowered and confident in your body.
Please comment below and share if you want to help out other new mums looking to get back to exercise and activities they love!
Until next time - Kate
(If you’re local to Brisbane and are wanting to get back into exercise or activities you love, let us help guide you through the process safely so you can not only reach those goals but smash right through them. You can book in with us here)
