mishfit - pregnant & post-pregnant specialist

Returning To Exercise After Giving Birth

by Michelle Wright

note: this article was previously published on Family Capers

When is the best time to return to exercise after giving birth? What sort of exercise should you be doing? Will your body return to how it was?

The guidelines on when to return to exercise can seem a little vague and often rely on how you feel postpartum. Don’t underestimate the marathon your body has endured. Both carrying and delivering a baby takes a huge toll on your body, no matter how fit you are or were. It doesn’t matter if you left the hospital in your skinny jeans, or in your husband’s trackies!

Exercising post pregnancy can begin the day of or after giving birth (both vaginal or C-section), but it is the style of training at this point that is most crucial. Athletes, upon completing a marathon, take time off their regular training to allow their body to rest and recover.

I like to think of exercising post-pregnancy as training from the inside out. Just like running an efficient car, the most important work goes on beneath the hood! The pelvic floor (PF) is probably one of the most under-appreciated functioning muscles in the human body. The PF is hung like a hammock between your legs and during pregnancy, incurs stress from holding Baby (and other important bits) up and out of the way. It is attached to another under-appreciated working muscle, your transverse abdominus. Understanding a little about your anatomy can make a huge difference in appreciating the very important role these two muscles play during pregnancy and especially post-pregnancy in aiding a return to a strong and shapely body.

Quite simply, if these muscles are not strong you may be plagued with sore lower back (exacerbated by constantly leaning down and picking up an ever-growing baby), a belly that remains bulbous and looking still pregnant (yikes!) or a degree of incontinence. The good news does not end there! Reluctance to acknowledge these two important muscles and heading back to your training because you “feel okay” may contribute to a condition called prolapse. This may rear its ugly head through another period of change in your body, menopause, and can be further aggravated if obesity is a factor. A prolapse, in simple terms, is when the bits that are supposed to be held up and out of the way, fall down. Yes, quite literally. Your underpants can catch them, but the whole situation is really not ideal.

Incontinence Australia estimates that 1 in 3 post-pregnant women and 1 in 5 Australians (yes, that means blokes also need to be aware of their pelvic floor) suffer from some level of stress incontinence, the involuntary loss of urine that occurs during physical activity, such as coughing, sneezing, laughing, or exercise. If you are not into facts and figures just check out the products next to the sanitary needs aisle in the supermarket — I swear the options in adult incontinence pads and pants have doubled in the last 3 years alone. But if facts and figures are your thing then please pay a visit to http://www.continence.org.au/site/index.cfm?display=112756

So, will this problem be resolved simply by doing pelvic floor exercises? The simple answer is yes, but it is not the whole answer. Every six months or so I take my car to the mechanic. I leave it there for half a day and when I pick it up, I pay the bill and leave. The reality is that I have no idea what he does under the hood. He may tell me, but bless! I have already zoned out because I have only a very basic knowledge of what all the working parts are and what they do!

Understanding what goes on under your “hood” may be a little the same. Visiting your GP, midwife, your mother… they will have similar sort of explanation of what a pelvic floor contraction should feel like. You’ve heard the drill: lift up and squeeze as if you were stopping the flow of urine. But all of this is happening internally, so how do we know that it is not getting lost in translation? The pelvic floor is not an external muscle, like the bicep, that we can see flex to confirm that we are indeed working it correctly.

With pelvic floor contractions, precision is the key! Put simply, if you involve other bigger muscles (like the obliques) as you are contracting, then you may be bearing down on your pelvic floor and further exacerbating this overworked and under acknowledged little darling!

Fortunately, help is at hand! Most of us are visual learners and seeing the correct contraction at the same time as performing it can greatly enhance our understanding, via the use of Real Time Ultra Sound Technology. This is quite readily available at any women’s specialist physiotherapist and often just one session with a qualified physio can give you exact feedback on not only the condition of these muscles, but also confirm that you are contracting them correctly.

It is simply a case of “you don’t know what you don’t know”. The novice can leave after even one session equipped with knowledge that may very well serve you for the rest of your life. Cheaper than a car service and much more interesting than a crash course in mechanics, this knowledge will help you to exercise correctly, allowing you to push confidently pass the incontinence product aisle of the supermarket with confidence.