Do you know the safest time frame to go back to exercise after birth?
Historically, women have waited until the 6 week check with their doctor after birth, before they embark on any exercise. If a more medical delivery took place. the trend would be more toward waiting until 12 weeks. Both scenarios bring with it a few issues which all women should consider…
More than a decade ago, the 6 week postnatal check up would involve an extensive abdominal assessment of the mother, along with an internal examination. These days, however, women are questioned more about their mental health and the physical examination is often only performed on the 6 week old bundle of joy. This means that mums leave these appointments without understanding if the they are suffering with abdominal separation (diastasis recti), pelvic weakness, twisted pelvis or even prolapse of the pelvic organs.
These are very common problems among new mothers, to varying degrees, so it would make sense that these checks should be common practice so mums know what they are dealing with.
The Doctor said I can… ?
What alarms me most is that many women are being given the go ahead to go back to “normal” exercise at these check ups, including running and other high impact/intensity exercise. Without the appropriate assessment, many women go headlong back to high impact causing themselves serious long term damage, often without realising.
Most mums are severely sleep deprived, so combining high impact exercise in their recovery program is a recipe for serious pelvic, spinal and/or joint injury. Marathon runner, Paula Radcliffe spoke openly about returning to too much too soon after the birth of her baby, resulting in a serious stress fracture of the pelvis* which impacted hugely on her running career.
Impact exercise should only be revisited after a gentle and progression based return to exercise, preferably under the guidance of a well qualified and experienced women’s fitness specialist.
Being sedentary and waiting to exercise until 6 weeks (12 weeks if post operative) can also cause problems which worsen the postnatal conditions mentioned above. If the muscles are not being used correctly, they will atrophy (waste away) and mum is more likely to suffer with pelvic instability, mild to severe back pain, and pelvic weakness/abdominal separation will worsen.
Couple this with spending much time seated to feed baby, the changes of pelvic tone worsening is increased. Throw in trips to the coffee shop with friends, lots of sugar to get through the day, and we are looking at a severe lack of connective tissue repair for these delicate areas of the body. Sugar causes inflammation and is a nutrient thief.
So what advice do I give to mums I help to rehabilitate?
I begin rehabilitation with mums as soon as they are well enough to drive and their bleeding has eased up enough for them to feel comfortable. First, I take them through an extremely gentle, but effective, rehabilitation program for 6 weeks, which stabilises their pelvis and spine, improves posture and repairs the broken tummy and weak pelvic group of muscles.
Then, if another 6 weeks of early rehabilitation is not required (everyone is different), we begin to carefully increase the intensity of the exercise, using clever training techniques which continue along the theme of keeping the pelvis and spine stable, essential for creating a strong & healthy body, and increase fitness levels appropriate to the mums ability.
I also address the nutrition to ensure mum is getting enough of the right nutrients for her body to heal.
So when can you switch it up?
When it comes to running and higher impact, each women is different, but I usually train them with my specific high intensity, low impact methods until they are at least 9 months postpartum before performing a test run with impact… any time before then is dangerous in my opinion.
In the past 12 years, I have had only two women who have safely been able to cope with impact exercise before 9 months postnatal, without causing injury.
So many women tell me they can’t wait that long, but you really do have to ask yourself what do you really want? Do you want to rush back and suffer injury in the short term, or do your take the safe route and enable yourself to physically achieve great things. Perhaps even exceed your pre-baby fitness levels and take motherhood to the next level? The choice is yours, but I know which I’d go for every time!