The benefits of being physically active after you have a baby are numerous. Regular exercise can lift your mood, elevate your energy energy levels, make you stronger and help with the adaptations the body has gone through in pregnancy and childbirth. However, the wrong type of exercise, or too much too soon can do more damage than good.
The most common complaint I get from women is that they feel discomfort in their pelvic floor, and often some incontinence, mostly as a result of going too intense with their cardio work too early. This shouldn’t be something that women just expect, but needs to be regarded as a signal from your body that this issue needs to be addressed. You wouldn’t continue to exercise with a pulled muscle, so neither should accept that pelvic pain, pressure or leaking is acceptable. However, if high intensity interval training (HIIT) or running give you that buzz of endorphins and get you out there feeling fabulous, then you definitely want think about how you can go about doing this.
Firstly, start remedial work on your pelvic floor. You should aim to exercise little and often, if you can do it every day then brilliant. The pelvic floor is made up of layers of muscle that work to activate in a couple of ways. The slow twitch muscles provide muscular endurance and work to be strong and sustained at all times. They provide support for your internal organs, help prevent incontinence, improve sex life and help in birthing the baby. The fast twitch muscles activate at moments of pressure, for example, higher intensity exercise, sneezing and coughing, jumping up and down. Therefore, pelvic floor exercises need to activate both the slow twitch and fast twitch muscles. Generally, this means that you need to combine slow sustained pelvic floor squeezes with short sharp contractions in your daily workout. A strong pelvic floor will greatly help with starting higher intensity exercise.
Work to build up to your run without going crazy the first time. I would suggest start walking fast as part of your daily exercise and when you are ready speed up to a jog and analyse how that feels on your body. Go for 30 seconds to a minute, and then slow to a walk again. Observe how your pelvic floor, and actually the whole pelvis/lower back area is feeling and if it is comfortable with no pressure then speed up to a jog again. Repeat this process a few times – and with each session take the running portion up by 30 seconds.
If this jogging/walking combination is feeling good after a couple of weeks, then extend to a longer jog. The most important thing is to be aware of your body, notice if there is any leaking/pressure throughout the exercise, or even afterwards/the next day.
Everyone is different, and had a different birth experience so will recover at different speeds so there is no hard and fast rule for when to start running. However, before 6 weeks for a natural birth and 8-12 weeks C-section, anything more than pelvic floor activation and walking is contraindicated. Even if you feel like the body has recovered fully, there has been much internal shifting through the pregnancy to accommodate the growing foetus and it takes time for everything to get back to normal position.
In addition, be aware of relaxin, the brilliantly useful hormone present in your body throughout pregnancy and until you stop breastfeeding. This hormone relaxes the joints and ligaments, allowing the pelvis to widen to facilitate the birth. It’s the most wonderful adaptation in my opinion, but can result in increased flexibility so is something to be aware of when running. The ankles, knees and hips may be a little more mobile so have less stability and be more prone to rolling/twisting.
Once you start being able to run for a length of time, I would suggest a little pelvic floor activation before you hit the streets/treadmill might be beneficial. It will help the muscles engage and prepare for the higher intensity workout, although it is not recommended that you tense these muscles as you are working out. Even if you are managing to run distances again – or have taken your exercise intensity up a notch, always keep checking in with your body and observing any aches, pains or pressure.
If you are experiencing pelvic girdle pain, weak pelvic floor or abdominal separation that is not closing it is worth seeking professional help. There are brilliant women’s health physiotherapists available on the NHS, or privately if you can afford it. Don’t be afraid to push for a referral, it is better to put your mind at ease than just endure pain/discomfort. Untreated pelvic floor weakness/stress incontinence can really cause problems in the future and is not something that women should just have to ‘deal with’. If a trainer or class is making you do things that don’t’ feel great on your body, don’t be afraid to remind them that you are postpartum and need to be a little more mindful on certain moves. A decent instructor, whether they are postnatal trained or not, will be able to give you adaptations.
Whatever exercise routine you get into postnatally, be sure it is something that is enjoyable for you, so you’re motivated to attend, and start seeing results.
All information given here is Rosie’s professional opinion as a qualified and experienced pre/postnatal trainer. She is not a GP or physiotherapist, so cannot offer diagnosis. Always see your GP before starting to workout postpartum and if you have any further concerns.