Congratulations on bringing a new human into the world!! You’re probably feeling a mixture of emotions and are a little unsure where to start when it comes to returning to exercise. I know that’s how I felt. Exhausted, overwhelmed, but also aching to get my body moving again.
A lot of information you read on the internet will offer a ‘general rule of thumb’ and state giving yourself a ‘6 week’ recovery window (possibly longer if you’ve had a cesarean) is key. Beyond that, they often recommend “listening to your body”. But listening to your body is pretty hard to do in our sleep deprived state with so many new and demanding distractions going on around us.
What helped me, was to think of my return to exercise, as rehabilitation. My body was in rehabilitation. It was recovering from an injury. Multiple injuries in fact. I sought advice from my midwife and a women’s health physiotherapist. I received specific information, about my body, and set specific goals and timeframes according to my needs. This ensured my return to exercise was safe, and with minimal risk of injury or long term consequences.
Today, Womens Health Physiotherapist Libby Borman, offers more detail about what you should consider in several stages of your postnatal recovery.
The first few days
The first few days post-delivery, you really need to focus on you, your new bub and getting some serious rest time in where possible.
- Rest and recovery are essential right now. Labour is hard work and your body needs time to heal.
- Avoid prolonged periods of standing during these initial days.
- Gentle walking is fine, if it has been ok’d by hospital staff (this will be dependent on your own personal delivery experience). Light walking will help move the swelling in your legs and get your bodily functions working properly again.
- Ask to see the women’s health physio or attend the postnatal talk they generally hold on the ward. Ask her to teach you how to do pelvic floor and deep abdominal exercises. These are essential on your road to recovery.
- Ask for an abdominal muscle separation (RAD) check. If this is a concern, consider abdominal supports such as tubigrip or postnatal recovery wear and learn some exercises that will help correct it.
- Avoid lifting anything heavier than your baby. Your core stability is not capable of supporting your pelvis, back or your internal organs yet. This means ask your partner for help with any lifting activities, especially if you have a toddler.
The first few weeks
It may take a few weeks to settle in to your new life. You will likely feel physical and emotional fatigue during this time. The hormones can be out of whack, you are missing lots of sleep and your body is using energy to produce milk and complete any healing. Be very gentle and patient with yourself.
- Gentle walking is great, unless your doctor has advised you otherwise. Start with small distances with preferably no hills. Gradually increase the distance and intensity as you feel capable.
- It is very important to continue with the prescribed pelvic floor and deep abdominal exercises throughout these weeks. They may seem basic, but the pelvic floor and deep abdominals provide you with core stability and will help you get back to exercise safely.
- Depending on your previous experience and individual situation, you can possibly perform some gentle Pilates and stretching at home during these weeks.
- Any impact, straining or excessive training at this stage may compromise your pelvic floor, core and recovery, making things more difficult for you down the track.
- Focus on gentle movement and enjoying your newest addition.
- Have your breasts settled in size? Get fitted for a decent maternity bra that will hold their new weight adequately and help stop your upper back and neck from getting sore.
- Hydration and Nutrition – Eating a variety of quality, nutritious food and drinking plenty of water (2-3L) will provide your body with the building blocks for recovery and establishing breast milk supply.
First few months
Be sure to gradually ease back in to things. This will be different for everyone and you really need to listen to YOUR body. A good postnatal trainer can help you progress exercise at a pace that will keep you (and your pelvic floor) safe. Get advice from a women’s health physio if you have any ongoing concerns about your abdomen, pelvic floor or any persistent pain.
Breast-feeding puts greater metabolic demand on your body and needs to be considered in both your nutrition and training. When you increase your exercise, you will need to compliment it with adequate nutrition. Now is not the time to restrict calories, macro foods or cut out food groups. A decent bra is essential and worth every dollar you spend.
- Avoid high impact exercises and heavy resistance training for at least 12 weeks post birth. The point at which you are able return to this this type of training will be individual to you. It is best to work with a qualified postnatal PT who will perform certain tests to make sure it is safe.
- The pelvic floor and deep abdominal exercises should have been gradually increasing in difficulty so you should be feeling adequate core support in upright activities such as walking, squats and lunges.
- Listen to your body and with each increase in activity, ask yourself these questions. Is there any pain, heaviness, weakness or does something just not feel right? Discuss this with your PT and seek help before the small signs become a big problem.
If you had a caesarean section
It takes slightly longer to recover from a C-section and you must keep these extra precautions in mind.
- Allow 12 weeks or more for abdominal healing to occur.
- Lifting should be minimised to the weight of your baby. So, for most women, this is less than 4 kg. Avoid all heavy lifting and straining of the abdominals as this can cause pain and make the scar take longer to heal. Generally, by 6 weeks, the doctor and/or physiotherapist will give you clearance to begin specific abdominal exercises.
- When the abdominal pain from the caesarean has settled, consider starting transverse abdominal exercises which will help your abdominal tone returns ASAP. You may also find an abdominal support such as tubigrip or postnatal recovery wear will improve your comfort.
- It may take up to 14 days post delivery for you to be able to walk within limits of comfort. This is normal, so be patient.
- Progressing exercise with the support of a qualified postnatal PT and physio is essential when returning to exercise after a C-section.
Always remember – your situation will be individual to you, and it’s best to work with a professional to make sure you are doing what is best for your body.
Libby is a Women’s Health Physiotherapist practicing in Yokine, WA. She has a special interest in incontinence, pelvic floor dysfunction, pelvic floor prolapse, sexual dysfunction, and muscular pain & dysfunction.
If you want more information please visit www.perthwomensphysio.online. If you have any questions about your postnatal recovery, send Libby and email on firstname.lastname@example.org. Libby can help you find a women’s health physiotherapist who can help optimise your postnatal recovery.
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