Exercising After a Baby - Rather Safe than Sorry!

Exercising After a Baby - Rather Safe than Sorry!
Written by Jolene Smith, BSc Physiotherapy, Certified Orthopedic Manual Therapist

I believe new moms can be divided into two groups.   The one group has little or no motivation to resume, or start an exercise program, being overwhelmed with the time-consuming nature of taking care of their baby.   The other group (such as the new moms reading this magazine!) is extremely motivated to resume any and all exercises to regain their pre-pregnancy weight and shape.

As a physical therapist, I will always promote exercise, but I would like to make the case for a little caution and careful consideration in the choice of exercises after pregnancy and delivery.   Overzealous efforts too soon after delivery can very easily lead to injuries.

The most important issues after delivery are the following:

• Ligaments holding the pelvis together are more lax and stretched, causing a hyper mobile pelvis.  For most women this lasts until 6 months after ceasing breast-feeding.
• Lower abdominal muscles are very weak after delivery and cannot support the lower back and trunk as well as before pregnancy (worse in women who had a C-section).
• The pelvic floor muscles at the base of the pelvis are weak, decreasing the stability of the pelvis and causing incontinence in some women (involuntary leaking of urine or stool) especially with high-impact or lifting activities (worse after vaginal delivery, but women with C-sections still have pelvic floor weakness due to the tremendous pressure on these muscles during pregnancy).

Of utmost importance is to regain strength, endurance and co-ordination of the two muscle groups influenced the most during pregnancy and after delivery – the pelvic floor and lower abdominals.

My recommendation is to go back to basics, as the muscles are weaker than ever before.   For abdominals, avoid double leg lifts, full sit-ups and unstable positions.   If the exercises attempted are too difficult, your body will compensate, using for instance the hip flexors instead of the abdominals, which pull on the pelvis and may lead to injuries.

Pelvic floor muscles should be strengthened to hold an isometric contraction for 10 seconds, while breathing normally, at least 20 times in a row. It is not advisable to start high-impact exercises too soon after delivery, since it weakens pelvic floor muscles further and often leads to sacro-iliac joint problems (– my suggestion is to wait at least 6 months). Cycling, swimming and walking are good low impact alternatives.

If you have leaking past 6 weeks after delivery, it is absolutely worthwhile seeing a physical therapist trained in Women’s Health to help you with strengthening of your pelvic floor muscles. A little effort soon after delivery makes a world of difference later in life!

If you are struggling to resume normal exercises, or the exercises do not “feel right” after delivery, due to pain in the back, buttock or pelvis (or elsewhere), ask your doctor for a Physical Therapy referral.  We can guide you through an effective and safe progression of abdominal, pelvic floor and other exercises. It is healthy for your body, mind and sanity to return to exercise and these problems should ultimately not keep you from exercising.   Pelvis and lower back pain are common after having a baby, but not normal. It can very often be alleviated with the correct treatment, as well as the correct routine of exercises. Seeking professional treatment sooner rather than later saves time and effort in the long-term.

Good luck and stay active – babies need healthy, strong and happy moms!

Written by Jolene Smith, BSc Physiotherapy, Certified Orthopedic Manual Therapist

Women’s Health Certified Specialist, with American Physical Therapy Association.

(Jolene is Co-Owner of Hands-On Physical Therapy, Inc and more information can be found at: www.hawaiihandson.com)