Early Postpartum Tips for Pelvic Floor
Women’s health expert Physiotherapist Jenny Devlin gives insight on what you might expect from your postpartum body and the best approach to begin exercise and optimise your recovery
WRITTEN BY JENNY DEVLIN, MSK PHYSIOTHERAPIST AND SPECIALIST WOMEN’S HEALTH PHYSIOTHERAPIST AT PHYSIO EFFECT
So, you’ve just had a baby… CONGRATULATIONS!!
The first days and weeks postpartum can be a blur and prioritizing pelvic floor exercises might not be at the forefront of everyone’s mind. There are some things you can do, however, throughout the day to start working on your pelvic floor while also enjoying sweet baby cuddles.
BREATHE
Something that we do every day but often don’t do well. Once we have had a baby our breathing is often altered as our baby has been taking up the space in our abdominal cavity and achieving a deep breath might have been tricky for the past few months. Remembering how to take deep breaths can help with the healing process. Our diaphragm and pelvic floor move together and as a result breathing deeply in can help relax and lengthen the pelvic floor muscles and conversely exhaling can help engage the same muscles.
Women’s health Physiotherapist, Mariam Kilpatrick, educating a patient on diaphragmatic breathing.
Getting the muscle pump of the pelvic floor working can aid pelvic congestion and help heal the tissues through lymphatic drainage.
Deep breathing can also help us enter into ‘rest and digest’ mode which can help us feel calm and decrease anxiety and enjoy being present with our baby.
You can practice breathing anywhere but it might be easiest sitting or in a semi-reclined position. Make sure you’re comfortable. Inhale slowly through the nose, feeling the air fill the lungs and the pelvic floor lengthen. Exhale gently through the mouth and feel the recoil of the tissues. Keep your shoulders and jaw relaxed. You can learn more about the structures that make up your abdominal cannister, including your pelvic floor in our recent Blog Post.
Posture
Throughout the day, check in with your posture while sitting, standing and moving around. Has your posture changed since having your baby? Can you find your way back to your previous position?
How we hold ourselves while feeding baby for many hours per day is important. Make sure baby is supported to come up to you, so that you don’t have to hunch over to feed. Try to maintain an upright posture for feeding as much as you can - it has an impact, not only on your back, neck and shoulders, but on your pelvic floor too! This NHS guide has ideas alternative breastfeeding positions from the commonly adopted ‘Cradle Hold.’
Image Credit: Shutterstock. Breastfeeding in a reclined position can ease the tension of a painful back and shoulders.
Have a think when you’re holding baby, are you always holding them on one side? Can you switch? Can you wear them for a while in a carrier instead of carrying them? Try placing your hands on your ribs and stacking them over your pelvis.
There are lots of little ways we can improve postures throughout the day to make our pelvic floor a little happier and function better too!
Pelvic Floor Exercises
Throughout the day try to practice a few pelvic floor muscle contractions. You may find it easier to do it lying down or in sitting. Check in with yourself and see what you can feel. You should be able to feel a gentle lift of the pelvic floor without your pelvis tilting and without your legs or bum muscles working hard. You should also be able to feel it relaxing. Try for some longer contractions and some short, fast ones too.
Women’s health Physiotherapist Mariam Kilpatrick demonstrating the ‘Butterfly’ Technique to connect with your pelvic floor.
Gentle Exercise
In the first days postpartum, take it easy. No matter how your baby was born, the body goes through a lot to bring your little one into the world. You might feel like you can do more exercise wise, but do you really need to? Give your body time to rest and recover and gradually build in your exercises. The first days or weeks might start out just thinking about pelvic floor, core and posture and progress from there. We are all about getting you back to doing the things you LOVE so let’s make sure you’re doing them sequentially in a way that’s right for your body and will allow you to continue doing them long term!
We offer ‘CryBaby Pilates’ classes in our Studio to women and their babies from 6 weeks postpartum.
See a Pelvic Floor Physiotherapist
Pelvic floor symptoms are common, but they are not normal! We hear a lot of people normalizing pain or incontinence. Often ladies don’t know there is help out there but there is level 1, grade A evidence to show that pelvic floor assessment and treatment can improve pelvic floor function. Enjoy baby cuddles and gentle progressive exercises and anywhere from the 6 week mark, come and see us and have a pelvic floor evaluation so we can do an assessment, assist with any symptoms and help you work towards your goals, no matter what they are.
The Core
Think your core muscles are just a ‘six pack?’ You’re wrong! Learn more about your core and it’s importance in movement.
Written by Jenny Devlin, MSK Physiotherapist and Specialist Women’s Health Physiotherapist at Physio Effect
The Core
What do you think of when you hear the word ‘core’?
For most people, they think of the rectus abdominis muscles, or the “six pack muscles”, but the core is so much more than that!
The core is actually a full canister that comprises a top, bottom, front and back. Respectively, these are:
The diaphragm
The pelvic floor
The transversus abdominis (deep stomach muscles)
The multifidus (deep back muscles)
Abdominal canister illustration courtesy of ‘The Wellness Blog for Women.’
These muscles work all the time to hold us upright and provide a base from which other muscles can operate. People will often tell us they ‘have no core’ which simply can’t be true or they would be a floppy noodle! What they mean is that they have forgotten how to tune in to activate their core and the good news is that this can be trained.
Our core canister houses our fluid and organs and is responsible for controlling pressure within the system, namely intra-abdominal pressure (IAP). IAP helps our ribs and spine stay in place and is the central mechanism from which we produce strength and stability. Since the muscles surround the canister, they are in prime position to help to control the pressure. IAP changes to match the task we are looking to perform and without a strong inner unit, it is challenging to keep our bodies moving and functioning effectively.
At Physio Effect we can offer you a path back to exercise safely after pregnancy.
Why do i have weakness in my core?
There are many things which can contribute to the core functioning less optimally - it could be the way you train or perform your sport, from being overweight or just a lack of body awareness of how to engage the correct muscles. In particular, pregnancy can lead to dysfunction as the muscles have been stretched out over nine months to accommodate the baby and then afterwards we often just hope they will go back to doing what they did before. Strength and coordination often need to be retrained and, while traditional abdominal exercises are great, it is important to ensure we have the deep core muscles working efficiently before we layer on the larger muscle groups. When we don’t have good core control, it can lead to injuries anywhere in the body such as the low back or the shoulder.
It is normal to have a diastasis rectus abdominus (abdominal separation) following pregnancy but when the pressure is not well controlled, we see doming at the linea alba (midline connective tissue). If we can work to control the IAP with the core muscles, we can minimise this doming and increase overall strength and performance since we are not losing pressure at our core canister.
Illustration of Abdominal Separation courtesy of Cleveland Clinic.
What can I do to strengthen my core?
It is important to spend time connecting to the core and learning how to coordinate the breath, pelvic floor and deep abdominal and low back muscles before adding more challenging exercises to your program. Our physiotherapists can provide you with some targeted core exercises that are specific to your needs. You could also consider our Clinical Pilates, Pregnancy Pilates or Postpartum Pilates Classes to strengthen your core.
To find out more, give us a call or book in online.
Pelvic Organ Prolapse
Pelvic Organ Prolapse - Signs, Symptoms and Treatment
PELVIC ORGAN PROLAPSE
WRITTEN BY JENNY DEVLIN, MSK PHYSIOTHERAPIST AND SPECIALIST WOMEN’S HEALTH PHYSIOTHERAPIST AT PHYSIO EFFECT. MCSP & HCPC
For a lot of people a diagnosis of, or even the thought of, pelvic organ prolapse is terrifying. It is extremely common though with the Royal College of Obstetricians & Gynaecologists suggesting that as many as 1 in 10 women over the age of 50 are affected. This number may well be higher with an increasing risk of complications after pregnancy and childbirth.
The good news is that many people are able to reduce or resolve their prolapse with the help of a pelvic floor physiotherapist. In this blog we explain more about Pelvic organ prolapse and look at how our experienced and specially trained Pelvic health Physiotherapists can help you.
What is pelvic organ prolapse (POP)?
A pelvic organ prolapse occurs when a pelvic organ (or organs) bulge into the vaginal space. Strained, tight or weak muscles, ligaments or fascia can contribute to this. It can occur in different ways and we name the POP based on the organ that is not in its optimal position. A bladder prolapse (or cystocele) is where the bladder pushes against the front wall of the vagina. A uterine prolapse is where the uterus drops down into the middle of the vaginal space and a rectocele is when the rectum moves into the space at the back of the vaginal canal. You can also have a vaginal vault prolapse which occurs after a hysterectomy.
Pelvic Organ Prolapse
Symptoms of a pelvic organ prolapse
Prolapse affects everyone in a very unique way both physically and mentally. Some people live with prolapse and do not experience any symptoms. Other people can experience any number of symptoms which can be mild or affect your quality of life. Symptoms include:
pressure or heaviness in your pelvis area, which is often worse at the end of the day or with exercise
low back pain
urinary symptoms such as a slower stream, increased frequency or urgency to void, feeling of incomplete emptying of the bladder, urinary incontinence
bowel problems such as constipation, straining, feeling like the bowel doesn’t empty completely, increased frequency of bowel movements, faecal smearing (stool on the tissue after wiping clean), incontinence of faeces
Discomfort during sexual intercourse
Treatment options for pelvic organ prolapse
Pelvic Health Physiotherapy Assessment
Great news! Pelvic floor physiotherapy may be able to help with your symptoms of POP. Our team can help suggest changes you can make to your day to day routine to manage pressure on the organs, help with toilet positions to aid more effective urination/defecation.
Our specially trained Physiotherapists can assess muscle tension in the pelvic floor and abdominal muscles and help you to release this. We can also assess the strength and endurance of the muscles and teach you how to improve this if need be.
Physio instructed strengthening
We can guide you on correct strength and endurance exercises to help support the pelvic organs and the pelvis itself. This can help you in everyday functions when straining or lifting and on safely returning to sport. We can also make individual suggestions for more comfortable positions for intercourse.
Pessary For Pelvic Organ Prolapse
At Physio Effect our specialist team can assess and fit a pessary. A pessary is a device you wear inside the vagina, intermittently or continuously, to help hold things in position while you do the things you love. Once it is in place, you don’t feel anything but it can provide instant relief from that heaviness or pressure and can help with symptoms of incontinence too.
Cube Pessaries
Best of all once fitted these pessaries are designed for self management so you are in complete control and can remove and fit the pessary as required. After assessment and discussing your individual symptoms and needs our physiotherapists can help you decide if surgery might be the best route for you if conservative therapy has not worked.
We are here to help so please ask us anything. Hopefully this information makes things seem a bit less overwhelming and gives you hope that your symptoms can be improved. Give us a call or book in online for a full assessment and personalised treatment plan.
What is Pelvic Floor Physiotherapy?
What is pelvic floor physiotherapy and how can our team help you get back to doing the things you love symptom free?
Written by Jenny Devlin, MSK Physiotherapist and Specialist Women’s Health Physiotherapist at Physio Effect. MCSP & HCPC
What is pelvic floor physiotherapy?
Pelvic floor physiotherapists are musculoskeletal physios who have undergone specialised training in assessing and treating conditions that affect the pelvic area. This can be from pregnancy, childbirth or surgery but it does not have to be!
Some pelvic floor issues that can be treated with pelvic floor physiotherapy include:
Urinary and faecal incontinence
Urinary urgency, retention, frequency
Diastasis rectus abdominus
Pain with bowel movements or urination
Pain in the vulvar area (vestibulodynia, vulvodynia)
Painful intercourse (dyspareunia)
Constipation
Interstitial cystitis
Pudendal neuralgia
Endometriosis
Low back pain
Hip pain
Prenatal care - including pain management, exercise advice, positions for birthing, breathing techniques
Postpartum care - including return to sport
Jenny Devlin, specialist pelvic health Physiotherapist explaining pelvic health assessment
What does a pelvic floor assessment involve?
At your first appointment you will be asked several questions about your current symptoms, past symptoms and other relevant medical and social information.
We will then conduct a physical assessment which will be different for everyone depending on what’s going on with you. It will likely involve postural assessment, checking your pelvic alignment, tummy muscles and how your body moves when you do certain tasks like squat or stand on one leg.
If your pelvic floor seems to be involved then we will recommend an internal assessment. The benefits of a digital vaginal or rectal examination are that the physiotherapist is able to assess tension, strength, prolapse and improve activation of the muscles. The risks are that there may be local discomfort or emotional stress, skin reaction, nausea or bleeding, though we take all measures to minimise these risks.The alternative is doing an external examination and observing the abdomen and giving verbal cues for exercises, however, we will not know exactly what the muscles are doing and often progress is slower with this option. All of this will be discussed with your physiotherapist prior to therapy and throughout treatment. Consent to assessment and treatment can be withdrawn at any time. You are in charge!
Women’s Health Physiotherapist Jenny Devlin conducting a pelvic floor assessment with a female patient.
Does pelvic floor physiotherapy work??
Studies have shown that pelvic floor physiotherapy has Level 1, grade A evidence for treating urinary incontinence and pelvic organ prolapse. Clinical guidelines (2008) on the conservative management of urinary incontinence by the Society of Obstetricians and Gynaecologists of Canada recommend “proper performance of Kegel exercises should be confirmed by digital vaginal examination or biofeedback”. This is crucial because a high percentage of women can not contract their pelvic floor correctly. Further to that, performing more kegel exercises may not be what you need and an assessment with a trained pelvic floor physiotherapist can help guide you as to what treatment is most effective for your body.
Often people are prescribed pelvic floor physiotherapy in their postpartum period or when they are older but physiotherapy should be routine for pregnant people too. Research shows that pelvic floor muscle training between 20-36 weeks of pregnancy had a shorter second stage of labour, less urinary incontinence and less pregnancy related low back pain compared to people who did not perform pelvic floor exercises. This is an essential time to have your pelvic floor evaluated, learn optimal positions and breathing for labour and delivery and to set yourself up for a more successful postpartum recovery.
Make sure you align yourself with a pelvic floor physiotherapist who understands that not all pelvic pain is tissue based. Pain, especially chronic pain, is multifactorial and therefore it is so important that you find a physio who understands the relationship between pain, biological factors, the nervous system, psychological and social factors so that you can have the best outcome!
How do I know if pelvic floor physiotherapy is for me?
Do you have a pelvis? Then the answer is YES, pelvic physio is for you! Joking aside, there are so many reasons that might bring you to a pelvic physiotherapist. If you have pain or discomfort in your pelvis area; heaviness or pressure at the vulva, vagina or rectum; leaking of urine or stool; need to go to the toilet often or experience urgency or have pain with intercourse. If you have uncontrolled doming of your tummy muscles when you move or have noticed a gap between your tummy muscles. If you have issues with constipation, hip pain or low back pain. If you are pregnant and in pain, or are looking for exercise guidance or tips and tricks for labour and delivery. If you are postpartum (6 weeks after childbirth for a vaginal exam, though physiotherapy can start before that). If you want to make a plan for returning to running or working out or to make day to day tasks feel easier on your body.
Still can’t decide? Call us on 01412304766 to discuss or use the link below and book your initial assessment, we will figure out what is best for you.
Antenatal Pilates Classes at Physio Effect
Some exciting news! We have a NEW Antenatal Pilates class running in our studio within our Northside clinic at Borron Street. This physio-led Clinical Pilates class aims to prevent pregnancy related issues such as pelvic girdle pain (PGP), symphysis pubis dysfunction (SPD), posture related pain as well as a full body programme to prepare you for the birth of your child. During the class, you will be guided through an individualised programme relevant to your stage of pregnancy and any other issues discussed during your initial physiotherapy appointment.
WHEN: Wednesday evenings at 7PM from 21st October
**CLASS NOW FULLY BOOKED**
Please contact us below if you would like to be placed on our waiting list or if you wish to attend any of our other Clinical Pilates classes which will be a mixed group, but you will still be able to do an antenatal programme due to the bespoke nature of the class.
WHEN CAN I START?
As long as you have an uncomplicated pregnancy and your midwife/ doctor approves, you can begin from any time in your second trimester if you have no Pilates experience. If you have previous Pilates experience, you may begin earlier.
HOW DO I GET STARTED?
You will be required to have a 1:1 session with one of our physiotherapists before joining a class for the first time. During this appointment, your physiotherapist will be able to plan a bespoke Pilates programme for you based on your goals, requirements and stage of pregnancy. You will be introduced to the various Pilates props and equipment used during a class including the Pilates Reformer machine.
HOW MUCH DOES IT COST?
Antenatal Physiotherapy Appointment: £49
Single class rate: £25
6 classes: £120 (£20 per class)
12 classes: £220 (£18.3 per class)
You have flexibility to use the class blocks within the following time period:
● 10 weeks on a 6-class block
● 4 months on an 12-class block
WHAT HAPPENS IF I HAVE MY BABY BEFORE I USE UP ALL MY CLASSES?
You may use any remaining class credit towards our Crybaby Pilates Classes. This is our specialist Postnatal Pilates class which you may begin once you are at least 6 weeks postpartum after a non-complicated vaginal delivery or 8 weeks if you have had a C-section/assisted delivery with any complications.
CryBaby (Postnatal) Pilates Class
Postnatal Pilates Classes at Physio Effect
This is our Postnatal Pilates class which you can begin from 6 weeks postpartum if you had a straightforward vaginal delivery or 8 weeks after a C-section or assisted vaginal delivery (with any complications)
The class is designed to help heal and strengthen muscles affected after pregnancy and delivery such as your pelvic floor and abdominals.
We are very excited to announce that we are starting our very popular Crybaby Postnatal Pilates classes again in our Pilates studio within our Northside clinic in Borron Street. This is our physiotherapy-led rehabilitation class for new mums.
Due to the current Covid guidelines and to maintain social-distancing protocols, we are having smaller sized classes with a maximum of 6 participants only.
To join this class, you must be a minimum of 6 weeks postpartum if you had a straightforward vaginal delivery/8 weeks after a C-section or assisted vaginal delivery with any other complications (which can be discussed at your initial postnatal physiotherapy appointment).
NEW CLASS STARTING!
Mondays at 12noon
Duration: 1 hour
The next block will begin on MONDAY 30TH NOVEMBER 2020
Please get in touch below if you would like to sign up. Spaces are limited!
HOW DO I GET STARTED?
If you are starting our classes for the first time since having your baby, you will be required to have a 1:1 Postnatal Physiotherapy Appointment with one of our physiotherapists and you must be a minimum of 6 weeks postpartum for this to take place. This is a pre-screening appointment where you will also be able to discuss your pregnancy, labour and set some goals you’d like to achieve after having your baby. The physiotherapist will assess your pelvic floor and abdominal function and go over some basic, fundamental exercises in preparation to starting the classes. This appointment will take up to 45 minutes.
HOW MUCH DOES IT COST?
Physiotherapy Postnatal Appointment: £49 (you must be a minimum of 6 weeks postpartum)
6-week block: £75
CORONAVIRUS (COVID-19) SAFETY PROCEDURES
The class size will be smaller than usual to allow adequate social distancing (maximum of 6 participants).
Please bring your own mat to the class as well as a mat (and toys) for your baby to lay next to you or they may remain in their carseat next to you. Buggies will have to be left in our reception area outside the studio to allow for more space.
Pilates equipment such as circles, balls, bands, weights etc. will be provided for the class with strict cleaning measures in place before and after use.
A face-mask/covering is required to enter and leave the building and Pilates studio. Once you are allocated your floor space in the studio, you may remove your mask for the duration of the class if you wish.
Hand sanitising gel is provided for entering and leaving the building.
Unfortunately, the EDA Gym lounge area is closed for use however the Coorie Cafe is located in the 100 Borron Street Business Park above the gym which has delicious food, good coffee and outdoor seating. They have also very kindly offered to reserve a space for you all to have a chat and lunch after the class!
Having a baby during Coronavirus Lockdown!
Lockdown has made many things more challenging, none more so than giving birth. Here I spoke to one mum who had been attending our Antenatal Clinical Pilates classes up until the country shut down on the brink of a global pandemic.
Written by Mariam Kilpatrick, Physiotherapist and Clinical Pilates lead at Physio Effect
Lockdown has made many things more challenging, none more so than giving birth. Here I spoke to one mum who had been attending our Antenatal Clinical Pilates classes up until the country shut down on the brink of a global pandemic.
Hi Elisa, thanks for taking the time to share your experience with us about being pregnant and having a baby during lockdown. Can you firstly tell us a little bit about yourself and your family?
My name is Elisa and I come from a small village in the Italian Dolomites. I have been living in Scotland for the past 12 years since I came as an Erasmus student studying Environmental Engineering. I met my husband at the University of Glasgow. We now have a very fluffy dog named Leo and two beautiful children: a three year old girl called Joanna Sofia and a our son, Eric Antonio, who arrived this April. He is known amongst our friends and family as our "pandemic" baby!
When lockdown started I was 36 weeks pregnant.
Pregnant Elisa and daughter, Joanna (3)
At what stage of your pregnancy did you start our antenatal Pilates classes in our studio, how did you find it and what did you enjoy about it?
I started the antenatal classes when I was 20 weeks pregnant. I was playing squash twice a week before my pregnancy and I wanted to keep exercising. I felt having a desk job I really needed to keep moving, especially for my back as the months progressed. I had heard great things from friends about the antenatal classes at Physio Effect and when I joined I loved being given exercises by Raz specifically tailor-made for me and my stage of pregnancy. It was also fabulous to meet other mums to be and have a bit of time for myself (which is hard to get with a toddler, a husband and a dog!).
How did you find moving over to the virtual (Zoom) antenatal classes during lockdown?
Virtual Pilates Class
It was a good! Technology wise at work, I use videoconferencing a lot and during lockdown cameras got switched on much more, so it was easy enough. At first it took a bit of time to get organised: finding the right space so that my dog and toddler would not interfere, identify the right room to have physical space to do exercise but after that it was a great opportunity to be active from the comfort of your own home, without the need to travel or drive. I found Raz was able to keep an expert eye on us all the time and could correct me if necessary. I also thought I knew what I was doing having done a few classes at the studio already.
And you had a beautiful baby boy named Eric! What was your experience like having him during lockdown compared to your daughter Joanna?
I have to be honest, it was quite different and worrying at times compared to the first experience. However on reflection it has also been an invaluable family time that I have not had with Joanna. On the run up to the birth I started worrying about going to a hospital and the risk of contracting the virus, not having my husband there at all times and also what to do with our toddler, who would have needed someone to be with her if dad was to be with me in the birthing room. However when the day came, I laboured alone in the hospital and in a way it was better for Joanna not to see me distressed. At the hospital everyone was fantastic, trying to make me feel as supported as they could. I was alone for a few hours but I was really well looked after by nurses and midwives. My husband was with me in the birth room and after the birth I got sent home the day after so my stay in hospital was very quick. We had some truly family time, getting to know each other and in a way not stressing about visitors. It was only us and our new baby, which gave Joanna a chance to not get jealous of her wee brother but instead accept him as a new member, especially since, as she said, he was so tiny and cute!
Can you give us an insight with what life has been like during lockdown, having a newborn/toddler/dog/husband working from home?!
Definitely not the maternity leave I was expecting, meeting other mums in coffee shops and at baby groups. However I do believe it has been the best time we have ever had as a family, with no pressure to do anything a part from being together. Life moved at a much slower pace and the kids, the dog and I had lots of walks in the park, which has been great.
Elisa with daughter Joanna, Baby Eric and Leo the dog
How old was Eric when you had your postnatal physio appointment and how did you find doing it virtually?
Eric was 8 weeks old when I had my "virtual" assessment. I thought it worked very well. I did like the fact I carried out an assessment on myself, getting to understand under supervision how my body was responding to the birth of my second child.
What was your experience like doing the virtual Crybaby (postnatal) Pilates classes? Did you find it enjoyable and would you recommend it?
I really enjoyed again having the time for myself. Life does get busy now and cutting out a bit of time for yourself to feel good I believe is key. I really enjoined them and the progression to harder exercises. I also feel was fantastic having had the possibility to watch the recordings afterwards: I had Eric there with me during the classes and sometimes he needed attention so I could replay the class whenever I wanted, which was brilliant.
From Bump, Birth And Beyond…
Here at Physio Effect, we support mums to stay strong, fit and healthy throughout their pregnancy and into their motherhood journey. For more information on all our ante- and postnatal services, click below:
A Guide On Returning To Running After Pregnancy
Running after having a baby is the obvious choice for many new mums wanting to begin or return to exercise. There are however some important things to consider in order to safely return to running and any other high impact exercise after having your baby. Returning too soon can cause long term implications including pelvic floor dysfunction, pelvic girdle pain and other musculoskeletal issues. This guide outlines the impact pregnancy and birth has on your body and important healing time-frames you must be aware of before returning to running. You will also find 2 free Pilates strength videos to give you an idea of the kinds of exercise that will help prepare your postnatal body for the demands of running
Written by Mariam Kilpatrick - Physio, Clinical Pilates Instructor, Mum and Ultra-marathon runner
One of the most common questions I hear from new mums after giving birth is, “When can I start running?” A fair question, as it’s one of the simplest forms of exercise to fit in around your baby, no gym membership required and a good way to burn off that extra baby weight. We’ve all been there.
There are however some important things to consider in order to safely return to running and any other high impact exercise after having your baby. Returning too soon can cause long term implications causing pelvic floor dysfunction, pelvic girdle pain and other musculoskeletal issues. This usually happens because you haven’t adequately rehabilitated your body following the huge stresses placed upon it during pregnancy and childbirth. Giving birth (either vaginal or C-section) can be considered equal to a major sports injury which would require the same attention, specific rehab and a graded return to any sport. It is just as important to work on muscles affected by pregnancy and childbirth (such as the pelvic floor and abdominals) as it is to work on the muscles around your knee if you’ve had a knee injury/surgery.
My baby is 6 weeks old now so I’m good to go…right?!
Healing of the body after childbirth goes well beyond the traditional 6-week timescale that many health professionals go by.
Did you know…
The levator hiatus, the opening between the levator ani muscles (which forms part of your Pelvic Floor) stretches and widens significantly during pregnancy and childbirth. This can take between 4-6 months to recover (Stær-Jensen et al 2015)
After a C-section, the abdominals only regains 50% of its original strength by 6 weeks postpartum and 73%-93% of original strength by 6-7 months postpartum (Ceydeli et al 2005)
Up to 30% of first time mums will experience urinary incontinence (Milsom et al 2004)
Up to 56% of new mothers between 3-6 months postpartum demonstrate pelvic organ prolapse where one or more of the pelvic organs (bowel, bladder or uterus) descends downwards to the vaginal opening (Bø et al 2017). This can result in incontinence issues and the feeling of heaviness/dragging in the vagina.
You can’t go wrong with strong!
Your Pelvic Floor is a hugely important part of your body. It is made up of layers of muscle and connective tissue. These layers stretch like a hammock from the tailbone at the back, to the pubic bone in the front. They support your pelvic organs and control your bladder and bowel movements. The front passage (pee hole), the vagina and the back passage (poo hole) all pass through the pelvic floor muscles. Throughout your pregnancy, your pelvic floor has carried the weight of your baby, the placenta and a 50% increase in blood volume! As such, this will greatly affect its ability to do its job properly compared to pre-pregnancy function. It is therefore vital to work on these muscles after having a baby, regardless of the type of birth you had (whether vaginal or C-section).
In the latter stages of pregnancy, the connective tissue or fascia between your outermost abdominal wall (your six-pack muscles) can thin out/stretch to allow for a growing baby bump. After giving birth, you can be left with a gap between the two sides and sometimes it can look like you are still pregnant i.e. the dreaded “mum-tum”. This is called a Diastasis Recti or abdominal separation, a common condition that causes a lot of grief for many mums. However, like any muscle in the body, these can be addressed and worked on with specific corrective exercises targeting your deep abdominals.
When you are running, multiple times your body-weight in the form of ground reaction force is produced on impact with the ground. This has to be absorbed and controlled by the tendons, muscles and joints in the legs. Strengthening the muscles of the lower legs and core help prevent injury and increase the muscles’ load bearing capabilities.
Guidelines for postnatal exercise progression
Week 0-2: Walking, pelvic floor muscle strength and endurance exercises, basic abdominal exercises
Week 2-4: Introduce functional body weight exercises such as squats and lunges
Week 4-6: Introduce low impact cardio such as static bike, rowing machine or X-trainer
Week 6+: Progress to resistance training such as Pilates for pelvic floor/core and weights training
Week 12+: Graded/progressive return to running (e.g. Couch to 5K)
Some expert physiotherapists have developed a free guidance to help health and fitness professionals who work with postnatal runners which can be found here.
Postnatal Pilates
Pilates is a great form of rehabilitation to target the working relationships of your pelvic floor and core muscles (abdominals and diaphragm) especially in the first few months after having your baby. The benefits of Pilates include:
Strengthening your Pelvic Floor
Targeting your deep abdominal muscles to help heal Diastasis Recti (abdominal separation)
Addressing muscle imbalances that may be contributing to lower back pain or pelvic girdle pain
Targeting postural muscles of the back, neck and shoulder girdle
Postnatal Pilates Class at Physio Effect
Pilates for Runners
Try these free sample routines for strengthening your legs and gluts:
Pilates legs workout
Pilates Gluts Workout
We Want To Help You Get Your Body Back On Track
Physio Effect specialises in helping mums recover their health, fitness and confidence after having a baby. Our Cry-Baby Pilates classes where new mums attend with their babies has been a great success and very popular!
Want to read some REVIEWS about our classes from other mums? Click the links & read below: Yell.Com Reviews or Facebook Reviews
The cry baby Pilates classes led by Mariam were an absolute highlight of my maternity leave. They offered important rehab for all the changes to my body left by pregnancy and a c-section and the strengthening work got me back safely running sooner than I expected - yay! The classes were warm, friendly and supportive and my baby Helena loved meeting the other babies too (as well as getting cheeky cuddles from Mariam). Couldn’t recommend more highly to new mums!
Katherine C via Facebook reviews
I’ve recently completed 2 blocks of Crybaby Pilates with Mariam & would highly recommend it for postnatal recovery. Mariam was great at making you feel relaxed, gradually building up the intensity of the exercises over the weeks so it wasn’t too daunting in the beginning. I liked how the exercises also allowed you to interact with your baby. The classes are small enough that you get the opportunity to get to know the other mums & babies, which helps you feel completely at ease in the class too. I now feel back to my pre-baby self & body, ready to start running & hitting the gym! Thank you!
Keri. L.K via Facebook reviews
Seek Help & Advice Sooner Rather Than Later
As with everything in life, there isn’t a one size fits all when it comes to returning to running after pregnancy. Factors that need to be considered include:
Type of birth you had; was it a straightforward vaginal birth, a vaginal birth with complications such as forceps delivery/episiotomy/tears, a C-section? The timescales may be different for each case!
Previous level of exercise (e.g. were you a runner before pregnancy?)
Experiencing symptoms of lower back pain, pelvic or pubic pain, leakage and/or feeling of vaginal heaviness (which could be a sign of pelvic organ prolapse), coccyx/tailbone pain (which could be a sign of a hypertonic or tight pelvic floor)
Are you currently breast-feeding? Pregnancy hormones stay in the body for about three months postpartum, continuing to loosen joints, muscles, tendons and ligaments as they did in preparation for delivery. For those breast-feeding, hormones can still have a loosening effect even months after you stop.
Lifestyle changes such as sleep deprivation, lack of routine, demands of breastfeeding and altered eating habits which can cause energy deficiency and fatigue.
If you are unsure, it is advisable to seek help from a specialist trained physiotherapist or a pelvic health practitioner.
If you would like to chat to one of our physiotherapists you can use the link below to book an appointment. Or if you prefer send us a message with any questions you have and we will get back to you as soon as we can.
Thank You
Thanks for taking the time to read this guide, we hope you find it useful. Please share with anyone else who might benefit and if you have any questions comment and let us know. Please subscribe for regular updates and advice on everything health and fitness related - Zero spam promise.
Postnatal Pilates at Physio Effect
Restore your core after pregnancy: A safe return to exercise
Returning to exercise after having a baby can be daunting & difficult. It is possible to cause yourself more harm than good if you return too soon or to the wrong type of exercise. This blog looks at the evidence and guidelines for returning safely to post-natal exercise and the specific benefits of Post-natal Pilates in restoring your Pelvic Floor muscle function, reducing Diastasis Recti and rebuilding your core strength and function. A FREE 30 minute Post-natal Pilates class is linked for you to try.
Written by Mariam Kilpatrick - Physio, Clinical Pilates Instructor, Ultra-marathon runner & Awesome mum
After 9 long months, finally, your cute little bundle of joy has arrived! Goodbye to feeling like a bloated whale and goodbye heartburn. Say hello to sleeping on your tummy and to eating stinky cheese & sushi again. You’re keen to get back to exercise, get that endorphin rush and reclaim your pre-pregnancy body! You’ve had your 6 week check-up and your doctor has given you the all clear to exercise. Yay! BUT…yes there is a but. You can sometimes do more harm than good if you push your body beyond what it is ready for. Here we review the guidelines for returning safely to postnatal exercise and look at the specific benefits of Postnatal Pilates which include improved Pelvic Floor function and reduced Diastasis Recti (abdominal separation). Read on for more….
As the saying goes, you shouldn’t build a house on a weak foundation.
For many women, it has become a common thing to accept “a little bit of wee escaping” with a sneeze or running for the bus, just because you’ve had a baby. But no matter what age your baby is, either 6 weeks or 6 years, this should not be the perceived norm. Some women may feel embarrassed to raise their concerns around continence and other intimate issues but this should never be the case. Please seek professional advice early, as with the right help and guidance, these issues can and should be addressed.
The Pelvic Floor Muscles
Your Pelvic Floor is a hugely important part of your body. It is made up of layers of muscle and connective tissue. These layers stretch like a hammock from the tailbone at the back, to the pubic bone in the front. They support your pelvic organs and control your bladder and bowel movements. The front passage (pee hole), the vagina and the back passage (poo hole) all pass through the pelvic floor muscles. Throughout your pregnancy, your pelvic floor has carried the weight of your baby, the placenta and a 50% increase in blood volume! As such, this will greatly affect its ability to do its job properly compared to pre-pregnancy function. It is therefore vital to work on these muscles after having a baby, regardless of the type of birth you had (whether vaginal or C-section).
Let’s practice how to correctly engage your pelvic floor…
Take a deep breath in, fill your lungs completely and allow your pelvic floor to relax.
As you breathe OUT, close your back passage as if you were holding in a fart, then pull upwards and inwards towards your front passage to close it, as if you were holding in a pee.
Visualise trying to "squish" your anus (poo hole) to your urethra (pee hole) towards your pubic bone.
Do this without clenching your butt cheeks, your jaw or tensing your neck and shoulders (tricky, huh?)
Let everything relax again as you breathe in.
Repeat x 10Now try and engage your pelvic floor as above in 10 x quick flicks on and off.
*Practice turning your pelvic floor on in both sitting and standing positions
**Practice turning your pelvic floor on when doing things at the same time like picking your baby up from his/her cot or picking a toy up from the floor.
Why do I still look pregnant months after giving birth?
In the latter stages of pregnancy, the connective tissue or fascia between your outermost abdominal wall (your six-pack muscles) can thin out/stretch to allow for a growing baby bump. After giving birth, you can be left with a gap between the two sides and sometimes it can look like you are still pregnant i.e. the dreaded “mum-tum”. This is called a Diastasis Recti or abdominal separation, a common condition that causes a lot of grief for many mums. However, like any muscle in the body, these can be addressed and worked on with specific corrective exercises - all hope is not lost! The key is to target the deep layer of abdominal muscles. This may mean avoiding certain traditional core stability exercises initially (e.g. sit ups and planks). Your deep abdominal muscles have functional connections to - guess what - the pelvic floor…so it’s a win-win situation all round!
Postnatal Pilates
Pilates is a great form of exercise to target the working relationships of your pelvic floor and core muscles (abdominals and diaphragm) especially in the first few months after having your baby. The benefits of Pilates include:
Strengthening your Pelvic Floor
Targeting your deep abdominal muscles to help heal Diastasis Recti
Addressing muscle imbalances that may be contributing to lower back pain or pelvic girdle pain
Targeting postural muscles of the back, neck and shoulder girdle
Postnatal Pilates Class at Physio Effect
Here is a short taster video of a postnatal Pilates workout:
We Want To Help You Get Your Body Back On Track
Physio Effect specialises in helping mums recover their health, fitness and confidence after having a baby. Our Cry-Baby Pilates classes where new mums attend with their babies has been a great success and very popular. We are working hard to bring this content to full digital online form so that all mums everywhere can enjoy and benefit from this safe, structured and fun specialist postnatal program. For advanced notice of when this course is available and for special early-bird promotional rates please register for your free sample class below and we will keep you informed.
Want to read some REVIEWS about our classes from other mums? Click the links & read below: Yell.Com Reviews or Facebook Reviews
The cry baby Pilates classes led by Mariam were an absolute highlight of my maternity leave. They offered important rehab for all the changes to my body left by pregnancy and a c-section and the strengthening work got me back safely running sooner than I expected - yay! The classes were warm, friendly and supportive and my baby Helena loved meeting the other babies too (as well as getting cheeky cuddles from Mariam). Couldn’t recommend more highly to new mums!
Katherine C via Facebook reviews
I’ve recently completed 2 blocks of Crybaby Pilates with Mariam & would highly recommend it for postnatal recovery. Mariam was great at making you feel relaxed, gradually building up the intensity of the exercises over the weeks so it wasn’t too daunting in the beginning. I liked how the exercises also allowed you to interact with your baby. The classes are small enough that you get the opportunity to get to know the other mums & babies, which helps you feel completely at ease in the class too. I now feel back to my pre-baby self & body, ready to start running & hitting the gym! Thank you!
Keri. L.K via Facebook reviews
Would you like a FREE 30 minute Specialist Postnatal Pilates class to try?
Please Click the following link to register & we will send you a video link to enjoy
Returning to Exercise - What do the guidelines say?
In the first six weeks after giving birth and when you feel you are able, you may commence your pelvic floor and abdominal exercises, functional bodyweight movements, as well as low impact cardiovascular exercise such as walking.
From six weeks onwards (or a little longer if you’ve had a C-section), you may commence light resistance exercise such as Pilates and light weights training.
The earliest you should start high impact exercise such as Running/HIIT/Bootcamp is between 3-6 months after having your baby. This of course may differ from person to person depending on the type of birth you had. A recent study for guidance in returning to running post pregnancy by some expert pelvic health physiotherapists can be found here
Seek Help & Advice Sooner Rather Than Later
As with everything in life, there isn’t a one size fits all when it comes to returning to exercise after pregnancy. Factors that need to be considered include:
Type of birth you had; was it a straightforward vaginal birth, a vaginal birth with complications such as forceps delivery/episiotomy/tears, a C-section? The timescales may be different for each case!
Previous level of exercise (e.g. were you a runner/gym-bunny/Crossfitter before pregnancy?)
Experiencing symptoms of lower back pain, pelvic or pubic pain, leakage and/or feeling of vaginal heaviness (which could be a sign of pelvic organ prolapse), coccyx/tailbone pain (which could be a sign of a hypertonic or tight pelvic floor)
Are you currently breast-feeding? Pregnancy hormones stay in the body for about three months postpartum, continuing to loosen joints, muscles, tendons and ligaments as they did in preparation for delivery. For those breast-feeding, hormones can still have a loosening effect even months after you stop.
If you are unsure, it is advisable to seek help from a specialist trained physiotherapist or a pelvic health practitioner.
If you would like to chat to one of our physiotherapists you can use the link below to book an appointment. Or if you prefer send us a message with any questions you have and we will get back to you as soon as we can.
Thank You
Thanks for taking the time to read this guide, we hope you find it useful. Please share with anyone else who might benefit and if you have any questions comment and let us know. Please subscribe for regular updates and advice on everything health and fitness related - Zero spam promise.
Postnatal Pilates at Physio Effect