Exercise is fantastic to physically strengthen your muscles; lose weight and raise your energy levels. Mentally, exercise can relieve stress and help prevent postpartum depression. It is understandable as a new mother that you will have limited time to exercise. At any opportunity you get 5 minutes of exercise is better than no exercise! However, as your body has recently undergone major changes, returning to exercise can be difficult, especially when you are more prone to injuries.
Bodily changes from pregnancy
Pain during and after pregnancy is not uncommon. With the added weight of your child within your belly, it’s no wonder that your lower back and hips may feel strained and sore. The weight of the baby shifts your center of gravity forward, which may cause an anterior pelvic tilt and strain the muscles of the lower back and legs. You may also begin to sit and rest more during pregnancy, causing your muscles to lose some strength. Due to the stretching of your abdominal muscles and stomach, and thus the weakening of your core, you may develop lower back pain after pregnancy. This pain can make exercise quite difficult and returning to your pre natal workouts will be prolonged. If you are feeling any pain for more than two weeks, book in to see a soft tissue occupational therapist for treatment. If you would like specific post natal exercises for body strengthening, book in to see an exercise physiologist.
Hormones and how they can make you more injury-prone
Pre and post pregnancy, you are more prone to injuring yourself. During pregnancy, the ‘relaxin’ loosens the ligaments and muscles of the body. This hormone can remain in your body for up to 6 months post-pregnancy. You are more likely to injure yourself with a sprain, strain or overstretched muscle during this time. Due to this, you have to be wary of the intensity of exercise you do. During the first 3 months it is recommended you complete gentle exercises. Check with your GP or health professional about returning too higher intensity exercises.
How soon after giving birth can I return to exercise?
If you had any C-sections, vaginal repair or any other post-birth complications, please consult with your GP about when it is safe for you to return to exercise and consult with your GP or exercise physiologist about what exercises are safe for you. The wait can be very frustrating if you were very active prior to pregnancy and can’t wait to return to your prior activity levels. It will be safe to begin pelvic floor exercises a few days after giving birth, and ab bracing exercises a week after birth (if you have had a C-section, please consult your GP). An exercise physiologist can also assist you with pre and post natal exercise.
If you have no complications, you may begin gentle walking as exercise after 1 week of giving birth. If you want to return to exercises, wait until 6 weeks post pregnancy and restart them gently. Since your body has just undergone such drastic changes it is best to begin slowly and not push yourself too hard. Do not exercise vigorously too soon as you can cause further damage to your body. Do not return straight to your pre-pregnancy workouts as you can cause further damage to your body. Stop any exercises if you feel any pain.
Safe exercises after birth
- Exercise Physiology
- Pelvic floor exercises
- Abdominal bracing (If you have had a C-section, please consult a medical professional beforehand. Otherwise this will be safe 1 week post-pregnancy)
- Walking (gentle and short walks are safe after 1 week post-pregnancy)
Safe exercises – you can begin these 6 weeks post-pregnancy
- Exercise Physiology
- Swimming (after your postnatal check and once you’ve stopped bleeding)
Unsafe exercises – avoid these until 3 months post pregnancy or once you have the go ahead from a qualified health professional.
- Any exercises that stretch the abs: Don’t do sit ups, don’t do cat/cow, don’t do crunches, don’t do Russian twists, don’t do jack knives, don’t do boats, don’t do upward facing dogs.
- If you have diastasis recti, these exercises will cause injury. If you have a weak pelvic floor, abdominal intensive exercises can place too much pressure on your pelvic floor, inhibiting healing and causing a potential organ prolapse.
- Avoid high impact sports such as soccer, basketball, rugby, netball
- Avoid high intensity/impact activity such as crossfit, weight training, running.
- The hormone relaxin is still circulating within your body, making your joints more unstable and prone to injury. High intensity too soon can also cause long term bladder and bowel issues.
Pelvic floor exercises
Your pelvic floor may have weakened during your pregnancy, causing you to be incontinent. Pelvic floor exercises are perfect as pre and post natal exercise, and are sometimes known as kegal exercises. Pelvic floor exercises are safe to do after birth and after a C-section.
The muscles of the pelvic floor can be difficult to locate. If you need to locate these muscles, try to stop urinating half-way through next time you are on the toilet (don’t make a habit of doing this on the toilet mid-stream though!). The muscles you use to stop urination will be your pelvic floor muscles.
- In a seated position, squeeze your pelvic floor muscles.
- Try and hold the squeeze for 8 seconds, and rest for 8 seconds. If you are unable to hold for 8 seconds, hold the squeeze for as long as you can.
- Repeat this 10 times.
You can do this exercise anytime throughout the day, in a waiting room, when you are stopped at a traffic light during a drive, when you are watching tv. You know you are doing these exercises correctly if you are not tensing your abdominals (your belly) or your gluteal muscles (buttocks).
Bracing involves strengthening your deeper abdominal exercises. Your traditional abdominal workouts such as sit ups and crunches only work your outer abdominal wall. These exercises are also unsafe post-pregnancy as the downward pressure may cause an organ prolapse. An organ prolapse is when the internal organs may drop and fall out of place. This could be your uterus, large intestine, or bladder. These will require surgical intervention to place the organs back in place. Bracing exercises are safe to do after birth. If you have had a C-section, please consult with your health professional about completing abdominal bracing exercises.
It is best to strengthen your pelvic floor first before starting with abdominal bracing exercises.
Gently draw in your lower abdominal wall to your spine and slightly upwards. Hold this position for as long as you can, continuing to breathe. You should not feel any pain during this exercise.
Here are some tips to check you are doing this correctly:
- You are targeting the abdominals below your belly button. IF you feel you are pulling up into your ribcage, you are too high.
- If you are holding your breath as you do this exercise, you are pulling too hard.
- You should feel no additional pressure on your pelvic floor. If your pelvic floor lifts slightly, that is okay.
- These exercises can be done in sitting, lying or standing.
- As you slowly get strong, aim for 10 repetitions of this exercise, for 10 seconds at a time. While you are just starting, begin by aiming for 10 repetitions for 5 seconds at a time, 4 times a day.
If you are unsure if you are doing these exercises correctly, consult with an Exercise Physiologist.
Examples of gentle exercises
Once you have the go-ahead, here are some gentle exercises and stretches to help you return to exercise:
This strengthens your glutes (buttocks), hamstring and abdominal muscles. This also gently stretches your hip flexor muscles (iliopsoas). Bridge exercises are a great strengthening exercise to prevent lower back pain.
- Lie on your back, your arms by your sides, palms down.
- Bend your knees, placing your feet closer to your buttocks, pointing forwards.
- Press your heels into the floor and lift your hips into the air. Your body should form a bridge. Ensure you are squeezing your glutes (buttock) muscles to maintain your posture. You may also attempt to do a pelvic floor exercise at this point.
- Hold this pose for a few seconds and gently lower yourself back down.
- Childs pose
This stretches your paraspinals (deep back muscles) and also helps elongate the spine and ease any pressure you have in these areas. This is a great stretch to relieve lower back pain.
- Start by sitting on your knees -sitting with your legs bent underneath you, with the soles of your feet facing up underneath you.
- Spread your knees slightly and bend your torso forwards, so that your forehead touches the floor.
- Stretch your arms out in front of you, palms to the floor, so that they are pointing straight ahead of you.
- Allow your weight to sink into the floor and breath deeply. Hold this pose for a minimum of 30 seconds.
- Glutes seated stretch
This stretches your gluteus maximis, gluteus minimus, gluteus medius, piriformis and deeper gluteal muscles gemelli inferior and superior. Stretching these muscles can help relieve back pain or pain that radiates down the leg.
- Start by sitting on a chair with both feet on the floor.
- Bring one leg up so that your outside ankle is placed just above the knee of the other leg. This position should resemble loose crossed leg a number 4.
- On the leg that is crossed, gently press down on your knee until you feel a gentle stretch deep in your hips. (try leaning forward instead of pressing)
- Hold this pose for 30 seconds. Swap legs.
Experiencing aches, pains, strains, sprains or a sore lower back? Book in to see a soft tissue occupational therapist.
A soft tissue occupational therapist is an expert in diagnosing and treating soft tissue injuries of the body – anything that involves the muscle, ligaments, tendons or fascia. They use a ‘hands-on’ approach to therapy, using techniques such as trigger point therapy, dry needling or myofascial release, to get you pain free.
Wanting to improve the strength of your body after pregnancy? Book in to see an exercise physiologist.
An exercise physiologist is an expert in rehabilitating the body after injury, surgery or pregnancy. They will assist you with pre and post natal exercise. They aim to improve the strength of your muscles and improve overall wellbeing by prescribing exercise as ‘medicine’.
Book in today to see a soft tissue occupational therapist or exercise physiologist at Urban Health HQ by calling 0411 563 391 or emailing firstname.lastname@example.org