The Postnatal Athlete: Returning to Exercise
Spoken by Lucy Young, a Postnatal Athlete Herself and Certified Pre / Postnatal Exercise Specialist
Motherhood changes you emotionally, physically and mentally and these changes can be exciting, confronting and at times exhausting. Many mums will tell you it's a rollercoaster suddenly being responsible for a small dependent human, and yet there's no ride they'd rather be on. However, realising life as you once knew it has changed can be an intense concept to wrap your head around. At least it was for me.
Late last year, in my second trimester, I wrote an article for The Pregnant Athlete, about exercising during pregnancy. I explained how 'just listen to your body' is a well-meaning expression, but a confusing one for an athlete who is accustomed to pushing their body past fatigue and psychological discomfort. This is also true in the postnatal period, because while you might think your body is ready to return to exercise, it's often craving more rest and/or rehabilitation.
As a pre/postnatal exercise specialist I understood postpartum that my body would need significant time to recover. I was preparing for a natural birth, but my body had other plans. An emergency caesarean at 42-weeks exacerbated a sudden disconnect I felt with my body, and I wrestled with all my expectations of the weeks post birth - especially that my body would 'bounce back' to pre-baby shape.
I know this feeling is not unique to me as many women get the 'message' that the postnatal body is somehow, both maternally successful but aesthetically problematic.
After three days recovering from my cesarean the parting advice from the hospital was 'do your pelvic floor exercises'. I remember commenting to my partner 'how vague is that! What if you don't know what your pelvic floor is, what exercises to do, and how does this help rehabilitate from the major abdominal surgery you just experienced?'
Movement, exercise and sweat can be game changers in the postnatal period. These endorphins are key for mental health and postpartum training goes far beyond aesthetics. Having time alone as a new mum can be almost impossible, but when women are able to do something for themselves, such as taking care of their rehabilitation and exercise (albeit with many interruptions and a baby in tow), it can dramatically boost their mental health. In fact, six months later, I've accepted that for me to be a better partner, a better mum, a better human, I personally need exercise.
With the understanding that postpartum rehabilitation can do wonders for the mind, it's critical to understand where to start, so here are some of my top tips for navigating the postpartum period and how BUMPSTRONG can help
1. Don’t jump back into your pre-baby training
If you’re a devout member of #thesweatlife then I get it, you’ve waited nine+ months to be back exercising, so you’re chomping at the bit to jump back in. However, throwing caution to the wind and trying to pick up where you left off pre-pregnancy is a recipe for disaster. Countless times I have worked with women six+ months postpartum who are still having issues with incontinence and/or pelvic floor heaviness and it’s either due to lack of any rehabilitation work postnatally, and/ or starting training before their body was ready. My guidance is to trust the process, follow a rehabilitation guide that helps keep you accountable, and celebrate the small wins - like progressing from a wall push-up to a kneeling one.
2. The three P’s: Pain, Pressure, Peeing!
This tip is important. When performing exercise pre or postnatally, being attune to the three P’s is a great way to monitor your training and understand when it might be time to pull-back or modify an exercise.
Pain is the first ‘P’, and arguably the easiest to remember considering it’s natural to notice when an exercise is hurting or causing pain. Working with a pre/postnatal exercise specialist allows you to distinguish common aches and pains depending on where you are in your gestation or postnatal recovery. If you are an athlete used to pushing through pain, pregnancy and/or the postnatal period is NOT the time to embrace discomfort and enter the Hurt Locker.
Pressure, the second ‘P’, during pregnancy and the postnatal period is almost always in relation to intra-abdominal pressure - the pressure in your core. Mismanaged pressure often results in abdominal coning (pressure escaping through the centerline of your abdominal muscles) or pressure downwards onto the pelvic floor.
Peeing – the other ‘P’ refers to incontinence during pregnancy and the postnatal period and can indicate pelvic floor dysfunction. Countless times I’ve heard women say ‘I cannot do high- intensity exercise because I’m a mum - I’ll pee myself!’ as though leaking is a natural, and inevitable part of becoming a mum. I cannot stress enough that incontinence does not need to be accepted as part of a ‘motherhood package’. If you notice peeing during exercise, regress/modify the exercise and flag it with your pre/postnatal exercise specialist or women’s health therapist.
3. Understanding how to breathe effectively does wonders for recovery
Learning to breathe might sound unnecessary because you do it all day, every day. However, mastering effective breathing is vital for a proper functioning core and postpartum, this may just be the single most significant improvement you can make for your health. In fact, a 360-degree breathing pattern allows the body to tap into the parasympathetic nervous system - the one that makes us feel calm and relaxed. Some poor breathing patterns can be solved by learning how to breathe into your front, back and sides. Understandably, many women lose the ability to breathe effectively because during pregnancy the baby occupies so much space that the diaphragm is unable to functionally contract downwards. Many pregnant and postpartum women are also taught to belly breathe to promote relaxation, but belly breathing in the absence of rib cage movement places a lot of stress on weak abdominals, and postpartum this can inhibit abdominal rehabilitation (or diastasis).
4. Don’t fret if you notice abdominal separation post-birth
All women, by due date have diastasis (abdominal separation) because, if your abdominal muscles couldn’t separate there would be no room for baby to grow! Postpartum, many women become laser focused on this separation because it is usually easier to notice on a lax core than a firm pregnant belly. However, immediately postpartum it’s important to take it easy and not rush. The abdominal muscles need rest and recovery postpartum to knit closer together naturally. Trying to perform endless sit-ups in the hope you’ll aid your diastasis is almost certainly going to cause more harm than good. It might also contribute to pelvic floor dysfunction as your core is unable to manage its pre-baby demands after nine months of core muscles being in a lengthened state. While many women fret over the width of their abdominal separation, it’s important to point out the depth of a diastasis is just as important as its width. A squishy two finger size separation could indicate that the connective tissue is weak and maybe less adept at managing intra- abdominal pressure (IAP).
5. Get a pelvic floor examination
During pregnancy and postpartum (generally 6-weeks pp), I often recommend clients visit a pelvic floor physio for an internal exam. These examinations allow for an evaluation of your pelvic floor tone, ensure you know how to effectively contract/relax the pelvic floor and allow a pre/postnatal exercise specialist to design workouts/exercises based on the individual client’s needs. Too often during pregnancy and postpartum women are told ‘do your kegels’ (another way of saying ‘pelvic floor contractions') without first understanding what might be most appropriate for their pelvic floor. For example, jumping the gun and blindly performing multiple kegels on a tight pelvic floor (hypertonic pelvic floor) can exacerbate pelvic floor dysfunction! Think of it this way, if you were to tense your bicep muscle all day, eventually the muscle would fatigue and lose strength. In the same way, holding tension in the pelvic floor can cause tiredness and weakness, sometimes even too tired to control continence!
While motherhood is a wild rollercoaster, my short experience has shown me it’s also a rewarding one. It’s important to rest as much as possible as you recover, seek a detailed physical assessment before you return to exercise (rather than following a blanket six-week clearance date), and follow the above guidelines to return to full training. Never underestimate the need for core rehabilitation post-birth. If you’re unsure where to start, following a program like what we offer at BUMPSTRONG, can help take the guess-work out of re-strengthening your core and help keep you accountable.
Remember you’re not alone as you return to exercise and connect with your postnatal body. No matter how raw your postnatal body is, it’s a symbol of your strength, your baby’s existence and in many cases, your greatest accomplishment.
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