08 Mar exercise after pregnancy
How is your body after baby, and how should you exercise after pregnancy when your body has changed? I think most ladies like the idea that any exercise they completed before pregnancy can be resumed after baby is born and for many women that is possible. However I work with women who have not found a return to exercise after pregnancy straight forward at all. The purpose of this article is to share their starting point and where they are at now – it’s inspiring! Here’s 4 complex examples of how your body can change because of pregnancy, and how their exercise routines have changed forever.
- Pubic Symphysis Dysfunction (PSD) / Diastasis symphysis pubis
- Neural damage to pelvic floor
- sacroiliac joint issues
- pelvic floor damage
- Pubic Symphysis Dysfunction (PSD) / Diastasis symphysis pubis
What’s this? Basically the midline cartilaginous joint uniting the left and right pubic bones (right between the legs at the front) becomes sore and perhaps stretches or begins to separate a little. This should be taken seriously from day 1 that any discomfort happens. You can read more here, as I’d like to talk more about unusual total breaking of this joint. For this client she spent a few years on crutches. Yes, years. She was only just off crutches when she started doing water based PT with me, and I took a very cautious approach with her. We worked on strengthening her legs and core without any sideways exercises – we still adhere to this (I’ve been training her for 5+ years now). She also needed a goodly amount of upper body work around her shoulders as well, as does any one who has been on crutches for any length of time who additionally had a baby on the hip (so often only one crutch was used)! We started land based PT a few years back and slowly and progressively moved her fitness forward. She also did pilates once a week. She will always have to adhere to this fitness routine and she is happy too. Just over a year ago we set a challenging goal for her – a 25 km endurance walk. I am please to say she achieved this goal without a setback.
2. Neural damage to pelvic floor
What’s this? Neural damage can occur during the birthing process (the nerves that feed the pelvic floor no longer activate muscle contraction) and for this client she was unable to lift her pelvic floor on command. I’d like to add, this is unusual. She claims she felt like she had a prolapse (a sense that the pelvic floor is hanging low) but she did not have a prolapse. However this feeling was worse if she ran, had a bout of illness with coughing, or lifted heavy things (like children). She simply could not activate her pelvic floor. This requires a surgical resolution once all babies have been born. So what is the role of exercise when you have this issue? It’s gentle and restorative, we do as much core work as we can without affecting the pelvic floor (the pelvic floor is the floor of the core after all). Swimming is ideal. Bike riding and pram pushing must be on the flat. Heavy weight lifting is out until the surgery as ANY kind of weight lifting requires a healthy activation of core – and the pelvic floor is the floor of the core. Light weights can be undertaken seated on a swiss ball. You would have to accept that this is a temporary stage and that some exercise is better than none (it always is).
3. Sacroiliac joint (SIJ) issues
What’s this? For most women who have SIJ issues the SIJ has become unstable or hypermobile, however it could be hypomobile (very stiff). The SIJ is both left and right of the spine on the pelvis – and one side or both may be affected. It is really important that before you start exercising you are certain you know whether your SIJ is hyper or hypo mobile. The exercises and approach are very different. We used to once think that this joint did not actually move, but we now know it does and the forces on it when we squat are quite extra-ordinary – so mainstream exercises can exacerbate it very quickly. The large sciatic nerve runs very close to the SIJ which is often why any damage to this delicate joint can cause out of proportion pain. There’s no quick fix with this, but make sure your physio / osteopath / masseuse communicate with your exercise professional (who may or may not have expertise in this area). Generally you need to build up the ‘posterior chain’ the glutes, hamstring and lower back muscles and well and internal and external hip rotation muscles. It is enough to say I’m not going to add a whole bunch of exercises for you to self administer – go get some professional advice 🙂
4. Pelvic Floor Damage
What’s this? I don’t mind telling you this one is a personal story – but it is the same story for so many women. Following a ‘natural’ birth of a fairly large lad I did have my fair share of pelvic floor damage with the main symptom being the very common sneeze and leak. I went to a Women’s Specialist Physio and was diagnosed with a mild prolapse and an over active bladder (a need to pee far to often). This was resolved within about 8 weeks of dedicated pelvic floor exercise and by counting backwards from 100 in 7’s each time I got the urge to pee. It’s quite amazing how effective that counting backwards is in making the brain forget it’s need to pee. I do a few rounds of pelvic floor exercise each week but I’ve had a few ‘set backs’ over the years. The first one was a return to work – as I work as an aerobics instructor the high impact nature of this work led to an increase in sneeze and leak (or jump and leak). I revisited the physio, did my exercises and returned to carefree living. My second set back was trying to extend the length of time between going to the loo and while this is generally a good strategy when you are an aerobics instructor pee before you take the class – because the sheer weight of a full bladder can stretch your delicate pelvic floor further still! So pee often, not too often, not too irregularly either! A few years later on I had another set back and this was following a return to sport. While I had trained myself to lift pelvic floor during a star jump there is a mighty pelvic floor test when you sprint, stretch and smash a ball. So back to pelvic floor school for me, but I am having great success using a free app called KEGEL TRAINER. (however when it says ‘squeeze’ – ‘lift’ instead. )
So I hope you enjoyed reading this article and if it applies to you gives you some hope for a healthy and active future.
Jo Cordell-Cooper runs the twice award winner business Active Solutions and Health Network, specialising in women’s fitness, all ages, all stages. Ring 0409 862206 to see if we can help. Or email here