Returning to higher intensity exercise postpartum - by Karen Lindner (Accredited ESSA Exercise Physiologist)
Like any injury, there are certain considerations when returning to higher intensity exercise for short and long term health outcomes.
The levator hiatus (or levator ani) is the opening in the pelvic floor muscle which allows the urethra, vagina and anorectum to cross the abdominal envelope. During a vaginal delivery, the muscle forming this opening has to undergo a degree of distension that would rupture any other skeletal muscle in the body, hence why a gradual return to higher intensity exercise is so crucial!
The recovery of your levator ani muscle and all the connective tissue and nerves that have been stretched via delivery is healed to the best it can at 4 – 6 months postpartum. If you start jumping, running and placing high impact loads through your pelvic floor as it is still recovering, you may delay your recovery or take a step backwards.
Returning after a caesarean, or C-section, is just as important. A C-section is major abdominal surgery which can take at least 6 weeks to heal. The current recommendations are to avoid high impact exercise until 3-4 months post delivery.
How to safely return to higher impact exercise
Restoring motor control (that is, the regulation of movement and muscle activation) is altered between the deep abdominals and pelvic floor after pregnancy. It is important to restore this! This helps with your core stability and control of intra-abdominal pressure.
Restoring pelvic strength and stability is also important. Single leg strengthening exercises are beneficial for this, especially if you are keen to return to activities such as running, which involve a lot of single leg stability. This can minimise risk of injury to your lower body.
It is also important that your pelvic floor is strong enough to withstand impact exercise! If you are experiencing pelvic floor weakness symptoms, speaking to a Women’s Health Physiotherapist is a great first step. Your Exercise Physiologist can then help by strengthening the muscles supporting the pelvis and core. They can also provide alternatives and modify exercises to keep you moving without fear.
You can book an appointment with our Exercise Physiologist Karen by calling the clinic on (02) 6925 7734.