post-partum exercise

Starting Slowly

30 July, 2020 Steph's diary

Lying in the hospital bed, with my brand new little boy next to me was an indescribable feeling. The pain of the birth which at the time felt like it would never end, felt like a million years ago and I couldn't stop smelling and kissing his still-shaped-like-a-butternut-head. (Thankfully it was back to a regular head shape within a day, although I dare say I would have loved him nonetheless!).

At some stage, my hand went to my stomach and I immediately felt what I assumed to be a bowl of custard someone had left under my shirt. Nope! That was my stomach, in all its jiggly glory! Now I by no means claim to have ever had a six pack in my life, but I like to think that my stomach was fairly firm. Now it felt like someone had surgically removed every muscle fibre from that area. I soon felt the physical effect of this when I had to sit up and my stomach felt as weak as a newborn kitten!

Nine weeks down the line, the custard has firmed up just slightly… let's call it a Creme Brulee now. But knowing that post partum women are at high risk of long term damage if they exercise too soon after giving birth, I needed to find out what these risks were and how to avoid them.

I would not recommend starting any kind of exercise at all before a month… Not that many moms would be able to, just getting a shower feels like a huge feat! I started walking at 4 weeks and then core re-building from 5 weeks and I added running from 6 weeks.

Also, I didn't have a cesarean section which is major abdominal surgery, and the recovery is much longer than with a natural birth. If you did have a c-section please get advice on starting exercise from your doctor.

The major problems postpartum women can face are diastasis recti, pelvic floor weakness and pubis symphysis dysfunction.

Diastasis recti is the separation of the abdominal muscles, causing a protruding bulge in your tummy. Some women complain of still looking pregnant months after giving birth,and this is often because of diastasis recti. Ideally these muscles should come back together after birth but when this doesn't happen, and you try to do certain abdominal exercises, you may have major problems.

Here is a video to check if you have diastasis recti.

If you do, don't fret. Start by making an appointment with a physiotherapist who will be able to guide you in fixing it. Once the diastasis recti is reversed you should be able to go back to regular exercise without risk.

Natural birth as opposed to a c-section is more likely to cause pelvic floor weakness which can lead to incontinence and prolapse of pelvic organs. It is very important to start pelvic floor exercises early during pregnancy. This is as simple as kegel exercises…. Pretend you are stopping the flow of urine… Congratulations,you have just done a kegel! Doing three sets of 20 every day throughout your pregnancy and starting again as soon as possible after birth can be hugely beneficial in preventing pelvic floor weakness and reducing the risk of incontinence and prolapse.

Pubis symphysis dysfunction is a group of problems that affect the pelvic region. During pregnancy, hormones cause the ligaments that keep the pelvic girdle straight to become stretchy. This can cause pain in the pelvic and groin area. Although it commonly occurs during pregnancy, after birth the hormones take a while to go back to pre-pregnancy levels and the stretchiness remains. This means that starting exercise too soon can be the cause of pelvic organ prolapse or even abdominal separation.

So it is obvious that one needs to start slowly. But what can you do and what should you prioritise? To put it simply, the two things to focus on (just on their own initially and then continuing to focus on them along with other exercises as you get stronger) are the transverse abdominis muscles and the pelvic floor.

The core takes the biggest hit during pregnancy and birth and you literally have to start building it up from the inside. This is nothing like an abs workout you may have done at gym pre-pregnancy...these are small, targeted movements that work the deepest of the core muscles, the transverse abdominis (the rectus abdominis are the six pack muscles that are closer to the surface).

We are so lucky to live in a time where in 10 seconds you can find something online to guide you. I found this great postnatal exercise guide from momsintofitness to be very helpful, as well as these Youtube videos.

Until next time!

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