Postpartum
After childbirth, many women experience a period of physical deconditioning, where the body adjusts to the changes brought on by pregnancy and childbirth. This can manifest as muscle weakness, decreased cardiovascular fitness, and changes in flexibility and balance. During pregnancy, hormonal shifts, weight gain, and altered biomechanics may lead to reduced physical activity levels and changes in muscle usage.
As women transition into the postpartum period, it's common to encounter various forms of physical discomfort. This may include perineal pain from vaginal delivery, uterine cramping as the uterus contracts to its pre-pregnancy size, breast pain related to breastfeeding, and back pain due to strain on the muscles and ligaments during pregnancy.
To address postpartum physical deconditioning and discomfort, a gradual return to exercise is often recommended. Starting with gentle activities like walking and pelvic floor exercises, women can gradually rebuild strength and fitness while respecting their body's recovery process. Incorporating core strengthening exercises helps to alleviate back pain and improve posture, while targeted pelvic floor exercises can aid in perineal pain relief and bladder control.
Exercise tailored to postpartum recovery can be immensely beneficial. Personalised exercises and techniques to address specific areas of weakness and discomfort, can support women through a safe and effective return to exercise. Additionally, supportive devices such as abdominal binders and breastfeeding pillows can provide comfort and support during the recovery period.
It's crucial for women to listen to their bodies, respect their physical limitations, and seek guidance from healthcare professionals as they navigate postpartum recovery and return to exercise. By gradually reintroducing physical activity and focusing on rebuilding strength and fitness, women can support their bodies' recovery and promote overall well-being in the postpartum period.
General Recovery Timeline
Here's a general timeline and guidance for returning to physical activity postpartum:
Immediate Postpartum Period (0-6 Weeks):
Focus on gentle exercises such as deep breathing, pelvic floor exercises, and gentle stretching.
Begin pelvic floor exercises as soon as you feel comfortable, ideally within the first few days after childbirth.
Take short walks around the house or outside, gradually increasing the duration as tolerated.
Avoid high-impact activities, heavy lifting, or intense abdominal exercises during this period.
Early Postpartum Period (6-12 Weeks):
Continue with gentle exercises such as walking, pelvic floor exercises, and stretching.
Gradually increase the duration and intensity of walks, aiming for at least 20-30 minutes per day.
Consider joining a postpartum exercise class focusing on core and pelvic floor rehabilitation.
Begin incorporating low-impact activities such as swimming, cycling, or yoga, avoiding high-impact activities or exercises that place excessive strain on the abdominal muscles.
Monitor for signs of pelvic floor dysfunction or diastasis recti (abdominal separation) and seek guidance from a healthcare provider or pelvic health Physiotherapist if needed.
Mid-Postpartum Period (3-6 Months):
Continue with low-impact activities such as walking, swimming, or yoga, gradually increasing the intensity and duration as tolerated.
Incorporate strength training exercises targeting the major muscle groups, including the legs, arms, back, and core.
Begin incorporating gentle abdominal exercises to strengthen the core muscles, focusing on exercises that engage the deep abdominal muscles without exacerbating diastasis recti.
Consider incorporating activities that promote balance, stability, and functional movement, such as Pilates, to support overall physical well-being.
Late Postpartum Period (6-12 Months and Beyond):
Gradually reintroduce higher-impact activities such as jogging, running, or aerobic exercise classes, taking care to listen to your body and progress gradually.
Continue with strength training exercises to build muscle strength and endurance, incorporating a variety of exercises and equipment as desired.
Monitor for any signs of pelvic floor dysfunction, abdominal separation, or other postpartum issues, and continue to seek guidance from healthcare providers or specialists as needed.
Stay consistent with your exercise routine and prioritise self-care, including adequate rest, hydration, and nutrition, to support your body's ongoing recovery and well-being.
It's important to remember that every woman's postpartum journey is unique, and the timeline for returning to physical activity may vary depending on individual circumstances, including mode of delivery, overall health, and any complications experienced during pregnancy or childbirth. Listen to your body's cues to ensure a safe and effective return to physical activity.
Postpartum Deconditioning and Returning to Exercise
Diastasis Recti
Diastasis recti is a condition characterised by the partial or complete separation of the rectus abdominis muscles, which are the muscles that run vertically along the front of the abdomen. Normally, these muscles are held together by connective tissue called the linea alba. However, during pregnancy or due to other factors such as obesity, rapid weight loss, or certain exercises, the linea alba can become stretched or weakened, leading to separation of the abdominal muscles.
Diastasis recti is commonly associated with pregnancy, particularly during the third trimester and postpartum period, as the growing uterus puts increased pressure on the abdominal muscles and stretches the connective tissue. Women who have had multiple pregnancies or large babies may be more prone to developing diastasis recti.
Symptoms of diastasis recti may include:
A visible bulge or "doming" in the midline of the abdomen, particularly when contracting the abdominal muscles or performing certain movements.
Lower back pain or discomfort.
Weakness in the core muscles.
Poor posture or difficulty maintaining proper alignment.
While diastasis recti is not typically associated with pain, it can contribute to functional limitations and may affect core stability and overall abdominal strength. In severe cases, it may also be associated with other pelvic floor issues such as urinary incontinence or pelvic organ prolapse.
Treatment for diastasis recti often involves exercises to strengthen the deep core muscles, including the transverse abdominis and pelvic floor muscles. Physical therapy with a focus on core strengthening and alignment may be recommended to help improve muscle function and reduce abdominal separation. In some cases, surgical intervention may be considered, particularly if the diastasis recti is severe or causing significant functional impairment.
It's essential for individuals with diastasis recti to seek guidance from a healthcare provider or physiotherapist experienced in treating the condition to develop a personalised treatment plan tailored to their needs and goals. With proper management, many individuals with diastasis recti can achieve improvement in abdominal strength and function over time.