10.21.19|Posted by Kirsty Lee

Rebuilding strength and exercising after birth

Since qualifying as an MSK physiotherapist, Kirsty Lee has pursued a particular interest in women’s health issues through a range of specialist courses and additional training.  Here, she covers a hot topic amongst many new mums – what can I expect from my physical recovery and when can I exercise again?

There’s a lot of pressure on women these days to ‘bounce back’.

Magazines and the internet don’t help with their coverage of post-natal celebrity bodies, but these women typically live lavish lifestyles that are very different to yours and mine. 

The main thing to remember is that every woman, pregnancy, and birth experience is different. 

The speed of your recovery and how quickly you can return to exercise will depend on a number of different factors. For example: issues during pregnancy, the level of activity you did beforehand and the type of birth that you had.  

How much pain will I be in after birth and when will it subside?

Again, this will be individual to you and depend on a range of different factors. 

Your midwife will advise you on managing any initial post-natal pain and will give you advice about using painkillers and looking after yourself. 

Your movement may be restricted for a few days and often the best form of pain relief can be ice and heat therapy.

You can read more about using ice and heat at home here

When should I start pelvic floor exercises?

Everybody is safe and encouraged to do pelvic floor exercises from the first day of giving birth. 

You will probably have already been told about this by your midwife and the sooner you can get into a good pelvic floor exercise routine, the better. 

It will play a key role in helping your muscles to recover and regain strength. 

What is my pelvic floor?

We use the term ‘pelvic floor’ to describe the area of muscles around a women’s lower abdomen that help to control your bladder, bowel and sexual organs. 

For example, when you need the toilet but hold this in by tensing the muscles, then you are engaging your pelvic floor.  

Pelvic floor exercises help to repair and strengthen these muscles. They also help encourage the abdominal walls to come back together, as these will have been stretched during your pregnancy and are sometimes left with a slight divide. 

This can help to avoid future problems like incontinence or pelvic pain and weakness around the abdominals that can affect the lower back. 

How do I do pelvic floor exercises?

There are different variations of pelvic floor exercises, but this is a good combination to start with. You should repeat these 2-3 times daily for as long as possible and a minimum of six months.

Pelvic floor exercise 1 

  • Lie comfortably on your back with your feet on the floor, with your knees bent and shoulder width apart. 
  • Contract your pelvic floor as if you are holding in a wee or a bowel movement. 
  • Make sure you’re not just holding your tummy or squeezing your buttock cheeks, really engage in contracting in the right area. 
  • Recruit the muscle slowly.
  • Hold for five seconds and then release and relax the muscle. 
  • Repeat this 10 times.  

Pelvic floor exercise 2

  • Stay in the same position as you were for exercise 1. 
  • Contract your pelvic floor as if you are holding in a wee or a bowel movement. 
  • Perform 10 fast contractions – contraction release, contraction release. 

When can I start exercising and moving normally again after birth?

The most important thing is to listen to your body. 

The biggest misconception is that you need to just rest and wait for months after birth. 

Women’s bodies are designed to give birth and the majority will recover quickly and without the need for any additional intervention or support. 

If you’ve had a natural birth without instruments and were reasonably active before and during your pregnancy, then you can return to light activity as soon as you feel ready to. 

Most people who have had a natural birth would be able to return to light exercise within 4-6 weeks. 

If you had any issues during your pregnancy or birth, then I would recommend that you talk to a physiotherapist before you return to exercise. 

What about exercising if I had a caesarean? 

You normally have to wait around 6 weeks after having a C-section before getting started on any exercise. 

If you had a caesarean, you will typically have regular checks with the midwife. They will be able to check your wound and advise you on when you are safe to start light exercise and lifting. 

What exercise should I start with?

You should continue with your pelvic floor exercises and combine these with some light impact cardio like walking with baby, cross training or cycling. 

Yoga is good, but gentle yoga and nothing too extreme within the first 8 weeks after birth. Your body is still very supple due to the relaxin hormone so you need to be careful. 

Swimming isn’t advised until at least 4-6 weeks post-partum due to risk of infection.

When can I return to my pre-pregnancy routine?

Again, listen to your body and don’t push yourself too hard. 

Once you have established normal pain free movement again with basic light cardio, you can try returning to exercise or the gym, but pace yourself. Start with shorter sessions and low impact activities. 

If this feels comfortable then progress and work towards your pre-injury level, but don’t train through pain or push yourself too hard. 

I’m still in pain and worried about my recovery - when should I speak to someone?

Pain during and after pregnancy is common but it shouldn’t be deemed as normal or something that you have to put up with. 

Pain has lots of different pathways and the physical aspect is just one. Your emotions and how you are feeling as a new mum can also play an important role. 

Many women worry about what is ‘normal’ when it comes to their body and recovery. 

If you are still in pain or concerned about your recovery after 6 weeks, don’t suffer or worry alone. Speak to a women’s health physiotherapist or any chartered physiotherapist. 

During pregnancy the abdominal wall separates and in a lot of cases it goes back to normal within two or three weeks. 

For some people it doesn’t come back together completely and you may need some special exercises and support from a physiotherapist to progress your recovery. 

How can physiotherapy help me? 

With my patients I would typically talk through their personal goals and carry out a full objective assessment. 

We would then agree a rehabilitation plan, which may include strength building exercises for good posture and abdominal strength, lifestyle advice and manual therapies, such as soft-tissue massage.

Often breastfeeding mums find that they experience tension in their back from holding the baby and postural changes. Soft-tissue massage can help to relieve any areas of tension and promote healing. 

Are all Ascenti physiotherapists trained in women’s health issues?

Myself and a number of Ascenti physiotherapists are specialists in women’s health issues. 

Not all Ascenti physiotherapists are trained to this degree, but they will be able to help you or refer you to a specialist if needed. 

My advice would be to contact us in the first instance to find your nearest clinic, learn more about the services we offer in your area and how we can help you. 

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