Kirsten is one of our Masters Physiotherapists, a certified Health Coach, Crossfit coach and mum of 2 girls. In this blog she’ll take you through some of the considerations for returning to running or high intensity exercise after having a baby….

Getting back to or even just starting a new exercise routine after having a baby can be one of the best things we can do for ourselves as mums. There are loads of reasons why we want to do this and each of us will have our own priorities - physical health, mental health, body composition, social connection and even just feeling a little but like your “old self” are all things I hear often and can certainly relate to with my own journey into motherhood.  Unfortunately there is also a mind boggling amount of information out there about what you should or shouldn’t be doing - add in sleep deprivation, hormonal fluctuations and the general adjustment to life with a baby - it's all too easy to feel overwhelmed. 

So in this blog I’m really hoping to simplify that and give you some guidance around what choices you could be making for yourself when it comes to returning to exercise, particularly higher impact exercise like running, F45, gym classes or sport. 

Firstly, It’s really important to take the time to connect with why you want to do it. I really want you to separate this from why you think you “should'' do it. Yes there are a few things that are really important to do when we’re recovering from birth, but in my experience, as a new mum, we’re already struggling to keep up on the escalator of expectations moving at double speed - some of these are our own expectations and then there’s those of society and people around us. Ask yourself if you really want to go back to running/gym/sport now or are you’re doing it because you think you should be at that point by now? 

Before having kids I would definitely have told you that my exercise was for physical health, body aesthetics, and keeping up with how I thought I “should” look and how fit I “should” be, especially given that I was a Physio and a CrossFit coach. Since the addition of my 2 girls to my life over the past 5 years, I’ve realised that I placed an extraordinary amount of pressure on myself to get back to all that. Not that those reasons were wrong in any way but more that I could have been kinder to myself over time and given myself some credit for what I was actually achieving. Also know that your reasons for exercising can change over time and that’s absolutely fine too. These days I find that the benefits I get for my mental wellbeing from exercise far outweigh anything else.

On the topic of expectations let’s take a quick look at the reality of what many women are experiencing in the pregnancy and postpartum period. There are many things that are more common than we think:

• Up to 65% of women will experience some form of urinary incontinence during pregnancy
• Over 30% of women will continue to leak after childbirth (even years after, it’s common but not normal)
• 1 in 5 women will experience pelvic girdle pain during or after pregnancy
• 9% of women suffer from depression during pregnancy 
• Up to 20% of mothers experience post natal depression with many more reporting changes in mental wellbeing. 
• 40% of women report decreased physical activity/exercise for up to 3 years after having a baby

Now whilst those stats aren’t exactly sunshine and rainbows the good news is that there are simple steps we can take to improve them with a huge component being the advice and support a mother has during this time. Luckily for you that’s a massive part of what we do at AP, so let’s take a look at some of that advice..

So it’s time to consider if you are ready to return to exercise at the level you’re aiming for. There are a few key factors that come into this decision and whilst some health providers might say that you’re cleared for exercise from 6 weeks postpartum this doesn’t mean you can jump straight back in. In reality the healing process continues long past this time. When we consider other musculoskeletal injuries or post surgical rehab protocols (like a knee or shoulder for example) we are often working with clients for several months prior to them returning to exercise and sport so we need to be thinking the same way after having a baby. 

Ideally we would love it if every new mum had access to a postnatal check with a qualified Pelvic Health Physiotherapist so if you can afford it then this really is your best first step. 

Let’s take a look at the key screening questions you want to ask yourself about your pelvic health:

• Do you have any incontinence?
• Do you have heaviness or a dragging sensation in the pelvic region?
• Have you noticed any changes in your ability to have intimate relations with your significant other?

If you answered “yes” to any of the above, we would really encourage you to book an appointment with one of our Women's Health team to ensure you get the appropriate assessment and treatment before progressing on your exercise journey.

If you answered “no” then that’s great. A few other things you might want to consider:

• How many weeks post-partum are you? 
  • There is a significant difference in the amount of healing taking place at 6 weeks in comparison to 12 weeks. Most women will not return to higher impact activity within 3-6 months. 
• How did things go during the birth of your baby? Did you push for a long time? Did you tear? Did you need forceps or other assistance? Did you have a c-section? Was it traumatic?
  • These factors all impact the healing of your pelvic floor. If you answered yes to any of those questions we’d really encourage you to come in for an assessment so we can ensure you get started successfully
• Are you breastfeeding? Do you have a supportive bra for exercise? 
  • The hormonal changes associated with breastfeeding affect our musculoskeletal system and our energy availability as well so its important to keep this in mind
• Did you experience or are you still experiencing any back or pelvic pain during your pregnancy? 
  • Your body has been through significant changes over the 9 months of pregnancy and will take time to recover in the postnatal period, these areas may also need attention to ensure your return to exercise is successful.
• How active were you prior to and during your pregnancy? 
  • This can have both a positive and negative impact on how easy you might find it to return to exercise. Positively you may still have kept up an element of strength and fitness. On the other hand, if you’re struggling after birth, this can drive you to push yourself more than you need to. Be kind to yourself!
• Have you started or are you doing any form of pelvic floor exercises? 
  • These are a key component of your recovery and it’s important to do them correctly. If you haven’t done any form of pelvic floor specific exercise, we wouldn’t recommend starting any high impact activities yet
• Have you started any low impact exercise? 
  • Walking and basic strengthening exercises are important foundations before we progress to running and other higher impact activities. Again if you’ve skipped these out, don’t rush, spending time on gradually building your core, lower body and upper body strength means you’re more likely to be successful in the long run. 
• Are you getting any sleep or are you significantly sleep-deprived?
  • Sleep is key for recovery from exercise so if you aren’t getting it, we need to factor that into how much effort we can put in at higher intensities
• Are you eating well enough to support more exercise? 
  • As a mum I know I still find it hard to prioritise my own nutrition, and as a new mum some days it didn't even make the list. It can be easy to be under fuelled for higher intensity exercise which puts us at risk of developing other health issues that affect our hormones and bone health. 

So if you’ve got to a place where you can honestly say that you have no pelvic symptoms, you’ve been building up your walking gradually, you’ve done the boring basic strength work and you think you’re eating and sleeping well enough, then congrats you’re likely ready to ramp things up to the next level with your exercise! Continue to build up gradually and allow yourself the chance to rest and recover as you move through the different phases of your child’s first few years! If at anytime you experience symptoms or need advice then we’re here. 

If you feel like you have more questions than answers….or you may be wondering how some of these factors apply to you individually then we’re here to help and we have a range of services available:

Book in for a complimentary phone consultation to have quick chat with one of our team about your situation.

If you’re experiencing any pelvic symptoms - book in for a consultation with one of our Womens Health physiotherapists.

If you’re not experiencing any symptoms and are looking for strengthening advice and testing for return to sport readiness then book in for a Post Natal Return to running assessment with Kirsten.