Erica's Story

Erica was a triathlete, so was keen to get back into training, but to do it safely and wisely, as she had heard about how people could experience problems after if they did go back too soon. Having swum regularly during her pregnancy, she still felt 'swimming fit'. She had been swimming at least three times a week, between one and a half and two kilometres a time, including drills, sprints and kicking. She had avoided a lot of breast stroke, mainly preferring freestyle, so had placed no strain on her lower back or pelvis by doing this. She had also stopped butterfly early in her pregnancy because it hurt her tummy too much.

Cyclist2.jpgOnce her bleeding stopped, Erica was again able to return to the pool, which limits the strain on the pelvic floor muscles or back.Once she was comfortable after the birth, she also started cycling again. Cycling means that the pelvic floor is supported when you are seated and use low resistance,, although your abdominals, muscles do need to strengthen to support your lower back, before you start heavier training eg hills. This can take a few months after the birth, but should occur as you do your postnatal abdominal bracing exercises recommended for after the birth in As Your Shape Changes. At the same time your fitness level should be improving again, so the two should coincide together several months after the birth.

It was running that Erica took the most care with. She was aware of the boat theory, and that the effects of pregnancy hormones can take up to 3 to 4 months to leave the body. She also knew that it was important for her abdominal muscles to get firmer and stronger again before she started running. She followed the Pregnancy Exercise Guidelines and The Postnatal Exercise Guidelines, and used the booklet As Your Shape Changes with her physiotherapist to monitor her progressions and her rate of improvement before attempting running. She found that these and other similar post natal bracing exercises toned her abdominal muscles really well, particularly as she did them regularly, even with her baby on the floor next to her.

As Your Shape Changes also recommends, as do Continence and Women’s Health Physiotherapists, checking your pelvic floor muscle control before returning to running, sport or higher impact exercise. It is usually ideal to wait until 12 – 16 weeks, before commencing high impact activities.

Erica went for a light run to test it out around 8 weeks, but she actually could feel her pelvic floor muscles 'bouncing' while she was running. So she waited until 13 weeks before trying again. Her pelvic floor muscles felt fine when running slowly on flat ground. As her running fitness increased and Erica started to run hills around 6 months after the birth, then she again felt her pelvic floor muscles not feeling as strong as they used to be. After 8 - 9 months she could run hills and run hard, with no problem or feeling of any weakness in her pelvic floor muscles.

It is normal for women who really enjoy exercise to want to get back into it soon after the birth. This is a good thing. Exercise brings many benefits, and also provides the opportunity for some time for yourself while someone else looks after your baby, which can be a welcome break. Women also want to exercise as they may feel flabby and not toned. But it is important to consider what type of exercise you do initially, and how quickly you go back to higher impact exercise, sport and running.

Use the Pregnancy Exercise Guidelines and the Postnatal Exercise Guidelines and the booklet As Your Shape Changes to help you make the right decisions about your exercise choices. Also consider alternatives if you enjoy running, such as water running with a buoyancy belt. This can be hard work pushing against the water, and can be done with less impact on your pelvic floor or lower back.

Other low impact activities which are safer choices include swimming, walking, walking on a treadmill with hand weights or a small incline, seated cycling, low resistance on a cross trainer and low impact aerobic or post natal exercise classes.

You can return to your previous activity levels after 16 weeks, providing that your pelvic floor muscles are back to normal. If you are pregnant, now is the time to test and record your 'normal' pelvic floor fitness in your booklet, so you have a 'normal' to aim for after the birth.

If you do feel any vaginal heaviness, urine loss or back pain during or after exercise, you should slow down or reduce your intensity level, and wait a bit longer. You should also seek further advice or treatment from a Physiotherapist working in the area of Women's Health if any problems persist.

 

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