If you have recently given birth and are wondering how to begin safely exercising to help your body build stability and strength, then read on…
Firstly, it is important to know that it took your body nine months to grow your baby and during this time it underwent many changes. Your abdominal muscles stretched, your posture changed as your centre of gravity shifted, your joints became a little unstable as a group of hormones called ‘relaxin’ made your body more flexible. The purpose of relaxin is to:
- Prepare your womb for pregnancy
- Relax the wall of your womb to help prevent contractions to prevent premature childbirth
- Regulate your heart and kidney to help you cope with the demands of your growing baby
- Helps to open and soften the cervix and vagina for childbirth
- Relax the ligaments in your pelvis to help with an easier childbirth
So now you have had a baby did you know it still takes up to five months for relaxin to leave the body and if you are breastfeeding it can take longer? If you return to exercise too soon especially with activities such as running and weight lifting without focusing on your all over body stability then you are putting yourself at risk of injury. You should also avoid returning to exercise until after the flow of lochia has stopped so a good time to think about returning to exercise is after a 6 week check with your GP or talk with a suitably qualified exercise instructor to decide what is best for you. Relaxin is also present during and a little while after your menstrual cycle so be aware of not pushing yourself during this time.
Why does the body produce relaxin?
The purpose of relaxin is to provide increased movement in the pelvis to accommodate the growing baby and to allow an easier birth. It also helps the abdominal muscles to stretch during pregnancy and the pelvic floor muscles to stretch during delivery.
Although relaxin is no longer manufactured in the postnatal period, the effects of the hormones on the ligaments are still evident. Relaxin has an effect on every joint in the body (even the little finger) and the effect on the joints lingers on until about five months post-birth.
In the beginning….
- Return to an exercise class after 6 weeks and after you have had a 6 week check. Give yourself time to bond with your baby and recover from childbirth.
- Pelvic floor exercises are a really good way to start to regain stability and strength in your spine, pelvis and abdominals and you can start those a few days after birth.
- Breathing exercises can help you relax and work your deep abdominal muscles (transverses abdominus) without even doing sit ups. In fact avoid doing any sit up until after your 6 week check so your abdominal muscles (rectus abdominus) have time to start contracting and returning back. It’s very normal for your abdominals to stretch or separate during birth and just as normal for them to come back together again.
- You can do simple exercises at home when you have first had your baby but seek the advice of a qualified professional who can help you decide what is best for you according to the type of birth that you had and how you are feeling.
- Incorporate exercise into your daily activities as much as possible e.g. go to your baby changing station upstairs when you want to change your babies nappy or park your car a few rows further away from the entrance of the supermarket.
- When it comes to the abdominal work, stick to static transversus tightening e.g. breathe in through your nose and as you breathe out through your mouth with 25% effort gently pull your belly button back to your spine. Repeat this regularly throughout your day in a variety of positions e.g. when you are washing up changing a nappy, watching TV, feeding your baby or spend dedicated time to it will get you faster results
- Don’t do any sit ups and leave out oblique muscle exercises until you are sure your abdominal muscle separation has come back to ‘less than two fingers’. You can ask your midwife, obstetric physiotherapist or your postnatal exercise instructor to show you how to check on these muscles in a Rec Check
Returning to class………
- When you first return to exercise make sure you attend classes with a qualified postnatal instructor who can check the strength and stability of your abdominal muscles
- If you had a caesarean delivery, it takes longer for you to recover so it is advisable to wait eight to ten weeks before returning to exercise. However, you can still start on your pelvic floor exercises.
- Wear a good bra to support your breasts when exercising.
- Wear appropriate footwear for the type of exercise you want to do so that you have the best shock absorption for your body.
- Wear comfortable exercise clothes.
- If you are breastfeeding, feed before exercising so you don’t get any milk leakage.
- Drink plenty of fluids before, during and after exercise. Good quality water is always the best.
- Have a small snack like yoghurt, nuts or fruit 30 mins before you exercise so that you have stable blood sugar levels. Always make sure you eat something after exercise like a protein bar as this can help your metabolism.
It’s also important to:
- Rest if you are feeling particularly tired instead of exercising. Pushing yourself only opens you to the risk of injury.
- Exercise at a level where you are comfortable and talk with your instructor about achieving your goals sensibly and with respect for your body.
- Recognise when your body has had enough.
- Stop immediately if there is pain or discomfort. Your instructor should help you make adaptations during class.
- Recognise that you should give yourself time to re-gain your strength and fitness levels.
- Start any exercise gradually, allowing yourself to build up over a number of weeks.
- Always warm up the body before doing more exercises
- Try and take the baby for a walk in the pram or carry papoose and ‘power’ walk till you feel warm and your breathing is a little faster than normal.
- Structured exercise may take many forms – swimming, walking, postnatal exercise class. But it is a good idea to leave anything that creates ‘impact’ on your body until you are at least five months postnatal. Impact can be defined as taking both feet off the floor at the same time.
- If you can get to a specific postnatal exercise class you will meet other mothers with babies of the same age and you will probably find you have much in common. The class can be a really great way to meet others and develop new friendships at this time, especially if you can take your baby along too and afterwards go for a coffee in the cafe.
- If you cannot find a class near you, investigate a ‘ low impact’ class, arrive early and let the instructor know you have just had a baby. He or she should encourage you not to jump, bounce or use jerky movements or work harder than you are really ready to do and build up your strength gradually. If you feel pressured into working too hard you can do damage so do not overdo it!
- Don’t work into any sort of pain. Pain is a warning signal that should never be ignored. Make adaptations or stop altogether.
When to seek help
- If you are feeling pain and discomfort that is not your usual discomfort after exercise
- If your abdominal muscle separation is more than two fingers. Your exercise instructor will be able to help you decide who would be the best person for you to talk further with about this
- You have pain anywhere in your pelvis, inner thigh or lower back
- You have strange and unusual symptoms during exercise like dizziness or fainting
Remember, the best choice for you is to attend classes given by qualified Level 3 Instructors. Ask if your teacher is qualified to teach postnatal exercise if you are not sure. It’s our job to help you.
Authors: Dr, J Helcke, R. Rafiefar Dip. Ed, Dip. BE
Reference: Judy Di Fores Postnatal Guide to Fitness
For more information go to:
Fit and safe to Exercise (http://pogp.csp.org.uk/publications/fit-safe-exercise-childbearing-year