By Dianne Edmonds – physiotherapist
After pregnancy, your body has changes and adjustments to make, including the effects of the relaxing hormones of pregnancy leaving your body. These hormones have relaxed the ligaments around your pelvis to allow the growth of your baby and the movement of your baby through the birth canal. The effects of these hormones are thought to last for several months after the birth, or more, and if you are breastfeeding your hormones can be affected for longer. The effects of these hormones are predominantly around your pelvic floor and abdominal muscles after birth.
Once you are ready to start exercising again, consider the softening effects of these hormones, and also think about how long your abdominals were stretched for over your growing baby inside your uterus. Your abdominal muscles after birth have been lengthened and now need to return back into their normal position, shorten and strengthen again. Your abdominal muscles after birth play an important role in supporting your lower back and pelvis. Together with the pelvic floor these muscles stabilise the spine and pelvis. If your abdominal muscles remain lengthened then this stabilisation ability is reduced, and this means that with exercise, including walking, there can be more movement of the back and pelvis. This can lead to increased risk of back pain in some cases, especially if the load that is applied is added too quickly before your body is ready.
One study showed that it takes a minimum of eight weeks before the abdominal muscles after birth are toned enough to support your lower back and pelvis. It can take longer, and in many cases it would be closer to three to four months or more before the abdominal muscles have been toned and retrained enough to provide good support and strength around the spine and pelvis.
One way to test your own pelvic stability is to have someone take a video of you walking or starting to jog, from behind. You can then look at it to see how much movement you have in your lower back and pelvis. If you have a lot of ‘wobble’ in your spine with movement, then it may be that you need to continue to strengthen your abdominal wall further before progressing and building up your level of intensity and activity.
You can also test how well you can maintain your level of stability, as you increase your exercise duration. You might find that with a ten minute walk or jog you feel strong and firm initially, but as you increase the time that you exercise for, the effects of fatigue can become apparent. Pushing through fatigue and ignoring the warning signs felt in your back or pelvis with some extra movement, may mean that your back is more vulnerable to injury or back ache. This can occur as you either increase your activity intensity or duration.
When you have a young baby to look after, there are a lot of extra demands upon you and your body on a daily basis, so taking this into account is an important factor in planning stepping up your program. Sometimes it may be wiser to take a break if you are tired rather than to push through, or to spend a week at the same level of progression to allow your body time to adjust, rather than quickly increase your level of activity.
Post natal abdominal muscle after birth exercises which are steadily progressed are an important part of your postnatal return to sport recovery plan, as are regular pelvic floor muscle exercises.
Even when you are careful with your level of activity and take your time, when you return to sport, monitor how your feel. If you do find that your back or pelvis doesn’t feel strong, or if you get any back ache or pain, reduce your intensity level, and continue to focus on your postnatal exercises, including flexibility and stretches to help your body return back to normal.