Part 4: Getting Ready For Impact

“When can I go back to my gym class and running after having a baby?” is a common question women have after giving birth. Often what is expected in response is a specific time (like after your 6 week check with your GP), however when your body is able to take the impact of running/jumping/crossfit after having a baby is not time related. It is more related to recovery of your post natal body and how prepared your body is for running. Take a woman who ran up until 6 months pregnant and had a relative straightforward pregnancy and vaginal delivery, and compare her to a woman who had pelvic pain in pregnancy which restricted her walking and exercise ability, and went on to have a forceps delivery. There is no way of putting these two women in the one category and give a standard number of weeks postnatal that all women can return to running.

So the question should change to “How do I prepare my body for impact exercise after giving birth?”.

You cannot do non or low impact exercise for 6 weeks after giving birth and then magically expect to be ready for running or impact exercise. A gradual return to impact is what the body needs.

How To Prepare for Impact Exercise

Is Your Pelvic Floor Strong Enough?

The pelvic floor needs time and strengthening exercises to restore normal function. Isolated pelvic floor muscle exercises are essential in preparing your body for impact exercise. See the previous blog post on how to do your pelvic floor exercises. You will need to do your pelvic floor exercises over a sustained period to restore your pelvic floor strength (a minimum of 12 weeks). So before you go back running and jumping ensure you have done enough foundation work on your pelvic floor.

The Return To Running Guidelines http://The Return To Running Guidelines https://www.researchgate.net/publication/335928424_Returning_to_running_postnatal_-_guidelines_for_medical_health_and_fitness_professionals_managing_this_population recommend a pelvic floor check by a women’s health physiotherapist for all women after giving birth before going back to high intensity exercise to assess pelvic floor strength but also the risk of prolapse. This check ensures that you are doing the pelvic floor exercises correctly.

Is Your Body Read for Load and Impact?

Can you walk for 30 minutes without pain, leaking or heaviness in the vagina? If the answer is no then adding impact to your exercise routine is only asking for trouble. If you can walk for 30minutes without issue then you may want to start preparing for impact exercises through a graduated exposure to impact exercise.

Load impact plan

Watch this video for an example of a load impact plan for getting back to running after having a baby https://www.youtube.com/watch?v=T7a0kE0LXVw

Monitor for symptoms of pain, incontinence or heaviness in the vagina. If you are experiencing symptoms during any of the load tests, this is the level of impact your body is ready for at the minute and below are some strategies to help you increase your tolerance for impact and move up to the next level. You can gradually build up your tolerance for impact through adding extra repetitions, increasing speed and increasing the downward force.

Strategies for Improving load management

The pelvic floor forms the base of your core cylinder and when you jump up and down there needs to be a balance of pressure down through the system and pressure up to maintain continence. That means the downward pressure should not exceed the upward pressure. You can increase your upward pressure by ensuring you have sufficient pelvic floor exercises to improve your resting tone in your pelvic floor muscles (you need to do them regularly). Women often mistake this to mean constantly squeezing your pelvic floor during exercise and keeping them pulled up tight, however rigidity decreases the availability of the pelvic floor muscles to support the bladder properly. The pelvic floor muscles actually descend before your foot strikes the ground. They then respond by lifting as you strike the ground. If you have the muscles constantly squeezed the pelvic floor is not able to responds appropriately to the forces of landing, which can result in leaking, so no more clenching tightly down below as you exercise.

Do you hold your breath as you exercise. Breath holding creates rigidity in the upper core cylinder which in turn creates a  downward pressure on the pelvic floor. Try focus on maintaining a relaxed breathing pattern as you exercise to ensure you are not driving unwanted pressure down onto your pelvic floor.

A relaxed tummy is also key. Many women constantly suck in their tummy’s but this has the effect of increasing pressure down on your pelvic floor which may cause leaking.

Pay attention to your body position as you run. I see many women running with the chest up high and arms held rigid. Imagine leaning into your run and powering through your legs. Allow your arms to swing naturally and try not hold them tense.

In summary, do your pelvic floor exercises just not while running and jumping, let your tummy relax, breath and let your arms swing as you lean slightly into the movement. Work at a level where you are not experiencing any symptoms and build from there. Your body may not be ready for a 5km run today but I have created a video to show you an example of a graduated plan for return to impact exercise.

 

Is Your Body Strong Enough for Impact?

Pregnancy changes your body, and your body has to make certain adaptations to compensate for the way your centre changes. You cannot grow a baby without having some impact on the way your trunk and pelvis move. Pregnant runners tend to show a lot of side to side movement (remember that waddle in pregnancy?) and not enough forward propulsion. Small studies have shown that the changes the body makes in pregnancy have not returned to normal at 6-7 weeks post natal. The changes and compensation means mums need to re balance their centre in preparation for impact. So this brings us back to getting back to sport is not a question of time but one of body readiness.

Its not just about pelvic floor strength when returning to impact exercise. Your body needs to be in good physical strength to be able to cope with the added stress of impact exercise.

The Return To Running Guidelines https://www.researchgate.net/publication/335928424_Returning_to_running_postnatal_-_guidelines_for_medical_health_and_fitness_professionals_managing_this_population published in 2019 has given us some guidance on what strength is required before impact exercise is recommended. The authors recommend 4 baseline tests: Single leg shoulder bridge, single leg heel raise, hip abduction and single leg sit to stand. Watch video of the strength tests in action here:

https://thebumproombeyondbirth.ie/wp-content/uploads/sites/38/2019/05/Running-Strength.mp4

Are you able to do these tests with ease? Monitor your body for pain, heaviness or dragging in the vagina or incontinence. If you are struggling you will need to continue working on your strength before adding impact exercise. The Bump Room Beyond Birth Programme is specifically designed to help you restore your bodies strength after giving birth and guides you back to full strength gradually.

 

So How Do I Know I Am Ready?

Get a check by a women’s health physiotherapist. If you have strengthening up your body and have followed the load impact plan about without symptoms then you are ready to start a walk run such as the couch to 5k programme and gradually build form there. Monitor symptoms as you go (ie: pain, leaking or heaviness in the vagina). Move back a level until you are ready to progress if you are experiencing symptoms.

Other Factors To Consider

Supports

I hear from many women who love the EVB shorts. Yvonne Brady in Drogheda is the driving force behind these shorts. She used her engineering brain to come up with shorts that help support the pelvic floor muscles as you exercise.

Sleep

Your body needs adequate rest to be able to perform well so if your baby has been up all night (we have all been there) today may not be the best day to start impact exercise.

Hydration

Avoiding water in the hope you wont leak never really works (our bladder never empties fully) and our muscles need adequate hydration to perform at their best so get the recommended 1.5-2L in a day.

Warm up

When you have a small baby a lot of time is spent sitting feeding and cuddling so you body will need just a quick little warm up stretch to get your nervous system ready for impact exercise and wake up your muscles.

 

I hope you found this information helpful and you now understand that returning to running and jumping is not time related but how able your body is to take the impact. Some women will take longer than other depending on the type of birth and their own muscle strength.

 

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