Maximizing Postpartum Pelvic Floor Recovery (While Staying Active as an Athlete)

Maximizing postpartum pelvic floor recovery is a topic commonly discussed in the clinic. Depending on the pregnancy support available and if there are other kids in the mix, it can be tricky to think about your own recovery since you’ll be devoted to caring for your growing family!  As female athletes, we typically want to jump right back in to our usual routines no matter what causes us the temporary hiatus--injury, illness, or a new baby! However, maximizing postpartum pelvic floor recovery can be simple! Simple things like breath work, proper introduction of activity, pelvic floor therapy, core and hip strengthening, and protein intake can all help you be successful.  This blog post will give you more details on these simple strategies to help safely guide you back into fitness!

Walking and the 5-5-5 Rule

As an athlete, it’s hard to imagine taking time off. However, it’s important to take into consideration the fact that you’ve been growing a baby for 9 months and once that baby is delivered, there is essentially a large wound in your uterus that needs to heal. The 5-5-5 rule helps you figure out how to introduce walking after the baby is born and allows the organs, muscles and tendons to return to their resting position without excessive physical demand.

• 5 days in the bed, mostly feeding, recovering and relaxing. 

• 5 days on the bed sitting in a comfortable and supported position and walking to complete your basic daily needs.

• 5 days near the bed where you’re still having meaningful periods of rest but can be up and about the house a little more. 
  

Strength training

2-4 weeks postpartum: Gentle strengthening exercises can begin at the two week mark to reintroduce core, back, and hip strength as a focus to stabilize the region that was most affected during pregnancy. Focus on breathing (see below) and deep core exercises that target on the transverse abdominis. It’s important to use the first month postpartum to connect to the breath and the deep core.

4-6 weeks postpartum: Start introducing gentle body weight exercise and let symptoms be your guide. Remember, your uterus is still healing at this point! Gradual introduction of activity allows not only time for the body to heal, but also time for us to assess whether or not our bodies are trying to tell us something! For example, if you feel pain, heaviness, leakage or pelvic pressure, consider backing off on the intensity or seek help from a therapist for modifications. 

6-8 week postpartum: Introduce light free weights and resistance bands that can help provide a new stimulus to the muscles as the pelvis, trunk and ribcage begin to come back towards their resting positions. Make sure you use lighter weights than you normally would when you’re just getting started. Monitor symptoms of pain (pelvic, hip, low back), pelvic pressure/heaviness, or leakage. If you are having any of those symptoms, consider waiting 24 hours to exercise again and reduce the duration of the activity. For example, if you spent 30 minutes performing gentle strength exercises and felt increased pelvic pressure the next day, try for 15-20 minutes at your next workout. 

Plyometrics and Running

Generally speaking, waiting until at least the 12 week mark for running, jumping, and power based exercise will be important to allow the body to be prepared for more challenging movements. Consider an assessment from a therapist to see where your strength deficits are the greatest in order to create a customized program for you!

Check out our behind the scenes video on how we perform a running analysis in our clinic

Breath Work

Breath work will help provide the basis for core stability. Working on focused inhalation with emphasis on expanding air into the side body, back body and the pelvic floor helps to improve range of motion in a diaphragm that has been restricted from normal movement during pregnancy. During the exhale, perform purposeful pursed lip breathing to facilitate deep core activation.

Breathing can help to calm the nervous system, as well, making other daily demands feel less intimidating. Breath also provides the core stability components needed for all other higher level activities, so we want to build the basics first.

• If you are interested in a guided deep breathing video, click HERE

Pelvic Floor Rehabilitation

Pay attention to what you feel in your vaginal region. Consider if you had tearing or excessive pushing (>2 hours) during labor and the role that might play in the demand on your pelvic floor. Pelvic floor muscles expand close to 3 times their normal resting length during delivery. As the muscles shrink back down to their standard size, there is a benefit to performing gentle directed strengthening in the pelvic region to improve structural support for organs, improve sexual function and pelvic stability. In order to strengthen the pelvic floor, you can perform voluntary strengthening exercises, such as kegels, or you can train the pelvic floor to turn on within other strength exercises. For example, performing a kegel from the bottom to the top of a squat.

Performing kegels correctly can be difficult and may require feedback from a skilled pelvic floor physical therapist. If you are concerned that you may not be doing them correctly, try to seek out help from a therapist. Keep in mind, scar tissue and trauma can lead to dysfunction in pelvic floor contractions as well, but a therapist will be able to help guide you through the healing process. 

Protein Intake

In the immediate postpartum period, it is extremely important to consume enough protein in order to sustain our recovery in addition to our strength goals as athletes. It is recommended to consume 100 grams of protein daily with most sources coming from high quality meat and eggs as the primary source, if possible. Bone broths can also be a great option to add into your recipes for a nutrient dense base.  If you are vegetarian or vegan, you will definitely want to seek out a good protein powder to help sustain the healing needs of the body.

As athletes, always striving to be better, it’s important to seek guidance for return to sport. Whether you are dealing with dysfunction or not, pelvic floor physical therapy can help provide an individualized framework for returning to activity depending on your goals and your specific areas of weakness.  Our local pelvic health clinic is here to support you, contact us today to start your return to exercise journey!