A Pelvic Floor PT’s Pregnancy and Postpartum Journey

Dr. Brenda here, back from maternity leave!  I’ve gotten lots of questions from clients throughout my pregnancy about what I did to have a healthy, active pregnancy. So I thought I would share my pregnancy experience and my postpartum journey so far.  

Baby Photo
Our sweet little Toby!

My Prenatal Game Plan

I had a pretty smooth, straightforward pregnancy with no complications, and I was lucky enough to be able to stay active the entire time.  In fact, I worked right up until my due date (which is the day I had Toby!) with the help of the awesome therapists at Revitalize Physical Therapy and my chiropractor, Dr. Lee who specializes in prenatal chiropractic care.  But that’s not to say that I did not notice the changes occurring in my body or that I did not deal with some of the most common issues that most women experience. About halfway through my pregnancy, I started to have some low back pain and pelvic pain that came on very suddenly. This was a big surprise to me since I had been doing stabilization exercises and was very mindful of my body mechanics to try to avoid this.  But I still suffered from the pain until I worked with Dr. Ashley at the office to help relax and loosen my muscles that had tightened up - all things that I was not able to do on my own.

Around the same time, I also started to notice how tight my abdomen felt and had a lot of “pulling” across the lower part of my belly.  Some women know this as round ligament pain, but mine never progressed to the point of pain. Regardless, I was able to do some soft tissue techniques that I knew to help loosen these tissues and get some relief.  After a couple of sessions of this, the pulling sensations had stopped and did not return for the remainder of pregnancy. I still believe that this also really helped keep my abdominal muscles intact throughout pregnancy and helped me avoid diastasis recti  (there is no research backing this; it's just my own clinical observation).

Throughout pregnancy, I was diligent about exercise (if I was feeling up to it) and tried to get in some form of activity daily.  My typical routine was strength training 3x/week and walking at least 3x/week. Strength training consisted of barre class and weight lifting, all of which I modified as I got further along in my pregnancy so that it was within my tolerance.  I really tried to listen to my body, rest when I needed it and not push too hard with my exercise. It was quite humbling to me on the day that I had to do the rowing machine while sitting in a chair (shoutout to my awesome trainer Keely at Metabolix for pushing me to keep going!).  By the end of pregnancy, walking was a pretty decent workout for me!

My Postpartum Experience

As I write this, I’m 6 weeks postpartum and on my recovery journey.  Wow do things change! I couldn’t believe how weak I was after childbirth, even with all the exercise I had done during pregnancy.  Everyday tasks, such as getting out of a chair or off the couch, were suddenly challenging. I have been so surprised by how much muscle I lost during pregnancy!  Don’t get me wrong, my body did some pretty incredible things, and I am so thankful for all it has been able to do. But I did not anticipate to feel as weak as I do and to notice the loss of muscle so much.  Big wake up call for me!

Once I was feeling up to a little activity, I began to go for a walk everyday, slowly increasing the amount of time I could walk for.  I also began doing some gentle core stabilization exercises and pelvic floor exercises around 2 weeks postpartum. These exercises are simply to start retraining the muscles on how to work and get them activating again.  After doing these exercises all through pregnancy, I found them much more difficult once I was postpartum because the muscles had shut down. It took about 3 weeks of consistently doing these exercises before I noticed a difference in how difficult they were to do.  For those that have had kids or are currently pregnant, this is SUPER important to remember because without properly retraining the muscles, they do not automatically start working again. This puts you at a high risk for injury down the road (let me know if you want to avoid this by clicking here).  

As much as I feel ready for more strenuous exercise and look forward to resuming my workout routine, I can tell my body is not ready for it yet.  It’s been really important to me to take my time with exercise and start at the basics again (exactly what I teach all of my clients) so that I don’t end up injured later on.  Especially with my job being physically demanding, my body needs to be strong and healthy in order to help others! Taking it easy and going slow definitely has not been easy for me since I am always on the go!  I feel so thankful to have the knowledge and resources that I do to help me through pregnancy and my postpartum period. When I hear other women complain about how miserable they feel physically during pregnancy, it makes me cringe because I know that it doesn’t need to be like that.  There are options out there for you and if you have any questions, please feel free to reach out to me here.

Dr. Brenda Heinecke is a pelvic floor physical therapist and owner of Revitalize Physical Therapy (and a new mama!).  She specializes in helping women live healthy, active lives. Dr. Heinecke frequently presents on these topics to further educate women in the community.  In addition, she has a special interest in working with female athletes during and after pregnancy.

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