Maternity Physio

I have had the baby, now when can I run??

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It’s such a quick and convenient type of exercise. Just lace up the trainers and go, grab some fresh air and well-earned head space. But how do you know your body is ready for this after having a baby?

The NHS postnatal exercise advice says “It is usually a good idea to wait until after your 6 week postnatal check before you start any high impact exercise such as aerobics or running” What is this 6 week milestone about? Bleeding may have eased and scars may be healed but it can take up to 2 years for torn or stretched muscle to repair and remodel itself fully. In my experience the postnatal 6 week check with the GP has never involved any kind of hands-on assessment of the abdominals or pelvic floor so how can we really know we are ready to start pounding the pavement after its done??

It boils down to this, after pregnancy and delivery, your stretched and weakened pelvic floor and deep abdominals are unable to provide the support needed for your bladder, uterus and rectum when running, which may lead to a pelvic organ prolapse. What’s a prolapse? This is when one or all of the organs mentioned above fall into and sometimes out of, your vagina (yes, for real!). The sling of pelvic floor muscles needs to be strong to keep those things up and in!

The postural changes brought about by pregnancy due to bigger breasts and hormonal changes can also alter your running gait- leading to an increased risk of injury in general. Not good when you’ve got a busy life to lead!

A little facto for your head- You exert 2.5 times your body weight with each foot strike on the ground and your feet strike the ground an average of 160 times per minute whilst running. That’s a heck of a lot of force for a pelvic floor to hold up against.

But I still wanna run!

 

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Ask yourself why do I want to run? Is there an alternative type of exercise which will allow you to get that hit of endorphins without the impact or drag on your undercarriage?? Cycling, spinning, swimming or walking(quick and slow or up a hill)? You may love your running but love your pelvic floor more.

Nope, I still wanna run

Ok, well ignore the usual time-frames given out by some postnatal pundits (or even the NHS!). There is no magic postnatal date when your body will have fully recovered and is ready to run. Sorry if that’s not what you were hoping for…. Everyone has been through a different pregnancy, delivery, possible interventions and postnatal recovery and everyone is starting from a different pre-baby baseline. So why would there be just 1 date given for you to run again? If you want to run, you will need to take your own personal journey to get there. You will need to build yourself up from the inside-out to withstand the pressures applied to your body when running.

Tuning into your pelvic floor is a good place to start from. That is trying to actually isolate and lift in on an exhale-releasing it (also important) on the inhale. Then you an start building the strength by upping the reps (10-12), then add a couple of extra sets of this with a little rest in between. Then you can increase the  number of times you do it during the day (3 times a day is ideal). Stop when it feels tired. If you are not sure if you are doing this right or where it even is! then get in touch with a postnatal or womens` health physiotherapist. Some sessions with hands on feedback or biofeedback can be very useful.

Breathing right is important (not just for the obvious reasons!). Pregnancy can really throw it out of whack due to the change in posture and squished up diaphragm. Avoid upper chest breathing and holding your breath whilst exercising as this will add unwanted downward strain on the pelvic floor. Breath into your lower ribs and concentrate on the exhale (through slightly pursed lips if possible) especially on the effort, this allows your diaphragm to RISE, leaving room for your pelvic floor to RISE (win-win).

Alignment. Stand like you`re not pregnant anymore. SO ribcage should be stacked like a cylinder over your pelvis, as much as you can-sometimes life gets in the way-that’s ok! Just avoid hanging back or thrusted forward like in this picture. pregnant-vectorWhilst running, postnatal fitness physical therapist Julie Wiebe recommends the ski-jump posture, that’s slightly leaning forward, for your pelvic floor to really fire and keep your insides in! Click here for a demo of this

SO that’s pelvic floor foundation set, breathing and alignment sorted, more about that building up from the inside-out. Now, you need to challenge the pelvic floor and deep abdominals in standing to build strength and stamina. So squat, lunge, hula-hoop, balance on 1 leg, pull, push, walk and climb all WITH good breathing and excellent alignment, Walking up inclines (slowly and quickly) is a great way of getting your body used to that ski-jump position for running. It will also get your heart pumping! Then when you have got the hang of all of that, you can start adding in walk/jog intervals and slowly progress from there. This stuff can take a year so be prepared to put in the love and work, you are still exercising! Be good to your pelvic floor now and it won`t let you down later!

 

Signs that your body is not happy and you may need to step it back a bit:

·    Pain (anywhere!)

·    Leaking urine (or faeces)

·    A dragging or pulling sensation down below

If this persists, seek help from your GP or local womens` health physiotherapist

Tips to help:

·    Have a Mummy MOT Check to test your muscles/posture and pelvic floor, and see where you`re at.

·    You can find a good post-natal trainer to guide you through the strengthening stages.

·    Buggy class is an affordable, fun way of carrying out some non-impact cardio with strengthening exercises. Just don’t get carried away by any peer pressure- remember, you are on your own personal journey.

·    Avoid the boot-camp style scenarios, rebounding and aerobic fat burner type classes which tend to be heavy on the old jumping up and down. Nobody likes burpees anyway right?

·    Don’t forget to strengthen your postural muscles that need to hold you up and work hard whilst running , these include the Gluteals, Inner thighs and Lats.


 Useful Links:

www.mummymot.com to find a practitioner in your area

www.hoisticcorerestore.com to find a postnatal core restore coach in your area

www.project-me.co.uk Rachael, Postnatal Trainer at Project Me, Crouch End

www.zest-personaltraining.co.uk Vicki postnatal trainer for outdoor/home sessions in Crouch End

www.trainwithnicola.com Buggy Classes at Alexandra Palace and Potters Bar

www.buggy-belles.com Buggy Classes in Clissold Park

www.youtube.com/user/JulieWiebePT Great videos and a wealth of info on alignment and pelvic floor