The 6 week postnatal check- that’s when you get the all clear and it’s back to business as usual, right?

That’s how I remember feeling anyway, and from my experience training new mums, I know I’m not alone.

I remember sitting there and asking, “So I’m ok to go back to exercise now?”

And I got lucky, because my GP said yes, but advised that giving birth means my body had been through some big changes, and 3 months would be better, to really have time to recover.

That, plus having a baby who didn’t sleep well, plus geting mastitis at 3 months postpartum, meant that I didn’t get back to training as quickly as I had planned. Which probably saved me from doing myself some harm.

Because although I’d been a personal trainer for 7 years, I didn’t have any postnatal qualifications at that point, and the general message I’d absorbed from the media is that if you’re in good shape you should ‘bounce back’.

And I was fit, so I should be fine. In fact, because I worked in the fitness industry I felt I should be seen to recover and get my fitness back quickly, and I was very fortunate to have a doctor who gave me some good advice (and to be too exhausted to argue with it)!

Because The 6 Week Postnatal Check Does Not Mean You’re Ready To Exercise!

However, this hinges upon what your definition of ‘exercise’ is. Because I could also say you don’t need to wait 6 weeks before you exercise.

The problem I come across is that many doctors aren’t specific about what they mean by exercise. So while they’re thinking a few walks and pelvic floor exercises would be good, I know a lot of women will be thinking ‘back to my old workout routine.”

What Happens If You Do Too Much Too Soon.

Even though you might feel ok at your 6 week check, it takes so much longer than we realise to recover from childbirth. Then there’s the pregnancy hormones, lack of sleep and breastfeeding to consider. I’ve written here about postnatal recovery already, and the potential consequences of too much exercise too soon, and this blog is a must-read example of what happened to one mum when she returned to exercise too quickly.

Your Pelvic Floor

The pelvic floor is the area that often pays the price if you overdo it, and unfortunately this is one of the things your doctor probably doesn’t tell you.

Pelvic Organ Prolapse is when 1 or more of your pelvic organs (bladder, rectum, uterus, intestines even) move out of place, and prolapse down into the wall of the vagina. I had 2 children, did my ante and post natal exercise qualification, and still hadn’t heard of this. (I’ve since studied both pregnancy and postnatal exercise to a higher level to rectify the gaps in the fitness industry’s basic training!)

And I really wish GPs, or even the hospital/ homebirth team, would give new mums some information on this AS STANDARD! Because prolapse can have such a huge impact on your life, I’m sure a little information would lead to a lot of mums making far more sensible decisions.

Diastasis Recti

This is something else that I really wish GPs would check, but generally they don’t. I can count on 1 hand the number of mums I’ve met (out of 100s) who have had their diastasis checked at their 6 week appointment. For more information about what exactly diastasis recti is, read this blog, but it’s another biggie in that if it isn’t healed, you’re at a higher risk of injury or pelvic floor problems if you do too much too soon.

doctor 2In fact, I don’t know about you, but my 6 week checks have been a quick blood pressure check and then asking what contraception I was using. In case the 6 week baby wasn’t enough!

In many cases the check up is more about the baby than the mum, and even though one of mine was a seperate appointment than the baby check, it still didn’t go anywhere near as deep as it should. The only way to know for sure what’s happening with your pelvic floor is too see a Women’s Health Physio (if you’re local to me I recommend some here).

So What Can I Do?

I said before that you don’t have to wait for 6 weeks until you exercise, and you don’t. But I’m talking about exercise so gentle you may not even think of it as exercise.

You’re advised to start your pelvic floor exercises (kegels) as soon as you’ve had baby, and you can start doing some gentle deep core connection work after a few days. Even with a c-section, you can do these from around 7-14 days. I do this with clients and mums doing Restore My Core, as there can be a loss of responsiveness in those muscles, which needs to be restored.

Following on from this, progressing to glute exercises to promote pelvis and hip stability is also beneficial. This, plus some gentle walking when you feel up to it (and I’d advise a few weeks rather than a few days for that) can help in a number of ways:

Faster Recovery Post Birth

The pelvic floor exercises will increase circulation to the area, helping to heal any tears, and both the core and floor work will help your nervous system to re-connect to these muscles.

Healing Diastasis and Preventing Incontinence

The right exercises, especially those that involve the deep transversus abdominis and pelvic floor, will help to heal diastasis recti. And pelvic floor exercises will help you regain control if you’re suffering from any leaking post-birth.

Reduced Pain

Having a stronger core will help take the pressure off your back muscles, which have to pick up the slack when the rest of the core isn’t functioning properly. Some gentle stretching and release work can help with this too.

The best course of action is to follow a specific post natal restorative programme, such as Restore My Core, but to learn more now you can download my 10 Tips for getting into shape after baby. And remember- the most important thing in the early postnatal period is rest, and when you do start exercising it should make you feel better, not worse. If you feel fatigued after you may have over done it. Listen to your body, and take it slowly.

So, you’re ready to get started. You’ve read my last blog about how long you should wait before running after baby, and it’s time to run.

Running is a great form of exercise- it’s free, and anyone can do it, anywhere. But it’s an advanced exercise. Your feet will hit the floor about 1500 times per mile: that’s your body weight plus the extra g-force, and if you’re carrying any extra pounds then that’s pretty intense.

I can’t remember where I heard this (I definitely stole it from somewhere!), but it’s so true:

training running

So Let’s Make Sure You’re Ready!

I don’t just mean make sure you’ve recovered from giving birth. I mean let’s get your body ready to cope with the stress, and get better results when you do run. Here are 5 tips to get you ready.

1. Incline Walks.

I know, I know. You want to work. Really feel like you’ve built up a sweat, get that kick that only running gives. And you will. Seriously. Hiking up a steep hill is hard work, and it’s perfect for preparing to run.

More so than walking on a flat surface, a good hill will get you using your arms and rotating your body, just like you do when you run. This will help your running technique. It requires loading and control on one leg, like running, but without the impact. And all this means you’re integrating your core and building the strength needed to run.

So if you haven’t yet, spend some time doing hill hikes before you start the running regime.

2. Build Your Butt!

The bum, or glute, muscles, are important for a number of reasons: they help maintain posture, play an important role in reducing the risk of injury (underactive or weak glutes mean more strain on the back, hips and knees), and they help to balance the pelvic floor by keeping the pelvis in alignment.

Those hill walks will do a great job of getting your butt working, and here are a few exercises you can start doing right now to work on your glute strength. Click here to find out where to buy the minibands.

Kickbacks.

I love these because you’re standing up and on 1 leg, so it engages your core too. This exercise really focuses on making sure you get a good extension behind your body. So many runners just fall forwards from one leg to the other, rather than using their glutes to propel themselves forwards.

Side Steps.

These work the butt muscles at the side of the pelvis, so help to keep it stable when you’re on 1 leg. Having strong muscles on the outside of your hip helps to keep your knees in line and prevent injury.

1 Leg Miniband Squats.

A lot of people struggle to keep their knee in line when they stand on 1 leg and it moves inwards instead of staying in line with their toes. This is a corrective exercise where you use the band to pull on the working knee: the muscles on the outside of your hip have to work harder to fight this pull and keep your knee from moving in, thereby getting  better at doing this, even when the band isn’t there.

3. Breathing

How you breathe has a huge impact on your core and pelvic floor. I explain how in more detail here, but essentially your diaphragm (your main breathing muscle) and your pelvic floor work together, along with your core. If this system isn’t functioning properly you increase your risk of incontinence when you run.

A really important point here is to make sure you’re not tensing or pulling your tummy in while you run. It’s not always easy to do- when you’re working hard it’s difficult to stay relaxed. I see a lot of runners with tense shoulders, jaws or fists, and tummies can tense up too. This interferes with the natural movement of the core as you breathe and puts more pressure on your pelvic floor.

4. Alignment

This links to your breath- you need to keep your ribs over your pelvis so that your diaphragm and pelvic floor are in their strongest positions. ribs over pelvis

You also need to keep your pelvis in what’s called a neutral position. This means your bum shouldn’t be tucked under and your back flat (more about this here), but untucked so there’s a slight curve in your low back. If your bum is tucked under then your pelvic floor is left in a weak position and you’re at risk of- you’ve guessed it!- leaks. The butt exercises above will help with this too.

5. Reduce The Impact.

As with anything, build up slowly. Start with slow, short jogs or intervals, where you jog then walk, jog then walk. This gives your body time to adapt and get stronger, so you’re less likely to suffer the result of your pelvic floor giving way as a result of too much, too soon.

Other key things to bear in mind when planning your run:

Running surface.

Grass, gravel and sand will all reduce the impact on your joints and pelvic floor. Try to avoid alwasy running on the pavement.

Reduce your stride length.

A long stride will lead to a heavier landing on your heel, and more impact. Take smaller strides and land with your foot under your body, rather than out in front.

Avoid downhill running.

Downhill running tends to result in a heavier landing and more impact, so try to stick to flat surfaces, or walk down hills.

Vary your workouts.

Include other forms of exercise in your routine to give your body a break. Cycling and swimming are great pelvic floor safe cardiovascular workouts, and a good resistance programme will complement your running, as will yoga or pilates.

If you still feel you need help getting fit to run then personal training can help, giving you a programme to build up to running again, or to complement your existing running routine. If you’d just like a chat about where to go next with your training, or what help you might need, then get in touch here.