Getting Stroller Strong Safely - Prioritise Core & Floor

An informative article for postnatal ladies desperate to get exercising again-like me! If you've recently had a baby and have been cleared at your 6 week check up for exercise, you may want to read this to get a better idea of how to return to exercise safely.
 
Why new moms should work with a postnatal specialist: 

🤸‍♀️ We encourage moms to take it slow and choose low impact options during their first weeks back working out.
🤸‍♀️ We provide low impact exercises (and a higher impact alternative for moms who are well past their recovery period).
🤸‍♀️ We think it's perfectly fine for a new baby to distract his mom for part of the workout, because he is helping to be sure his mom doesn't overdo things in the early days.
🤸‍♀️ A group class provides a safe and fun place for moms to get out of the house, to start exercising and to feel better about themselves and most of all, to meet other moms who are in the same stage of life.

Please contact me at www.sarahlouisepearce.com for further information.

How to Restore Your Core and Pelvic Floor Postpartum

By Sabrina Grotewold (Source: Active Kids.Com)

After a few weeks and possibly months of being cooped up in the house with your cuddly, adorable, often ravenous newborn, going for a run—despite crippling exhaustion—probably sounds as good as a spa day or a free trip to a tropical island. Slow that run down to a walk (even a race walk, which can burn just as many calories as running. It just takes longer.) and consider this: Your recovering body may not be ready to resume high-impact activities in the first few months postpartum. 

"We're dealing with a pelvic floor that is functioning very differently than it was pre-pregnancy so we really need to make sure that we are training women to heal their core and pelvic floor from the inside out, build a really strong foundation and then we can start to get back to more intense forms of exercise like heavy lifting, running, cycling, triathlon," says Jessie Mundell, personal trainer, owner of JMG Fitness Consulting and coach who specializes in postnatal recovery. "We are far more effective if we take the time early postpartum to heal and recover well."

A study published in the International Journal of Obstetrics and Gynecology revealed that vaginal delivery caused partial denervation (loss of nerve supply) of the pelvic floor in most of the 96 study participants. In a few severe cases, this condition was associated with urinary or fecal incontinence and for others, the denervation likely contributed to prolapse or stress incontinence. Another study published in the British Journal of Surgeryinvestigated the occurrence of incontinence in a small group of women five years postpartum. Roughly 36 percent of women experienced incontinence five years after delivery, and researchers discovered weakness resulting from partial denervation of the pelvic floor in these women. 

The takeaway: Even if you are one of those lucky women who doesn't suffer from incontinence or prolapse after delivery, your core and pelvic floor need to recover, realign and get stronger after having a baby. And it's wise to start this process before resuming activities like running to prevent injury. 

Prioritize Core and Pelvic Floor Work First

Julie Wiebe, a Los Angeles-based physical therapist who specializes in women's health, recommends switching to low-impact aerobic exercise postpartum until the pelvic floor is strengthened. Wiebe's pelvic strength-training plan begins with proper posture and reconnection with the pelvic floor. Exercises are first completed in a half-kneeling position before progressing to single-leg moves. 

An easy introductory move: Lie on your back with your pillows tucked under your butt or lie on top of a Swiss ball; inhale and exhale, feeling the slight descent and rise of the pelvis as you breathe.

Similarly, Mundell's postpartum program includes an eight-week "core-floor restore" program of daily core and pelvic floor strengthening exercises that can be completed at home in 6 to 7 minutes. Mundell recommends that women visit a pelvic floor physiotherapy specialist for an internal exam to ensure that the pelvic floor muscles are functioning well and there's no prolapse of the organs happening; she has healthy clients wait two weeks after delivery to begin the two-phase regimen. The first four weeks focuses on rebuilding a strong foundation—important recovery and healing is still taking place during this early postpartum period so Mundell keeps moves basic with an emphasis on restoring proper alignment. 

"In pregnancy, we tend to see alignment change because there's so much weight on the front side of the body—usually the pelvis will drive forward and the rib cage will fall back to counteract the new weight on the front side of the body," says Mundell. "Postpartum, we're seeing that still happen, so we need to adjust and get that rib cage back over top of the pelvis in order for our body to create core stability." 

The second four weeks is a kicked-up strength-building phase that includes core training, abdominal activation, low back moves and exercises for the pelvic floor and glutes. Mundell usually gives the green light to return to total body, low-impact, interval-based strength training at six weeks postpartum.

"Circuit-style training can be great for keeping the heart rate pretty high during the workout. Say we have a circuit of 4 exercises with 10 to 15 reps of those exercises and we go through rounds at a pretty quick pace with good form," says Mundell. "Then we rest and let the heart rate come back down before getting back into it. That's what we typically want with cardio activity—interval training, which is usually our biggest bang for our buck if we're talking about fat loss."

To be clear, none of Mundell's workouts include high-impact moves in the first four to six months postpartum. Mundell recommends low-impact strength training circuits, walking, swimming and even cycling as preferred forms of exercise and stress release during this critical recovery period. 

"In pregnancy, we have all this weight, this downward pressure onto the pelvic floor, organs, muscles and connective tissue. Not only do we have that weight pushing downwards, but we also have hormonal fluctuations in the body that are making the connective tissues more lax and loose," explains Mundell. "We just don't have the support in the pelvis that holds vital organ—the bladder, uterus and rectum—up in the spots they should be in [postpartum]." 

Resuming or starting impact activities like running, where your feet strike the ground hundreds of times per minute, on a core that isn't stable can cause injury and exacerbate conditions such as incontinence and prolapse.

"What stats are telling us is that 50 percent of women who have been through pregnancy and childbirth have some degree of prolapse. There are many degrees of prolapse—grade 1 through grade 4 is how they're scaled and that can be that the organs are starting to fall a little bit in the pelvis, and in some women we see the organs pushing out of the vagina," says Mundell. "We need to be aware of this, and that's the biggest thing that we're concerned about in the postpartum return to exercise—making sure the organs stay up where we want them to be." 

It can be challenging mentally and emotionally to delay a comeback to running, CrossFit and other high-impact exercise during the early postpartum phase when all you want is to get out of the house, release stress, incinerate calories and do something positive for yourself. 

Try to look at it this way: Your body morphed dramatically over the course of about 10 months to nurture the development of another human life. Bouncing back to a state that closely resembles your pre-pregnancy self can take just as long—if not a little longer than 10 months. Your body needs a few months to recover from the changes and trauma of delivery, not to mention that you'll be pining for sleep and relaxation after caring for a newborn.

Even if you decide not to take Mundell's cautious approach of waiting six months to resume running after childbirth, invest as much time and energy as you can in strength training—particularly in core and pelvic floor conditioning. It will do you a world of good when you decide you're ready to lace up and head out for a run. 

Squat Your Way to a Restored Pelvic Floor

The traditional prescription for strengthening the pelvic floor: Complete 2 to 3 sets of 10 kegels three times a day. But kegels tighten the muscles of the pelvic floor and, according to Katy Bowman, biomechanist, author and director of the Restorative Exercise Institute, pelvic floor weakness results from too much tension, so further tightening those muscles can be counterproductive. Instead, Bowman favors alignment work, hip and calf stretches, and the squat for lengthening the muscles of the pelvic floor and strengthening the glutes. Start with an assisted squat; here's how:

1. Hold on to both sides of a doorknob or pole and extend your arms--this is how far away from the door you should be for the squat. Place a rolled-up towel under your heels to keep the shins in a vertical position. 

2. Move your knees back until they're aligned with your ankles to untuck your pelvis. 

3. Squat down as far as you can go until your knees feel like they need to move; keep holding on to the doorknob for assistance. 

4. Squeeze your glutes as you slowly lower back up to the starting position. 

Aim for 5 to 10 squats to start and progress as you get stronger. You want to target your backside, not your quads; this is why untucking the pelvis and keeping the shins in a vertical position is emphasized—it transfers the bulk of the work to your glutes. As you get stronger, let go of the doorknob.

Sarah Pearce