Post natal physiotherapy and exercise

Congratulations! You did it. You grew a little human for the better part of nine months. You now have your baby and you are learning this new stage of being a mother.

There are so many new skills – feeding, burping, settling, rocking, changing nappies, delegating domestic tasks (we wish) and hopefully, sleeping yourself. It is a time of massive change for your relationships too. It is not uncommon to have a little friction creep into relationships as you each battle sleep deprivation, differing ideas on early parenting and close proximity.

                                                                                         Becoming a parent whilst wonderful is a stressful and challenging time for both mum and dad.

For the mother, she also needs to heal from the child birth whether that was a vaginal delivery or caesarean section and that healing (both physically and mentally) can take quite some time. Her hormones are somewhat unpredictable too, making her elated one minute and teary the next. Her breasts may heart as she tries to establish breast feeding or mentally she may need to come to terms with not being able to do this. If she is a career woman, this change in identity can be extremely challenging. There is no true guidebook for how to be a parent and it is really hard to know ‘what is normal’ with your baby. During these times, some women they flourish, others just cope and for others it can lead to mental illness. PANDA (www.panda.org.au) state that 1 in 7 women (and 1 in 10 men) will suffer from postnatal depression. 

One way that can help is through having a strong support network and people that truly understand what you have been through and are now navigating through. Having health professionals that can guide and support your decisions as well as listen to your concerns without judgement can help to ease the sense of burden and worry. 

An experienced Women’s Health physiotherapist is an essential part of a woman’s post natal team. A women’s health physio understands what a woman’s body has been through and can assess where she is at now. They understand and can apply the latest evidence of post natal recovery to each and every individual woman regardless of her history, pregnancy and child birth experience. They can also help a woman rediscover her sense of self and identity and help her realise how strong and amazing her body (and mind) truly are by reintroducing her to movement and exercise.

Vital Core Physio post natal physiotherapy assessment

                                                                             Vital Core Mums and Bubs class to help you start moving well again

Around six weeks after the birth of your baby, which is usually the time you return to the Obstetrician or hospital for your check up we encourage you to have a post natal physio appointment at Vital Core. This is such a wonderful appointment where we hear your birth story (and about your pregnancy if we haven’t seen you before), how you feel you went, you joys your fears and any worries you may have. How is your pelvic floor feeling? what about your tummy? Is your back or neck getting sore? Have you worked out the best position to breast feed or settle your baby? We also have the wonderful task of making goals with you for the next 3, 6 and 12 months that as a team we can work towards. Then together we work out a plan that is just for you. It will be a step by step guide with rough timeframes to help motivate you to work towards those goals.

Exercise and the post natal woman

A significant part of any physiotherapy post natal program is movement and exercise. Exercise is a physio’s mantra. Human bodies were designed to move and with this movement we feel better both physically and mentally.

Babies seem small, but they are really heavy once you’ve lifted them up and and down a thousand* times in a single day. Making your muscles generally stronger will build some resilience in them and decrease the likelihood of overuse injuries. Being stronger will also mean you don’t get AS tired with all the activities you have to do every day. This will help your general mood. All new mums need a drug free way to feeling happier every day.

Exercise helps to repair and remodel damaged tissue

Stretched, paunchy tummy. It’s one of the most common reasons new mums want to exercise. The tummy muscles (and tissue in general) get stretched excessively in pregnancy. For many women that results in a rectus abdominis diastasis (RAD or DRAM). You can read more about it here. A stretched, weakened abdominal area may cause you to overload other areas, especially your low back making it sore with all the bending and lifting a new mums needs to do. Learning how to activate the right tummy muscles is a skill that needs to be taught by a women’s health physio and then practiced a lot at home or in guided exercise classes such as Vital Cores mums and bubs or MumFit classes.

The pelvic floor has nine months with the weight of a baby, enlarged uterus and a significant amount of fluid resting on it. It is usually less efficient in the post natal period regardless of delivery mode. Vaginal deliveries also have a risk of pelvic floor damage and at the very least pelvic floor muscle strain – a lot like a sports injury. Learning how to exercise the pelvic floor muscles correctly is associated with a significant decrease in incontinence issues and prolapse risk throughout the rest of your life. Vital Core Pelvic Health physios can help a woman who is concerned about the condition of her post natal pelvic floor – you just need to ask.

Exercise and movement improves your general mood

We all know that exercise stimulate endorphins – the happy hormones. These brain chemicals make us feel better. With all the stress a new mum goes through, she deserves every opportunity to feel good and happy. Exercise has been shown to decrease the incidence and severity of post natal depression.

Weight management and fluid mobility

Many women want to ‘lose their baby weight’ as soon as possible. At Vital Core we promote healthy lifestyle over weight loss for the majority of our patients. The reality is that many women just won’t lose that weight for many months despite their best efforts. For many women, the body holds on to the extra fat stores “just in case”. Most women find that once they are sleeping well, eating well and feeling less stressed (and sometimes actually stopping breast feeding and returning to usual hormone levels) the weight comes off. In the meantime, using exercise to get healthy and strong holds a woman in good stead for life. The exercise will also help move any fluid or puffiness in the lower legs, wrists and face.

Vital Core common post natal recommendations

                                                                                                      Source: www.bjsmreturntorunning

At Vital Core we understand and can apply the current evidence in return to exercise in the post natal woman. As a part of her management we will usually prescribe some home exercises. The type and number of exercises will depend on her and what she wants to do. It is very important that return to exercise is gradual and slow.

Some typical early post natal exercises are;

Pelvic floor exercises. We have so much scientific evidence that pelvic floor exercises decrease the incidence of incontinence as well as the symptoms of prolapse after having a baby. Many women are unable to accurately contract their pelvic floor, especially after having a baby. A Vital Core Pelvic Floor physio can help with this.

Upper back stretching and moving to combat all the strain of lifting and holding a baby. Making a woman feel more comfortable is our first concern. If she feels better, she will move better and rest better. 

Short distance/ time walking. Starting with just 5 to 10 minutes and seeing how you feel. Over a few weeks you can build up to 45 minutes if you feel ok.

Activation of the abdominal muscles. Contrary to many fitness instagram programs, planks and mountain climbers are not route to a flat tummy! They also won’t ‘close the gap’! Please read our blog on RAD. Before you can strengthen any muscle you must learn how to activate it. Don’t assume this will happen automatically.

Glutes glutes glutes! Making the bottom muscles strong is key to helping the low back pelvis and hips feel and move better.

Mums and bubs and MumFit classes

                                                                                                                  MumFit classes are in a circuit style a great step before returning to the gym

Some women find the thought of trying to exercise at home with a baby just too over whelming. Other women want to be pushed a little or have a weekly commitment for exercise. We are so fortunate at Vital Core with our very large onsite gym space to be able to offer classes for all women.

Vital Core mums and bubs and MumFit classes are held several times every a week. Check out our timetable here. These classes are specifically designed for new mums. We only do the exercises you need. No fluff. No fill. You will leave with some sore muscles – but this will be achieved safely. Mums and bubs is especially for the early post natal period or those who feel they need to go a little more gentle for a while. MumFit is a stronger level of post natal class in a circuit style that is a fabulous bridge between mums and bubs class and return to the gym.

We absolutely love our post natal classes and have been running them for more that 16 years. We know that exercising in a group with other mums is social and supportive. Having other babies in the room helps allege the feeling of isolation. It is a safe space to exercise, chat and restore a woman’s body and mind.

Regardless if you want to be strong enough to kick the footy with your kids at the park or you want to return to long distance running Vital Core Women’s Health physiotherapists can help you achieve your goals. Please call the clinic today (83310552) to book your appointment.