Resuming sport after childbirth – A short guide

Having a baby brings many changes to a woman’s body. As a result, returning to exercise after pregnancy can sometimes be fraught with difficulties. The main questions I hear as a physiotherapist are:

• When can I start running or doing sport again?
• Can I exercise after giving birth?
• What’s the best exercise after having a baby?

When can I start running or doing sport again?

Your body has just given birth, and a lot of changes have taken place to make this little miracle happen. It’s best to give your body time to get back into shape before getting back into running or contact sports.

To give you an idea, we’re talking about at least 12 weeks, in other words, 3 months. Some guidelines even recommend waiting a little longer before resuming running. It also depends on any complications that may arise after the birth.

Most frequent problems

Whether you had a natural delivery or a C-section, the most common problems remain similar:

• The muscles of the perineum need attention (muscle strengthening and/or healing in the event of a tear).
• Separation of the abdominal muscles (diastasis recti)

Rehabilitation of the perineum: why?

Rehabilitation of the perineum is necessary for 2 reasons.

During pregnancy, your uterus has grown from the size of a lemon to the size of a watermelon. Your baby has grown, as has your placenta, and the amount of fluid has increased considerably. All this weighs very little!

As gravity does its work, it’s the muscles and ligaments of your perineum that have had to support this little world. In some cases, especially if the perineal muscles were already weak during pregnancy, this can lead to genital prolapse .

In the case of natural childbirth, the passage of the baby may have caused a tear in the perineal muscles. Whatever the severity of the tear, your muscles will need to be strengthened, in the same way as any other muscle after a tear.

Why separate the abdominal muscles?

Abdominal separation, also known as diastasis recti, is a common problem for new mothers. As the name suggests, it’s the creation of a space in the abdominal area due to excessive stretching of the abdomen during pregnancy. This may be at the navel, above the navel, or below the navel.

Abdominal separation occurs when the space between the abdominal muscles exceeds 2 fingers (see drawing below). A healthcare professional will be able to assess whether or not a separation is present.

When thegap is less than 2 fingers, you can return to abdominal strengthening exercises without restriction. If you have a gap of more than 2 fingers, it’s advisable to follow a special program with the assistance of a physiotherapist.

To give you an idea, this health professional will give you specific exercises aimed at strengthening the abdominal, oblique, back and perineal muscles. In short, all the muscles that have been overstretched during pregnancy will need to be strengthened. This will be done gently and progressively, to activate these dormant muscles.

Are you wondering whether or not you have abdominal separation? If you notice a “dome” in the middle of your abdomen during certain movements (“doming”), consult a physiotherapist specializing in women’s health for assessment and advice.

Can I exercise after giving birth?

Absolutely. It’s even recommended ! Now that’s a treat! 🙂 Choose a gentle physical activity to start with.

Walking is an ideal activity. You can go for a short walk from day one if you like (and if you feel comfortable enough to do so). It’s recommended that you walk every day, for a total of at least 150 minutes a week. That works out at 30 minutes, 5 times a week.

Finally, from the very first days after the birth of your baby, you can perform exercises to strengthen your perineum and deep abdominal muscles. Kegel-type exercises are often recommended by health professionals specializing in women’s health.

What’s the best exercise after having a baby?

Week 1-6

Light physical activity such as walking or cycling is recommended. For swimming, wait until bleeding has stopped before jumping into the pool. Do gentle Pilates-type muscle strengthening, focusing on the perineum and deep abdominal muscles.

It can be hard to find the time to exercise while you’re looking after your newborn. Don ‘t put pressure on yourself, you’ll find the time when you feel ready. Here are a few recommendations:

• Take advantage of your baby’s “tummy time” (time lying down but awake) to lie down next to him and do your perineum and deep abdominal exercises.
• Go for a walk with your baby in the stroller. Fresh air is good for everyone!
• When your partner (or other caregiver) takes over to look after baby, escape for a quiet walk !

Week 6-12

Six weeks after giving birth, you should see a physiotherapist specializing in women’s health to assess the strength of your perineum and detect any complications.

If all the indicators are green, you’re well on the way to getting back into high-impact physical activities such as running. However, it is advisable to wait until at least the twelfth week before resuming this type of sport.

During these six weeks, gradually increase the volume and intensity of your cardio exercise (walking, cycling or swimming, for example), and muscle-strengthening exercises.

Week 12+

Twelve weeks after taking care of yourself with gentle to moderate physical activity, you should be feeling a little fitter (hopefully your baby will let you get enough sleep!).

If your physiotherapist hasn’t detected any complications at your sixth-week visit, you’ll probably be ready to resume impact sports. If you have any doubts, or don’t feel ready yet, don’t worry. Listen to your body! Give yourself a little more time.

To date, scientific studies show no ideal length of time for resuming running after giving birth. The general consensus is to wait at least 12 weeks, unless there are complications (prolapse in particular), in which case it is preferable to postpone a return to impact sports.

If this applies to you, cycling or swimming may be a better way of continuing to improve your cardio.

Finally, continue with your muscle-strengthening exercises, gradually increasing the intensity. This will give you the muscle strength you need when it’s time to resume your sport, when your body is ready.

Do I need to see a doctor or physiotherapist?

Not being able to hold back to go to the bathroom, peeing yourself when you run, or feeling like your organs are falling out… none of this is normal. Your body is asking for your attention ! These are signs that you need to consult a health professional (doctor or physiotherapist).

As a general rule, it is advisable to consult a physiotherapist specializing in women’s health as early as six weeks after the arrival of your baby. Bear in mind that your return to pre-pregnancy physical activity will depend on any complications during pregnancy and childbirth.

Stay in tune with your body, do the necessary work before returning to your favourite sport, and this will ensure a lasting, trouble-free return to what you love!