Consider your pelvic floor muscles after birth when returning to sport

by Dianne Edmonds – physiotherapist


Your pelvic floor is made of muscles, nerves, connective tissue and blood vessels and is affected by pregnancy and childbirth. Pregnancy hormones can soften the connective tissue within your pelvic floor, also allowing for your muscles to stretch and open as your baby is born. The effects of these hormones can take time to leave your body. Your pelvic floor muscles after birth (vaginal) can be stretched and the degree of stretch that occurs depends on a number of things. Each woman’s birth experience is individual and unique, and your pelvic floor is impacted by a number of things including:

  • how fit and well it was working before the birth.
  • the weight of your baby when he or she was born.
  • the length of the pushing stage of your labour, and.
  • whether or not you needed assistance during the birth (forceps or sometimes vacuum can further stretch the pelvic floor muscles).

Due to all of these factors being variable, there is no exact or set time suitable for every woman wanting to return back to sport and exercise.  One thing is for certain, you should consider your pelvic floor muscles after birth.

Take into account your level of fitness, your pelvic floor personal fitness, and the plans that you have for the level of activity that you are working towards.

Normally low intensity and low impact exercise can be recommenced around six to eight weeks post birth, after your postnatal check appointment. Walking is suitable to start with when you are ready, in the early weeks after the birth. Start at a comfortable and light pace initially, allowing yourself time to adjust to your post pregnancy body changes, and to assess how your body is feeling each day. Make adjustments for altered sleep patterns and interrupted sleep, plus the adjustment to being a mum, which takes energy that was previously available for your exercise programs. Be kind to yourself and realistic by learning to adjust and monitor according to what your body is telling you at the time.

From six to eight weeks to three to four months is the time many women find that it takes to build back up to their previous level of exercise, however some women may take six to eight or nine months if they did participate in quite high intensity exercise.

If you go back to higher intensity exercise before your body is ready, then it can have an effect on the pelvic floor muscles.

One of the roles of your pelvic floor is to support the pelvic organs, which include the bladder, uterus and bowel for women. pelvic floor muscles after birthThe ‘Boat Theory’ analogy is a good one to be aware of when thinking of the pelvic floor muscles after birth. Imagine that the pelvic organs are like a boat sitting on the top of the water and that the water level is actually represented by the pelvic floor. The ‘boat’ or the pelvic organs, are supported by ‘ropes’ which are the ligaments that support these organs, and these ‘ropes’ attach the boat to the jetty. If the water level is normal, the ‘ropes’ have no tension on them.  If the ‘water level’ is lower after pregnancy and birth, ie your pelvic floor muscles after birth have been weakened and stretched, then there is more tension on the ‘ropes’ ie the supportive ligaments. Until the water level returns back to ‘normal’, there is the chance for higher impact exercise or challenging activities to cause dropping of the ‘water level’ and further stretching of the ‘ropes’. If the pelvic floor muscles after birth do not strengthen again, then the tension on the ‘ropes’ or supporting ligaments is more, and then the ligaments can overstretch and weaken.  This weakening then increases the risk of a pelvic organ prolapse. This is where one or more of the pelvic organs drops down into the vagina, and can be felt as a bulge or as pressure or discomfort in this area.

Avoiding or minimising high intensity and high impact exercises until the pelvic floor muscles after birth are fully ready will be more protective of your pelvic floor longer term, than if you return to high impact exercise too early. Making a plan to steadily progress your level of postnatal fitness to match your current rate of pelvic floor fitness and recovery is better than just ‘jumping back into running, boot camp, heavy or high intensity and high impact exercise.

Please remember to consider your pelvic floor muscles after birth.  Seek advice from your women’s health physiotherapist or your fitness professional trained in pregnancy and postnatal fitness.  You can find a women’s health care professional register here.[block id=”love-stuff-share”]

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