Jenna Schulz
BSc (Hons Spec Bio, Maj Phys), MPT, PhD
Women are often advised to return to activity (RTA) or return to sport (RTS) as early as 6 weeks postpartum, despite undergoing significant physical, physiological and psychological changes throughout pregnancy.
Some changes following pregnancy may include: cardiovascular changes, musculoskeletal changes, loss of bone mass and mental health concerns (such as postpartum depression). Despite these changes, there is minimal guidance regarding the management of postpartum concerns that arise in active women. While some guidelines do exist, most state that RTA/RTS can begin once “medically safe”. Additionally, most recommend engaging in 150 minutes/week of moderate to vigorous physical activity.
Often the recommendations for how often, duration, or what type of exercise to do are not very specific.
What we do know is that like any injury or surgery, the progression through RTA/ RTS should be gradual. Before beginning or returning to physical activity or exercise, clearance should be obtained from a knowledgeable health professional with expertise in female athlete/women’s health (for example: pelvic health physiotherapist, gynaecologist, sport medicine doctor, etc.).
Immediately postpartum, activities such as walking and pelvic floor exercises can begin. However, before progressing to the next stage, you should be screened for any risk factors that could impact a successful advancement, such as incontinence, bleeding, pain, excessive fatigue, etc. You may then progress by increasing exercises to include
low impact cardio and gradually adding in sport-specific, functional exercises.
It is important to remember that each person is different. Instead of focusing on timelines When returning to activity or sport, focus on abilities. The common phrase, “Learn to walk before you run” applies here; If you are unable to tolerate walking without symptoms, then you need to build up more strength before progressing to running. It’s important to pay attention to all aspects of postpartum health; nutrition, sleep habits, stress levels, mental health, breastfeeding, and support systems. Finally, always listen to your body, to help ensure a safe RTA/RTS, and decrease the risk of potential injury.
If you are unsure where to begin or what exercise might look like, working with a physiotherapist who has expertise in pelvic health and sport can help guide you through this process!