When to STOP exercising Postpartum
When to seek help before retuning to exercise:
How to know your limits-
A lot of us are so ready to get back to the gym or on the road - here are a few considerations to be aware of for when to STOP.
There are a lot of comments being thrown out there on when to start, how to start, where to start and what to do…but what we need to understand before that is when we need to truly ask for help returning to the things we want to do, specifically running. There are several considerations for you to be aware of and many that need to be discussed with your provider before starting back.
The old guidelines of waiting 6 weeks to do any exercise is now being challenged and more of us are starting back to our favorite things earlier than ever. BUT - running can be different due to the repetition of the movements and requirements of the full system to work collaboratively, consistently and reflexively. There are a lot more research projects being performed to help us understand when and how to get there the safest. Screens are being established and as with all medicine - we are continuing to practice with the newest evidence and of course base all our decisions on the actual person present with their legitimate concerns, goals, and presentation.
What are those things that we need to know to STOP or prevent us to getting back at it?
This is a list from a recent article from the Academy of Pelvic Health Physical Therapy in June 2022 - This list is what we should consider to help keep women safe in returning to any exercise, not just running.
Vaginal bleeding - if you are experiencing bleeding not associate with your cycle or an increase in bleeding 8 week postpartum this is a contraindication of continuing and warrants a call to your OB
Any abdominal pain
Blood pressure instability - BP increase or decrease that is not associated with the amount of effort or that is beyond exertion timeframe
Pregnancy related conditions in which the clients provider has advised against vigorous exercise - example: Postpartum Cardiomyopathy
Post-C-Section should be cleared by provider before returning to run
Breathing difficulties - this with running can lead a whole host of issues due to the canister and core control relationship. Obviously, if you can’t breathe, your body can’t recover from any exercise participation
Chest pain
Dizziness
Neurological conditions - fainting, ataxia (unsteady walking), muscle weakness influencing balance and safety
Calf pain or swelling that may indicate a deep vein thrombosis
Strong is the new skinny
Doing your favorite activities and exercises is a great way to stay strong mentally and physically.
If you experience any of these or have a known condition that would prevent vigorous exercise - consult with your medical provider or OB before continuing.
Chat with you provider -
Work on the concerns with your health care providers, coaches, instructors and therapists to work on things from all angles.
This is a list of considerations that may not prevent you from resuming running, but need to be watched/monitored or assisted by a Pelvic Floor Physical Therapist/specialist and or your referring provider.
Unassisted pelvic floor dysfunction like urinary or fecal incontinence (if this is present - we can gradually manage symptoms and modify exercise prescription, gait, support options of organs and manage expectations with physical therapy in collaboration with a uro-gynecologist, OB/GYN or their provider)
Running related injury that was present before delivery (knee, ankle, foot, back pain…deal with these to prevent compensations and further injury)
Significant increase in BP to >250/115 or decrease in systolic >10mmHG without ischemic conditions
WHO CARES?
I write all of this for my own benefit as a provider to help remind me of the things that I cannot control and the things that we all need to screen for. I also know that I am limited as a provider in that I cannot treat everything nor is it appropriate for me to do so. I also write this to help other ladies and even trainers, PTs, instructors and collaborative providers to be reminded of this as well and use it as a guideline. This was not my own creation but based on the exclusion criteria for an amazing article written just this year. I will link it here and you can read it yourself.
As a pelvic health provider, mom, and athlete, I love assessing new moms who want to be proactive and healthy. I want to help other moms avoid the embarrassment and frustration of the issues I had - abdominal separation and relearning how to find the core, leaking with jumping, back pain, limitation with lunging due to pelvic pain and - of course - mental stress of not having someone to whom I can just ask my questions and gain that extra self confidence and “atta girl”.
Questions about prolapse…what is that??
Why does it feel like its horrible to poop?
Why can’t I side shuffle without feeling like my insides will fall out?
Why do I still have a pooch in the lower belly?
Why does my freaing back continually feel jacked up and I can’t sleep on my belly anymore??
Why does it hurt to have sex?
If you are good to go with all of the issues in the first 2 sections and do notice some of these questions - maybe it’s time to reach out to a Pelvic Floor PT. I have a free screening tool at the top you can self check without anyone else knowing…just click the link under resources.