by Ashley Newton, PT, DPT
Many people who give birth are ‘cleared’ at either 6 or 8 weeks by their medical provider. However, there is often a lot of confusion about what exactly someone is cleared for at that early postpartum checkup. Many people have questions about when they can resume exercising and often interpret that 6/8 week checkup as the green light to start their pre-partum exercise routine.
However, the body has just gone through a multitude of bodily changes associated with pregnancy, labor, and delivery and often needs muscle retraining to be able to exercise safely and without issues that include but are not limited to: pain, urinary leakage, and abdominal separation. Moreover, we know that it is labor itself that is traumatic for the pelvic floor and not the method of delivery (vaginal vs.C-section), meaning that all people who have delivered children have the potential to have pelvic floor issues!
The healing process extends well beyond the 6 and 8 week marks, but
1) there is often limited guidance on how to approach exercise and
2) not everyone gets to see a pelvic floor physical therapist after their pregnancy.
So, how do you know if
1) the pelvic floor is healthy and
2) when to resume exercises?
Check out the tips below to self-check your body’s ability to stabilize itself, aka use the deep core and pelvic floor muscles correctly (this is absolutely essential as you start to exercise again!):
1) Can you contract, relax, and lengthen the pelvic floor musculature pain-free?
When the pelvic floor contracts, it should compress and lift. For folks with vaginas: the contraction should feel like picking up a blueberry with the vagina. For folks with penises: the contraction should feel as though the penis is being drawn toward the abdomen. Do the muscles relax after contraction or are they stuck in the contracted position? Can you lengthen the muscles? Many people have trouble differentiating between pelvic floor contraction, relaxation, and elongation but knowing how to perform each of these movements helps to ensure that the pelvic floor is able to do its job well.
2) Do you have abdominal coning?
Abdominal coning is when the abdomen tents/cones/domes up in the middle with trunk movements. Perform a quick check: In lying with the knees bent, interlace the hands behind the head and lift the head and neck. Does the abdomen dome up or stay flat? If it domes, it means that your body is having trouble managing pressure, aka – the core muscles are not contracting enough and/or at the right time to combat the increase in intra-abdominal pressure when the head and neck lift. This can become an issue when we move as we need good pressure management to move pain-free and prevent issues such as urinary leakage and pelvic organ prolapse.
3) Are you able to perform a single-leg balance for at least 30 seconds?
If you are unable to, your body may be having trouble stabilizing with its deep core muscles. Over time, this can lead to overloading of other tissues and subsequent pain.
These are just a couple of things you can do to begin to self-assess the quality of your movement and start asking more questions regarding pelvic health and wellness in the post-partum period. If this self-check-in created more questions than it answered, it may be helpful to contact a pelvic health physical therapist in your area in order to determine what areas would be helpful to work on in order to optimize your health in the postpartum period and beyond! Check out pelvicrehab.com to find practitioners in your area or come see me in Princeton, NJ!