Crushing dreams or crushing goals?
There seems to be a common misconception floating around that the general goal of a pelvic physiotherapist is to crush your dreams. And by that, I mean that some women think I will be giving them a laundry list of things they can’t do.
No lifting. Please no heavy weights.
NO. CRUNCHING. STOP THE CRUNCHING!
The thing is, I don’t want to crush your dreams. My goal is to help you crush your goals. As in achieve them. While promoting great function of your core and pelvic floor so you can work on your goals without peeing, prolapsing, or having unnecessary pain.
Sometimes I will give you an honest opinion that you should temporarily stop or modify certain fitness pursuits while working on certain pelvic health goals, but the end goal will be to get you back into the things you want to do. It is very rare that I would tell someone that I truly believe they should completely give up an activity that is meaningful to them forever.
That being said, I do advocate for some dedicated recovery time postpartum to focus on rehabilitation of the pelvic floor and core. If you had surgery or trauma to any other body part, you would likely go to a physiotherapist for at least a few months. Seeing a pelvic physiotherapist after a vaginal delivery or c-section for at least a few visits should be common practice! Pregnancy and delivery are natural parts of life but they are also a huge strain to the pelvic and abdominal region. If you had a hip or knee injury you likely would not start a high impact workout program 6 weeks later. Similarly, when you are “cleared” to start exercising 6 weeks postpartum by your primary care provider, that does not mean that things are necessarily good to go or that it is wise to start a high impact program immediately.
I recommend seeing a pelvic physiotherapist at 6-8 weeks postpartum (or beyond then if that is when you feel ready) so that they can assess your pelvic floor function, check for diastasis, check for prolapse, discuss your fitness goals, and help you return gradually to exercise in a way that will minimize your risk of pelvic dysfunctions. If you start working out and you are leaking or needing to pee right before a specific exercise or feeling like things are kinda falling out down there, please take a break from that activity and get checked out. Those are signs that things ARE NOT functioning the way they should.
How fast can you get back to running/jumping/cross fitting/whatever other things you love? It depends. If you had a relatively straight forward delivery with minimal trauma, your pelvic floor is strong but able to relax, and you somehow have a miracle baby that lets you sleep, you’ll be able to get back into things sooner than a mama who had more trauma, or a weak pelvic floor, or is chronically exhausted.
After my daughter was born I began doing rehabilitative pelvic floor exercises within 24 hours. I did them diligently multiple times a day for about 9 weeks before starting to slack off a bit. I began doing moderate intensity and impact exercise at Stroller Fit Hamilton around 9 weeks postpartum. I went running with walking breaks beginning around 4 months postpartum, I did escarpment stairs while wearing her around 4 months postpartum, I joined a gym to start strength training around 9 months postpartum (I could’ve started sooner but life felt busy before then), and now that the weather is nicer I am starting to run more, do the stairs, and incorporate more jumping into my workouts. My main issue with jumping right now is fear of falling, not fear of peeing. You can see that in my video below - such dainty arm movements! I'm working on developing more power and less "I'M NOT GONNA MAKE IT" feelings...
I am not giving up all forms of impact or higher intensity just because I had a baby. I have done some rehabilitation, I have gradually built up my fitness capacity, and I do things to minimize risk of damage to my pelvic floor while I exercise. I have goals too, and I plan to crush them.