Thinking about returning to high-impact exercise after childbirth? For many years, unfortunately, impact exercise has been a bit of a dirty word in the world of pelvic floor health.
Women’s Health Physiotherapists like myself were taught to caution women against high-impact exercise like running, skipping and sports if they had any pelvic floor muscle dysfunction or if they were in a high-risk category such as being early postnatal.
With regards to the population of new Mums, we were taught to encourage low impact exercise options like walking, aqua aerobics and pilates. There was never mention of the magic time frame that all of this would be ok again.
And for some people, this suited them just fine. They enjoyed this type of exercise and postnatal pilates & pram walking were the end goals for the amount of load & impact they wanted to put on their body.
But for others, their goals were bigger than this - many women wanted to return to running, basketball or high impact gym classes like F45.
And as holistic physios, we would never want to discourage this. If we look beyond the health of a woman’s pelvic floor, then we know that the World Health Organisation recommends regular moderate to high-intensity exercise, and we know that impact exercise is a really effective way of both achieving higher intensity and of increasing and maintaining bone density.
New mothers are often in their 20s and 30s, and this is the time of our life when it’s most important to lay down a good foundation for bone strength so that when we hit peri-menopause, and oestrogen decreases, we have lots in reserve with regards to density in our bones. This is especially relevant for those who have a family history of osteoporosis and/or osteopaenia.
And women who are in their 40s, 50s and beyond who wish to do high-impact exercise should be encouraged to do so as well - although at that age, there won’t be as many bone density gains, a lot can be done to prevent and slow the rate of bone loss.
Not to mention the heart health benefits of increasing the intensity of your exercise beyond walking and pilates.
So my opinion now, looking beyond simply just the health of a woman’s pelvic floor, is that impact exercise should be encouraged, not discouraged, wherever possible.
Star jumps and burpees, and mountain climbers are not the enemies - but problems can arise when a woman wants to do these high-impact options, and they cause issues like joint pain, urinary leakage or prolapse symptoms.
And this is not uncommon - my Masters research project interviewed nearly 400 women who exercise regularly at a gym and found that approximately 50% of them leaked urine with coughing, sneezing or exercising.
After having a baby, or if you may have pelvic floor muscle dysfunction, there are some important things to consider when planning your way back to higher-level exercise. Here are our top tips...
#1 - Return to higher impact exercise is individual
There is no set recipe that suits all. It needs to be tailored so that you can work to the maximal level that your systems can manage without any pain, leakage or prolapse occurring.
#2 - Base levels matter
If you were a runner or sportsperson pre-kids then you’re likely to have a smoother, faster return. If you decide to run for the first time after having kids then there’s a lot more prep work and a longer journey ahead of you.
#3 - Consider your pelvic floor
Pelvic floors are made of muscle & connective tissue, so healing timeframes of these tissues apply just like elsewhere in the body. For instance, we know that an ACL knee reconstruction an average return to play is +10months following surgery with re-injury rates falling with greater rehab length. Don’t expect your pelvic floor to heal within 6-12 weeks. You need to rehab it like any other muscle/injury.
#4 - High intensity does equal high impact
The first insinuates that you are working hard, and the second that you have high loading/reaction forces - but they can help improve one another if prescribed right!
#5 - Consider other daily activities
High impact or high load exercise aren’t necessarily the things in your daily life that will cause the most pressure on your pelvic floor. A cough can be just as much load as running – it’s all about how you manage your abdominal pressures & ground reaction forces.
How FitRight can help you to return to impact exercise
At FitRight we offer FitRight Impact classes which we feel is the missing link in group fitness. There classes are:
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Small group exercise classes, led by a physiotherapist with extra training in women’s health and pelvic floor health, that introduce higher load and impact that the traditional FitRight classes
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Workouts that help you to achieve your goals to do with sport, running or the gym, with your pelvic floor and joint health taken into consideration
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Appropriate for women of any age, however, pre-screening assessments will be necessary to make sure that these classes are a good fit for you.
Spread the word! Exercise classes can be high impact and still ‘pelvic floor friendly’!
