The League of Extraordinary SuperMoms: Why postpartum matters for athletes
Postpartum is so much more than that non-glamorous period after having a baby when you are a sleep deprived zombie doing whatever you can to keep your pooping, feeding, sometimes sleeping mini-human alive. It certainly lasts more than 6 weeks, which is usually when most doctors say you can get back to what you were doing before (what is this “before” you speak of?). Your bun might be out of the oven, but your body is not “back to baseline” and these changes can impact you ability to tolerate exercise.
Let’s take a look at the whole postpartum picture and how it can influence your return to exercise.
First off, let’s set the record straight. I like a good schedule as much as the next person, but unfortunately we cannot define postpartum with a neat little timeline. It fluctuates based on things such as how many pregnancies you have had, the type of birth, whether or not you are breastfeeding, etc. Some researchers have even suggested that the postpartum recovery could take longer than 12 months. This all needs to be taken into consideration when working with a mother who has recently given birth.
Now that that is out of the way, here are a few key physiological changes to keep in mind when returning to exercise postpartum.
Postpartum Depression (PPD): Due to its prevalence, PPD is the most common serious postpartum disorder, despite it often going undiagnosed. PPD, like many mental health conditions, is best addressed with a multi-pronged approach which could include both pharmacological and non-pharmacological treatments. Physical activity like walking with the stroller and home-based exercise programs have been shown in the research to help decrease PPD symptoms. It is an added bonus if you can get outside for some vitamin D! That being said, please seek the help of a trusted health professional if you think you have PPD.
Breastfeeding and lactating: Producing breast milk requires a lot of calories. Exercise also requires a lot of calories. If you are looking to exercise while breastfeeding or pumping, not only will you need to up your sports bra size, you will also need to intake more calories. It is a debunked myth that exercise negatively impacts your breast milk volume, composition, etc, so long as you follow a few simple guidelines. A few key pointers are to maintain your hydration status, ensure your calories in>calories out, and you should not be losing >1lb/week. Consult your physician, dietician and/or nutritionist for more detailed guidelines!
Increased risk of tendinopathies: This one would have been good to know when I hurt myself at 3 months postpartum! There is a lot of research looking at hand/wrist tendon injuries in new moms, but the theory should hold water (literally and figuratively) for other tendons in the body. Due to hormonal changes, our bodies hold on to more water, and that fluid retention in tendons can lead to thicker tendons that are not stronger. Add some repeated mechanical stress to that tendon in the form of exercise, and BOOM - you have a tendinopathy. On top of that, if you are still lactating or recently stopped, you might still be a bit hypermobile, which increases the muscle demand in order to generate stability. This can be prevented with guided, intentional strength training.
Low back and pelvic girdle pain: I see a lot of this with my expecting and new mom clients. If we are dealing with regular low back and pelvic area pain, then a progressive strength training program that looks to build your core, back, and hip muscles should do the trick. It doesn’t have to be complicated, and it doesn’t have to take a long time, but it does require consistency over the course of weeks, and increasing the difficulty level of the exercises.
Increased risk of sacral stress fractures: This should be considered as a differential diagnosis for persistent and significant low back pain that does not respond to conservative treatment. Risk factors for developing a sacral stress fracture include: pregnancy related osteoporosis (this is a transient state, not a permanent condition), vitamin D and calcium deficiency, and high birth weight of the baby. A confirmed stress fracture would mean holding off on training until the bone is healed enough to tolerate a gradual reintroduction to exercise.
While this is not an exhaustive list of the conditions faced by postpartum athletes, and doesn’t address conditions such as postpartum fatigue (anemia, thyroid dysfunction, etc), urinary incontinence (see your friendly neighbourhood pelvic PT!), prolapse (see previous suggestion), it does highlight the changes your body continues to go through well beyond the delivery date of your baby. Working with someone to guide you along your postpartum return-to-exercise journey can be helpful! Interested in learning more? Drop me an email or book an appointment with me online!
