Many women are keen to return to their pre-pregnancy exercise routines following the birth. We recommend commencing Pilates six weeks after delivery following your post-natal check from your doctor. In this six-week period, your body will be gradually recovering from the birth regardless of whether it was a vaginal or caesarean delivery. During this time we recommend gentle walking, plus a focus on the pelvic floor muscles (PFM) and deep abdominal muscles. See our Postnatal Fact Sheet and Postnatal Exercise Fact Sheet for more information on the postnatal period.
On commencement of Pilates, whether you are an existing client or a new client, we recommend a one on one assessment with one of our Pilates Physiotherapists. Use of the real time ultrasound machine allows for assessment of correct activation of the PFM and deep abdominal muscles. It is very important that women are aware of how to correctly activate these muscles whenever any type of abdominal muscle exercise is performed to ensure adequate support of the pelvic organs.
As well as combining with the deep abdominal muscles and deep back muscles to help support the trunk, somewhat like an in-built corset, the PFM play an important role in the control of continence and pelvic organ prolapse. If you are concerned that you cannot feel your PFM working or if you are experiencing any of the following:
· leakage of, or difficulties controlling urine, wind or faeces,
· vaginal or pelvic heaviness or a lump or bulge in the perineal area,
We recommended that you seek advice from a Physiotherapist with Post-Graduate qualification in Continence and Women’s Health for a more detailed assessment of this region and a specific pelvic floor muscle exercise programme.
As part of your Pilates assessment, the abdominal muscles will also be checked for presence of a rectus abdominis diastasis. Presence of a diastasis means that any abdominal muscle exercises must be modified and the diastasis regularly checked to ensure that it is resolving satisfactorily. It is also important that the diastasis has returned to normal before any type of abdominal sit-up type of exercise is attempted.
Women who are experiencing lower back or pelvic girdle pain will require specific exercises for the lumbo-pelvic region. Assessment with a Pilates Physiotherapist will help to determine specific focus areas for each client. Generally a combination of muscle re-training exercises along with mobility exercises and stretches is required.
Most postnatal women also require exercises to assist with maintaining a good posture. The reason for this is that so much time spent caring for a new baby is in the flexed forward position. This may lead to pain and dysfunction in the neck, upper back and shoulders, as well as the lumbo-pelvic region. Exercises to assist with improving posture may also be incorporated into a Pilates programme.
A postnatal Pilates exercise programme is recommended to help prepare you for more strenuous activities. Before returning to more strenuous exercise, you must be able to feel a firm and sustained PFM contraction which co-ordinates with any abdominal contraction ensuring adequate support of the pelvic organs. The PFM must also be able to relax following a contraction. Any diastasis, which has occurred during pregnancy, should be resolved and the abdominal muscles must be strong enough to provide good back support. Your Pilates instructor will monitor your general strength and guide you to a return to previous activities.
FOR FURTHER INFORMATION contact your local LifeCare Pilates Centre
Or See a Women's Health and Continence Physiotherapist