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Maintaining Your Fitness During Pregnancy and Postpartum: How Physical Therapy Can Help

If you’re looking to become pregnant, are pregnant, or are postpartum, there are many ways physical therapy can support you through each phase of your journey. Finding a physical therapist trained in treating pelvic girdle pain, pelvic floor dysfunction, and treatment of the pregnant and postpartum athlete is important, particularly if you’re looking to stay active or to return to a specific sport or fitness regimen.

How physical therapy can help:

Assessment of core and pelvic floor function to determine areas of weakness, tension, and/or coordination deficits. This may include diastasis recti, pelvic-floor motor control and strength deficits, sacroiliac joint pain, low back pain, or hip girdle pain via multiple tests and measures to get to the root of your issue.

Instruction on modifications and progressions specific to you and your activity. Whether you’re into CrossFit, Olympic lifting, powerlifting, running, bootcamp, yoga – you name it, our goal is to keep you as active as possible (within your comfort level and with clearance from your doctor), in any stage of pregnancy or postpartum.

Education and management of intra-abdominal pressure. This is extremely important when working with pregnant and postpartum athletes, and it will look different depending on your symptoms and stage of pregnancy. Controlling the pressure within your abdomen during various activities is key to avoiding incontinence (leaking of pee or poop). Yes, this means we can get you back to squatting, jumping, running, and more without peeing your pants!

Assistance with breathing mechanics and techniques. It’s so important to make sure you're breathing correctly during exercise, especially when carrying a baby. This can be difficult to do when lifting heavy or during intense training. A physical therapist can instruct you on when it’s appropriate to breath freely, breath on exertion, or perform bracing and valsalva.

Guidance on managing expectations. This can be one of the toughest parts when trying to maintain or return to physical activity after having a baby. It’s important to understand your fitness level will not be the same immediately after giving birth, and that’s OK! If it is your goal to get back to your previous fitness level (or to go beyond it!), physical therapy can help you set a realistic timeline and progress safely to reach those goals.

Considerations when returning to fitness:

Mode of delivery: Everyone’s birth story is different, and how you delivered will determine your recovery afterwards. Someone who had a vaginal birth will have different considerations than someone who had a C-section when returning to physical activity. This is why an individualized plan of care is so important.

Sport-specific recovery: Your treatment will vary depending on the demands being placed on your body, taking into consideration the intensity and frequency of your training. Having a physical therapist who understands the demands of your sport and can progress you accordingly will make a huge difference!

Fitness before and during your pregnancy: Your ability to return to exercise postpartum is going to depend largely on your fitness level going into pregnancy and during your pregnancy. This looks different for everyone! Remember not to compare your steps returning to fitness with those of others!

Symptoms to watch for:

Incontinence - Leaking of urine during high intensity movements – or even when sneezing, laughing, or coughing – is very common, but it is not normal! Physical therapy can help this issue so you can get back to your normal workouts without worry.

Pelvic girdle pain - Pain felt anywhere from the lower back to the bottom of the glutes. This can include low back pain, SI joint pain, pubic symphysis pain, pelvic floor pain, or hip pain. If you feel any of these while exercising, during sex, or just throughout your day, see a PT who can get to the root of the issue and begin treatment.

Pressure or heaviness in the pelvic floor - This may occur when lifting heavy weight or with plyometric activities, and it can be a sign of pelvic organ prolapse. This issue is also quite common after pregnancy and can be managed with physical therapy depending on symptom severity.

Diastasis recti – This is a separation of the abdominals at midline and occurs with every pregnancy to make room for the baby. It can present with coning or doming in the abdomen, and the degree at which this occurs is different for everyone. When performing core work, you may notice your stomach creating a cone shape down the center: this is a sign of weakness in the abdominals, and it can be improved with the guidance of a physical therapist.

It’s never too early or too late to start seeing a physical therapist for treatment or management of any pelvic girdle symptoms, pregnancy- or postpartum-related issues, or even for maintenance and preventative measures. Reach out to Active Reload Chiropractic & Physiotherapy to find out more information and to begin the journey towards feeling your very best!

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