Returning to Strength Training Post-partum

Today, Longevity Exercise Physiology Drummoyne, Edgecliff, Marrickville, Bella Vista, Randwick, Pymble, Balmain, Neutral Bay, Coburg – Melbourne, and Barrie, Ontario – Canada  discuss returning to strength training post-partum, common challenges post-partum and how exercise can help.

 

Why is strength training important post-partum?

The two biggest physical issues affecting women post-partum are Diastasis recti abdominis (DRA) and urinary incontinence. The good news is that strength training can help with both!

Diastasis recti abdominis refers to a separation of the rectus abdominis (a muscle in the abdominal wall) along the midline, which is particularly prevalent during the last trimester of pregnancy and post-partum (Gluppe et al, 2018). Despite the high prevalence, the exact cause is still relatively unknown, however it is potentially associated with core and lower back weakness (Gluppe, Engh & Bø, 2021).

Urinary incontinence is also quite prevalent during the last two trimesters of pregnancy and the first three months post-partum, with about one-third of women affected (Soave et al, 2019). This is due to hormonal and anatomical changes compromising the strength of pelvic floor musculature (Soave et al, 2019). The most common types of urinary incontinence include stress and urge urinary incontinence. Stress incontinence is when leakage occurs due to increases in intra-abdominal pressure (e.g., through sneezing or heavy lifting. The other type is urge urinary incontinence, where an overactive bladder leads to an accidental leakage due to an urgent need to void the bladder that cannot be postponed (Soave et al, 2019).

The two biggest physical issues affecting women post-partum are Diastasis recti abdominis (DRA) and urinary incontinence. The good news is that strength training can help with both!

How can strength training post-partum help?

While the evidence on how strength training can help DRA directly is a little contradictory, what is clear is that it can help with body image, physical function and abdominal muscle strength, which are all incredibly important post-partum (Gluppe, Engh & Bø, 2021).

Training pelvic floor musculature is the best way to improve urinary continence. Pelvic floor muscle training leads to increases in muscle volume, which is associated with elevation of the pelvic floor and organs, closing of the levator hiatus, reduction of the pubovisceral length and elevation of the resting position of the bladder. These morphological changes improve support of the pelvic floor, increasing continence (Soave et al, 2019).

What are the guidelines for strength training post-partum?

The recommendations for strength training for post-partum women are the same as the wider population:

60-70% of your one-repetition maximum (1RM), 2-4 sets of 8-12 repetitions, 2-3 times per week, with gradual progression

(Gluppe, Engh & Bø, 2021)

Common exercises for DRA and urinary incontinence include more focused transverse abdominis work and pelvic floor training (Gluppe et al, 2018).

Some exercises that may be helpful include:

• Curl up exercises
• Back-supported core work e.g. heel taps
• Transverse abdominal breathing and activation
• Pelvic floor contractions
• Open chain core exercises
• Diaphragmatic breathing

In addition to more specific core and pelvic floor strengthening exercises, whole body strength training is also important to prevent further decline of muscle strength, which can make activities of daily living much harder.

What are some of the challenges with returning to strength training post-partum?

One of the biggest challenges with returning to strength training postpartum is adherence. Looking after a newborn baby is challenging work and juggling medical appointments and returning to work leaves very little time or energy for exercise.

However, exercise is still the most important thing for recovery post-partum, and to help increase your physical capacity to keep up with all the demands of life, so it’s important to find a way to make exercise a part of your daily routine.

 How can we at Longevity Exercise Physiology help?

At Longevity Exercise Physiology, we’ll provide you with hour long, one-on-one sessions to help you meet the exercise guidelines post-partum, in a way that’s tailored to your likes and needs. As everyone’s body responds differently to pregnancy and strength training post-partum, we can work with you to develop the best possible strength program to help you achieve your goals.

If you are interested in engaging in tailored exercise sessions to help you to return to strength training post-partum give Longevity Exercise Physiology Drummoyne, Edgecliff, Marrickville, Bella Vista, Randwick, Pymble, Balmain, Neutral Bay, Coburg – Melbourne, and Barrie, Ontario – Canada  a call on 1300 964 002 to book in a session today.

 

Written by Vaishnavi Pasupati

 

References

Gluppe, S., Engh, M., & Bø, K. (2021). What is the evidence for abdominal and pelvic floor muscle training to treat diastasis recti abdominis postpartum? A systematic review with meta-analysis. Brazilian Journal Of Physical Therapy, 25(6), 664-675. https://doi.org/10.1016/j.bjpt.2021.06.006

Gluppe, S., Hilde, G., Tennfjord, M., Engh, M., & Bø, K. (2018). Effect of a Postpartum Training Program on the Prevalence of Diastasis Recti Abdominis in Postpartum Primiparous Women: A Randomized Controlled Trial. Physical Therapy, 98(4), 260-268. https://doi.org/10.1093/ptj/pzy008

Soave, I., Scarani, S., Mallozzi, M., Nobili, F., Marci, R., & Caserta, D. (2019). Pelvic floor muscle training for prevention and treatment of urinary incontinence during pregnancy and after childbirth and its effect on urinary system and supportive structures assessed by objective measurement techniques. Archives Of Gynecology And Obstetrics, 299(3), 609-623. https://doi.org/10.1007/s00404-018-5036-6