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Returning to Sport After Delivery

By Dr. Brooke Meinema, DPT, FAFS

It can be difficult to know when and how to return to activity and sport after having a baby. From the dramatic changes our bodies experience during pregnancy, the delivery itself, and the changes after delivery, getting back in the swing of things can be a challenge. Oftentimes, women are given clearance to return to exercise after their 6-8 week postpartum follow-up, but that doesn’t necessarily mean our bodies are ready to return in full to whatever that sport may be. Everyone recovers at a different rate, so having individualized guidance is key to safely returning to activities. Seeing a women’s health therapist for an individualized treatment approach can be a game-changer for your recovery!

Let’s look at some of the common issues women report after delivery: 15-30% of new moms report urinary incontinence, 1 in 5 reports fecal incontinence at 1 year postpartum, 56% demonstrate a pelvic organ prolapse at 3-6 months, and 45% had diastasis rectus at 6 months postpartum (and 32% did at 1 year!). Tissues require an estimated 4-6 months to recover following delivery, and the abdominal fascia has only regained about 50% of its tensile strength by the 6-week check-up (requiring closer to 6-7 months before it is ~75+% of its tensile strength). To resume exercise, we need to address these issues before trying to tackle bigger tasks like running, jumping, or weightlifting.

The biggest takeaway I’m hoping to portray today is this: with all the changes our body experiences during pregnancy, we need time, patience, and guidance to safely return to exercise after delivery. Everybody’s recovery looks different. With this in mind, know that the guidelines presented are a generalization and not meant to be specific to each individual. If you are needing further help getting back into exercise, seek guidance from a professional! My hope is we can begin to give pregnancy and childbirth the same kind of care and understanding we give to any other injury we may experience and do right by our bodies.

 

 

 

*Guidance given in this blog is meant to be just that: guidance. It is not medical advice or a specific training program; these graphs are from the articles cited. If you are struggling with returning to activity or hoping for help returning to sport safely following delivery, please see a pelvic floor therapist for an individualized assessment and program.

 

Milsom, I., Coyne, K., Nicholson, S., Kvasz, M., Chen, C. and Wein, A. (2014). Global Prevalence and Economic Burden of Urgency Urinary Incontinence: A Systematic Review. European Urology, 65(1), pp.79-95.

Bø, K. Artal, R., Barakat, R., Brown, W. J., Davies, G. A. L., Dooley, M., Evenson, K. R., Haakstad, L. A. H., Kayser, B., Kinnunen, T. I., Larsénm K., Mottola, M. F., Nygaard, I., van Poppel, M., Stuge, B., Khan, K. M. (2017) Exercise and pregnancy in recreational and elite athletes: 2016/17 evidence summary from the IOC Expert Group Meeting, Lausanne. Part 3-exercise in the postpartum period. Br J Sports Med 51(21), pp.1516-1525.

Shek, K. and Dietz, H. (2010). Intrapartum risk factors for levator trauma. BJOG: An International Journal of Obstetrics & Gynaecology, 117(12), pp.1485-1492.

Stær-Jensen, J., Siafarikas, F., Hilde, G., Benth, J.Š., Bø, K. and Engh, M.E. (2015) Postpartum recovery of levator hiatus and bladder neck mobility in relation to pregnancy. Obstet Gynecol 125, pp.531–539.

Ceydeli, A., Rucinski, J. and Wise, L. (2005) Finding the best abdominal closure: an evidence-based review of the literature. Curr Surg 62, pp.220–5.

Sperstad, J., et al. (2016) Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors, and report of lumbopelvic pain. Br J Sports Med. 50(17), 1092-1096.

Goom, T.,  Donnelly, G. and Brockwell, E. (2019) Returning to running postnatal – guideline for medical, health and fitness professionals managing this population.

Donnelly, G., et al. (2021) Reframing return-to-sport postpartum: the 6 Rs framework. Br J Sports Med

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