It can be difficult to know when and how to return to activity and sport after having a baby. Between the dramatic changes our bodies experience during pregnancy, delivery itself, and the changes that follow, getting back into the swing of things can be a challenge.
Oftentimes, women are given clearance to return to exercise at their 6–8 week postpartum follow-up, but that doesn't necessarily mean our bodies are ready to return fully to whatever sport or activity we were doing before pregnancy. Everyone recovers at a different rate, so having individualized guidance is key to safely returning to activity. Seeing a pelvic health physical therapist for an individualized treatment approach can be a game-changer for your recovery!
Let's look at some of the common issues women may experience after delivery:
Urinary incontinence: Research suggests that approximately 1 in 3 women experience urinary incontinence during the early postpartum period, although rates vary depending on the population studied and how symptoms are measured.
Bowel control difficulties: Around 1 in 5 first-time mothers in one study reported anal incontinence at one year postpartum. This includes difficulty controlling gas or stool, so it is important to distinguish these symptoms from fecal incontinence alone.
Pelvic organ prolapse: One study found that 56% of first-time mothers examined three months after vaginal delivery had stage II prolapse on examination. This was a specific study population, and findings on an examination do not necessarily mean someone has symptoms or needs treatment.
Diastasis recti: Separation of the abdominal muscles is common during and after pregnancy. One study of 300 first-time mothers found that 45.4% had diastasis recti at six months postpartum, and 32.6% still had it at one year. The definition and method used to assess diastasis can influence these numbers.
These statistics highlight how much our bodies can go through during pregnancy and childbirth. They also remind us that postpartum recovery involves more than simply waiting for our six-week follow-up appointment.
Our muscles, connective tissues, and pelvic floor undergo significant changes during pregnancy and delivery. Recovery takes time, and the timeline varies from person to person. Rather than relying on a specific number of weeks or months to determine when your body is ready, it is important to consider your symptoms, strength, coordination, and ability to tolerate progressively challenging activities.
Before tackling bigger tasks such as running, jumping, or heavy weightlifting, we need to consider how our bodies are managing the demands of exercise. This may include assessing pelvic floor symptoms, abdominal strength and coordination, balance, and overall tolerance for impact and loading.
Returning to Exercise Requires Time, Patience, and Guidance
The biggest takeaway I hope to share is this: with all the changes our bodies experience during pregnancy and childbirth, we need time, patience, and guidance to safely return to exercise.
Everybody's recovery looks different. Some women may feel ready to resume certain activities relatively early, while others may need more time and support. There is no single timeline that determines when you should be ready to run, jump, lift weights, or return to your favorite sport.
The goal is not simply to wait a certain number of weeks before exercising. It is to gradually rebuild your capacity so your body can tolerate the demands of the activities you want to do.
With this in mind, the guidelines presented here are general recommendations, not a personalized recovery plan. If you are experiencing leaking, pelvic pressure or heaviness, pain, or difficulty returning to exercise, seek guidance from a qualified professional. You can also seek help if you simply want to feel more confident about your return to activity.
My hope is that we can begin to give pregnancy and childbirth the same kind of care and understanding we give to other injuries and physical challenges, helping women recover, rebuild strength, and return to the activities they love with confidence.
At Solstice Physical Therapy + Wellness, I provide individualized pelvic health physical therapy to help women navigate postpartum recovery and return to exercise in a way that fits their goals and needs.
If you would like support with your postpartum recovery, visit solsticeptwellness.com to learn more.
The information in this article is intended for educational purposes and is not medical advice or an individualized exercise program. Recovery recommendations should be tailored to your medical history, pregnancy, delivery, symptoms, and activity goals. If you are struggling to return to activity or want help returning to sport after delivery, consider an individualized assessment with a pelvic health physical therapist.
References
Prevalence of postpartum urinary incontinence: A systematic review
Prevalence and predictors of anal incontinence during pregnancy and one year after delivery
Urodynamic indices and pelvic organ prolapse quantification three months after vaginal delivery
Diastasis recti abdominis during pregnancy and 12 months after childbirth
Goom T, Donnelly G, Brockwell E. (2019). Returning to Running Postnatal: Guidelines for Medical, Health and Fitness Professionals Managing This Population.
Donnelly GM, et al. (2021). Reframing return-to-sport postpartum: The 6 Rs framework. British Journal of Sports Medicine.
