Tuesday 28 March 2017

Fit club

So you’ve got the healthy-eating part sussed but how about your exercise regime? Chartered physiotherapist Jenny Branigan offers tips on getting back into shape post-baby

Jenny Branigan

CONGRATULATIONS! You’re a mother! This is an exciting time learning to care for your baby and getting used to new feeding and sleeping regimes.

Pregnancy causes many body changes that do not immediately return to normal after the birth. Fatigue, weakened abdominals, breastfeeding demands and the day-to-day care of your baby can make it difficult to regain your strength and your figure. But it is important to build some exercise into your daily routine as early as possible. Current evidence suggests that as long as your pregnancy and delivery were uncomplicated, mild exercise such as walking, pelvic-floor exercises and stretching can begin almost immediately.

There are many benefits of post-natal exercise including:

? Increased energy levels
? Improved cardiovascular fitness
? Enhanced mood
? Reduced anxiety and depression
? Weight loss
? Pelvic-floor strengthening may reduce the risk of urinary stress incontinence.

After a Caesarean section or complicated delivery, medical clearance must be given before resuming exercise and would usually not begin until after your first post-natal check-up at six weeks.

What can you do in the first six weeks?

Pelvic-floor strengthening, basic abdominal work and walking are very important in the early post-natal days.

1. Pelvic-floor strengthening should be done by all women regardless of how they delivered. The pelvic floor is like a hammock, supporting your bladder, uterus and bowel. After supporting the growing uterus in pregnancy, these muscles need strengthening.

Activate your pelvic floor now!

? Sit or lie in a relaxed position
? Squeeze your pelvic-floor muscles as if trying to stop yourself from passing urine
? You should feel a lift upwards and tightening sensation around your bladder and vagina
? Hold for three–five seconds and continue to breathe normally
? As you get stronger, hold for 10 seconds and alternate between slow and fast muscle contractions.

2. Basic abdominal exercises that can be done include pelvic tilting and activating the deepest core muscle, the transversus abdominis, in conjunction with exhalations. The deep abdominals are the body’s natural corset supporting the vital organs, spine and pelvis. The surface abdominals may split during pregnancy to accommodate your growing baby (this is known as diastasis). If you notice a bulge in the midline of your abdominals when you exert yourself, you should have them checked by a chartered physiotherapist. A specific programme of abdominal bracing and strengthening will be necessary to resolve this separation.

3. Walking your baby is great post-natal exercise without the need for equipment or babysitters! Strolling in the early days leads to interval training with speed work and even hills as you get stronger. Don’t forget to have a bottle of water with you whatever the weather.

Six weeks later …

Aerobic exercise, like swimming, lowimpact aerobics or cycling, is vital for regaining general fitness and losing excess body fat. It can begin six weeks after a normal delivery. Low-impact exercise of moderate intensity has been shown not to affect the production of breast milk. Wear a good-fitting supportive sports bra to prevent discomfort and exercise after you have fed your baby. Build up to 45 minutes, three–five days per week. To get the most out of your training, exercise so that you feel a little out of breath but can still hold a conversation.

Try to do some resistance exercises at home using your own body weight. Wall squats, lunges and press-ups are easy to do and can assist weight loss by increasing your metabolism. The strength you build up will also protect your back from injury and make lifting your baby much easier.

A post-natal class, such as pilates or yoga, can begin after your six-week check-up (normal delivery) or after 10 weeks (Caesarean section). Ensure that your instructor has specific training in post-natal fitness as some exercise modifications will be necessary. Such classes are great building blocks for getting you strong enough to return to your pre-pregnancy sporting activities.

Listen to your body!

If you feel unwell, rest. Consult your GP if you have any of the following symptoms while exercising:
? Increased bleeding apart from menstruation
? Abdominal pain
? Mastitis
? Fainting, dizzy spells or severe headaches.

Look after yourself and remember these tips:

? Stop if you feel pain
? Stop if you feel very tired
? Do a little and often to gradually build up fitness
? Avoid sit-ups and crunches in the first six weeks
? Be guided by your chartered physiotherapist if you have abdominal separation
? Wear proper footwear when walking
? Maintain good posture when pushing the buggy.

Evidence confirms that appropriate exercise in the post-natal period is of great benefit to all new mums to maintain good health and protect against common post-natal injuries such as back pain and postural aches. A little effort as soon as you can will advance your recovery and help you get back into those skinny jeans!

Contact Jenny:

Jenny Branigan is a chartered physiotherapist and partner at Total Physio, an independent private practice based at the Slievemore Clinic in south Dublin. See www.totalphysio.ie or call 01 2000501.

Important:

This information is not a substitute for a proper assessment with your chartered physiotherapist or GP. If you are suffering with an injury, please contact your local chartered physiotherapist. It is vital to deal promptly with all aches and pains as they will get worse as your baby grows bigger and more mobile.

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