Why you need to work your pelvic floor and core muscles postpartum (even if you aren't having symptoms!)
“I don’t have any symptoms, so I’m good to go.” Jumping back into exercise can be a huge relief. Jumping back in in tandem with or after completing some focused pelvic floor rehab is like an insurance policy to give you longevity in your fitness. Ignoring pelvic floor and core work over time because you aren’t leaking, and don’t have any pain, heaviness, or bleeding, no matter how many weeks postpartum you are, can sideline you quicker than you think.
We hear it/see it all the time, especially with social media being a key place for information consumption for athletes, it’s hard to ignore! Women who are immediately running, biking or digging right back into their workouts just a couple of weeks, sometimes even days after giving birth. Many will say they feel fine, and they truly may! The tough part about postpartum recovery is that it’s vastly different for everyone. It also involved its own complex set of recovery timelines that are never fully linear. Some may feel fine, and go about your regular schedule again for weeks, and then some symptom/issue/injury will hit like a ton of bricks, causing them to be sidelined and frustrated. And this can happen at ANY point postpartum, but is most common within the first year. There are a few things to consider on this point, as women dive back into endurance sports.
Regardless of how you birthed, you still had a baby holding court in your uterus for 9 months, the final 3-4 of those being a substantially sized weight. The consistent weight of the baby, coupled with the size of your uterus, means there is a LOT of shrinking, contracting, and tightening for your uterus to do before it's back to it's regular shape.
All your pelvic floor muscles had to work to account for the substantial physical changes in pregnancy, and your hips and glutes did, too. Treating them like they didn't go through a trauma would be irresponsible.
If you have stitches, anywhere, you likely developed scar tissue. This can impact the musculature surrounding that area - hence, the importance of a Pelvic Floor PT analysis to gauge impact of scar tissue on your mobility and working through that moving forward.
Your gait can be permanently altered from pregnancy. Your muscles won't just naturally figure that out, and in order to support them through this change, they need to be strengthened. Ignoring gait changes and pelvic floor & core work means ignoring crucial muscles that impact your form on all types of exercise. Your body will find another place to compensate for the weakness, which can result in injuries to the hips, knees, ankles, and even feet. Everything in our bodies is connected.
A strong core means a strong body, less chance of injury, better posture (which, at a minimum, helps carry our children around without transferring stress to our backs and necks!), and better form. During pregnancy there are muscles we lose access to, or that physically move to accommodate the growing baby. They don't just "snap back" - we have to train them like we train for everything else in fitness. Forcing them to get back to work while we run, bike and swim again without retraining the brain to reconnect with these muscles and teach them to fire properly, will lead to injury over repeated use, even if it feels fine at the time.
Incontinence, prolapse, and pain are all common results of pregnancies, but they can be substantially treated and improved with proper recovery. They can also be exacerbated, and sometimes silently, over time, if recovery is ignored.
There is a reason that there are so many programs focusing on early postpartum recovery and core and pelvic floor rehab. It’s CRITICAL, no matter what your birth experience was, to rehabilitate these muscles and continue doing so. The truth is, women (and men!) need to be working on their pelvic floor muscles their entire lives, as their function carries importance not only in how we move, but also in how our digestive and reproductive systems operate on a regular basis. Treat your body responsibly in this time of substantial change, and it will repay you with a lifetime of happy running, cycling, swimming and racing!