When the postpartum body doesn’t cooperate

By Pia Johansson

Not being Über amongst the Übers and what to do to make it better

Sometimes, it’s not just about being committed and motivated and finding time for that precious alone time. If the body doesn’t cooperate then motivation doesn’t matter. And it can be difficult then, when your tribe is the Über Moms; a bunch of awesome, driven, continuously exercising supermoms!

But remember the postnatal awareness is not just about your mind, it is also about letting your body heal, and knowing how to help it along when things aren’t healing quite as it should with the appearance or persistence of incontinence, pelvic pain and diastasis recti.

After Baby 1 I didn’t try running until 6 months post-partum and it then took me another 6 months to be able to run 5 kms pain-free at a reasonable speed. Then, I immediately got pregnant, ran once, puked twice (during the run) and that was it, no more running for a while. Due to the problems after the first pregnancy I wanted to do it right this time. And I think I really did. It just wasn’t enough. I did a ridiculous amount of strengthening and rehab exercises and did my first run (15 min!) after 3 months. I then very carefully built up to do 5 km over the next three months (I know! Crazy right, I felt a bit silly even for being so slow and careful). Then I did 5 km in Karlovy Vary with the Über Moms (part of a relay time with Kerry and both our husbands. Go Team!). And it felt awesome! I was fast and it felt great!! I was soooooo happy.

And then the next day; I felt like I was going to split in two! I waited a week and did a small trial run and it felt horrible. My body just said NO NO NO! And has continued to say NO, even to walking sometimes. This is not fun. I need to run.It keeps me sane. A bummer to say the least. But I am sure it will get better. An important part of postpartum recovery is also to allow your body time to heal. And of course, just because the baby is out doesn’t mean your body is back to normal and start that healing process. It has other things to worry about first, need to produce an enormous amount of milk and deal with sleep deprivation for example. Obviously, your hormonal status is not the same just after birth as it was before you were pregnant. For example, Relaxin, the hormone that loosens the joints before birth can apparently linger (or are still being produced) up to 6 months after birth.

I realised that despite all my effort my pelvic floor was still quite weak and I definitely still suffered from pelvic weakness in general. C-sections do not protect against pelvic floor dysfunction and running is really bad for it as well. So ladies, be careful. If you wee when you shouldn’t be, take a break, do some Kegels, squats and pelvic thrusts or get professional help. Let me restate this; urinary incontinence is a not something you have to live with! It is in 99% of the time something that can be fixed it might just be that Kegels aren’t enough (or you are doing them wrong). There is even a Pelvic floor centre here in Munich. The general Rückbildungs courses offered and covered by Public Insurance are good and is indeed the minimum one should do.

So I went to my gynaecologist to make sure there was nothing really bad going on like uterine prolapse (which can be caused by a weak pelvic floor). Uterine prolapse is big time nasty, the uterus is no longer maintained inside your body, but starts to migrate out through your vagina!! Not great I am sure you understand.

See here for more info: https://www.bellybelly.com.au/post-natal/prolapse-after-birth-6-things-that-increase-the-risk

If you have a weak pelvic floor, some urinary incontinence and you are a runner do not assume this will not happen to you, let you gynaecologist check. Interestingly, it turns out that C-sections actually protects a bit against Uterine Prolapse (as the uterus is a bit attached to the scar now) and my pelvic floor wasn’t that bad after all so there was nothing obviously wrong. So back to exercises to try to strengthen my pelvic regions/girdle again. I found that this page was very helpful. In addition, I would recommend more one-legged exercises, like one-legged pelvic thrusts and split-squats (Bulgarian squats).

Another common postnatal complication, what is also often connected with pelvic floor, pelvic area and core weakness is Diastasis Recti (e.g https://midwiferytraditions.com/2015/09/03/healing-abdominal-muscles-after-pregnancy/). Diastasis Recti is when your stomach muscle don’t go back in place after their separation during pregnancy.

In order to maintain or regain proper core control this is a necessity. You can help by doing the right type of stomach exercises (in the beginning it is almost just tucking your stomach in). What is very important here is that the wrong exercises might actually make the separation worse. So NO crunches or planks!!!!! I really really recommend an App called “MammaMage.” It is in Swedish, but there are videos of everything and I would be more than happy to translate or explain things for you guys. It’s a 10-12 week programme (depending on how often you do it) and it’s for everyone not just for people with Diastasis Recti. And you can start it at any time after the baby (i.e. never too late). Mamma Mage means Mummy Tummy, and of course this is another thing it helps with, not just the separation but also to pull back that tummy that makes you look pregnant despite the 100 crunches you do every day (don’t do crunches)!

I have also seen ads for various programmes with Natalie Hodson and it looks quite good, but I haven’t tried it myself. I did try Jillian Michaels Baby Bounce Back programme and even though it is in general quite good I think the stomach exercises are really too difficult and not quite suitable. Lastly, if the separation really doesn’t heal, there are surgical options which you can discuss with your doctor, because this is also a postnatal complication that should be addressed.

So here I am, 10 months post-partum and still not running. So why am I telling you this non-success story? Well, to tell you not to stress or push too hard. As active moms we are asking a lot of our bodies. We are all different. And as well as all pregnancies are different, so are all the post-partums. Remember that by just being part of this group you have already made a difference. You want just a little bit more, want to be healthy and active and that is really great. And in a year I will join you at the starting line!

Disclaimer: I am not a health care professional and these are just websites and tools I found to be helpful. If you are experiencing pain I always recommend seeing a doctor.

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