Obvious note: I am not a doctor, physical therapist or medical professional. These are just my thoughts based on my own experience and research.
After two different people asked me about this, I thought I'd write a post. So what do you do if you're a postpartum woman returning to the intense exercise of something like CrossFit, and you want to make sure you're solid with your pelvic floor?
I have thoughts! Here's what I learned after a lot of research about postpartum workouts, as well as my own trial and error:
1. The first thing I always ask is if you had diastasis recti (separation of the abdominal muscles during pregnancy - super common), and if so, if it's been resolved. If not, you may want to see a pelvic health physical therapist to make sure it closes as much as it can.
2. The other thing a pelvic health therapist can diagnose are any unresolved issues in the pelvic floor. Assuming you're not experiencing any pain with general activity, there may still be a few issues -- some women experience some tightness in their hips and lower back after giving birth, and a PT can help do some myofascial trigger point work to help.
3. If you're not doing any pelvic strengthening stuff on its own (Kegels, lifts, bridges, etc.), I'd consider it. Otherwise, during jumping exercises (box jumps, double-unders, etc.) very heavy lifts, or intense workouts, you could have SUI - stress urinary incontinence, and leak a little. That usually only happens during high-repetition exercises, so one thing you can do if any of those seem problematic is just scale the number of reps they're asking you to do. I cut things in half sometimes because of this.
4. Here are the things that tend to cause issues:
- High Repetition
- Crunchy ab exercises like crunches, sit-ups, v-ups, etc. These compress the pelvic floor and make a lot of intrabdominal pressure (more here, including safe exercises: Exercising Core Muscles Without Damaging Your Pelvic Floor)
Good news is that you can totally lift weights. To do so safely, it's best to:
- exhale when lifting (basically, don't hold your breath -- it creates pressure in the pelvis)
- keep weight low at first
- if you feel wobbly, sit down and lift from a seated position
Most of all -- take it slow. It took ~9 months to make the baby, and it can take up to a year to recover all the way. I'm crushing it now, but it took almost a year for my body to feel normal. Relaxin and all the hormones of pregnancy and breastfeeding do a number on you, but it's really a short period in your overall life, and what matters is that you created a whole, rad human with your amazing body. So honor that process and take the time you need.