One Year Postpartum: Are There Any Special Training Considerations?
The short answer is a resounding yes.
A lot of articles and information directed towards postpartum women cover the initial weeks and months after giving birth. That’s awesome. But what about one year after? Five years?
As Dr. Sarah Duvall, creator of Postpartum Corrective Exercise Specialist, mentions below in today’s guest post: once postpartum, always postpartum.
PCES is an outstanding course, and one I’m currently going through now. It’s only being offered for another week, with a special offer for TG.com readers below.
Are there any special considerations for training a woman that is over a year postpartum?
For this question we need to ask ourselves, “does the postpartum period end at an arbitrary time?”
In some cases, yes.
Time does have a positive impact and in other cases, no. So, let’s take a look at when time matters and when it doesn’t.
In the early stages postpartum women are still dealing with excessive ligament laxity that was needed to help get the baby out. Most women notice a decrease in the laxity by 4-6 months postpartum but for those that continue to breastfeed, the laxity can continue well over a year.
This matters because laxity creates instability and increases vulnerability to injury, especially in the pelvic floor.
So, being further along postpartum is a real win for not having to worry about the extra ligament laxity.
Most of the stories I hear from patients about post-delivery prolapse development happen in this one-year window. There is still a chance of women getting prolapse outside this time frame, but thankfully, the chances go down with the recovery time.
Why does this matter?
Women should take it slow getting back into impact exercise that could place an unnecessary strain on the pelvic floor while it’s still healing. (This goes for C-Section ladies as well!)
Incontinence or leaking during exercise is another one of those pesky issues that a significant number of women complain about and we often associate with having a baby. A survey taken among women that experience leaking showed that women with no leaking three months after delivery had a 30% chance of experiencing leaking twelve years later.
This is a significant number!
Now we’re talking about a woman who decides to get in shape and head to the gym and all of a sudden she is experiencing this pelvic floor issue she never had before.
Why does this happen?
I think it’s a breakdown of the system. An accumulative effect, if you will.
When proper steps aren’t taken postpartum to ensure complete pelvic floor recovery, our system can form compensations. Sometimes these compensations can take years to show up. Much like many preventable chronic injuries throughout the body.
The same thing can happen with the core. If 100% of women that go into delivery have a diastasis, then checking for it should be a routine part of any initial visit. Pregnancy pushes women into poor movement patterns.
The large amount of weight in the front causes a posterior weight shift and lengthened abdominals.
Because of this weight shift, women will often end up with tight paraspinals and a hinge point at the T12-L1 junction. This can cause back pain and tightness as well as perpetuating a poor breathing system that prevents complete core recovery.
Along with this weight shift, the baby itself pushes up on the diaphragm continuing to shut down deep breathing. Proper breathing is the foundation for core and pelvic floor recovery.
These postural compensations can stay with women for the rest of their lives unless someone gives them the right corrective exercises to break these patterns. Checking for a diastasis and asking key questions about pelvic floor health should be high on the priority list for a woman at any stage postpartum.
Check out this video for a couple key posture tips that help promote diastasis healing.
Bottom line, once a woman is postpartum she is always postpartum.
Being pregnant increases her risk of pelvic floor issues, diastasis and postural changes.
These risks are not limited to the first year or even the first five years postpartum. These are issues that affect many women for the rest of their lives. The good thing is that with a little knowledge we can do something about it. These women can have hope for healing at any stage in life.
I’m not going to beat around the bush, if you’re a fitness professional you should considering taking this course.
It will undoubtedly make you a better coach and better prepare you for the delicate nature of working with women postpartum (which, as Sarah noted, never really ends).
I’ve trained several women through their pregnancies and have obviously trained hundreds after the fact. I thought I knew what I was doing, and I’ve done okay.
This course has helped me immensely and has really shed a spotlight on some coaching/information gaps on my end. I can’t recommend it enough.
Sarah only offers it a handful of times per year and she’s been kind enough to extend it for another week so my readers can take advantage. What’s more, if you use the coupon code TONYG at checkout you’ll get an additional $50 off your order.1
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About the Author
A wife, mom and adventure sports athlete, Sarah is a women’s fitness specialist that takes functional training to a whole new level. In her unique approach to treating patients, she believes in teaching. Fully understanding every aspect of the body is a necessity to complete healing. She integrates functional movement with cutting-edge exercises to bring you results-driven programs for postpartum recovery, with an emphasis on the pelvic floor and abdominals. When she is not hanging off the side of a mountain, Sarah enjoys writing and presenting at http://www.
Viktrup L, Rortveit G. Risk of stress urinary incontinence twelve years after the first pregnancy and delivery. Obstet Gynecol. 2006 Aug;108(2):248-54.