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Dr. Kate Mihevc Edwards fitness postpartum women's health

Postpartum is Forever

Postpartum is Forever

When I had a baby, I expected my body to bounce back immediately. It didn’t. I expected to return to running and triathlon as if I hadn’t skipped a beat. I was so caught up in what I was “supposed” to be able to do and what I “should” look like that I didn’t give myself the grace I deserved. Not once did I say to myself “You’re amazing! You just created a human!” Instead I beat myself up for being “too fat” or “too slow.”

As an athlete I expected my body to perform a certain way and when it didn’t, I thought something was wrong with me. There wasn’t. When I returned to running postpartum, I ended up with a stress fracture almost immediately. I felt that my body betrayed me. What I realized later was quite the opposite. My body did exactly what it needed to do to create life and give me my son. My body didn’t betray me. I was betraying it by pushing too hard and asking too much of it too soon.

Once you have had a baby your body will never be the same. This is not to stay it will be worse; in fact, it may even be better. But it certainly will not be the same as it once was. Changes that occur during pregnancy can remain for a lifetime. It is common for postural and biomechanical changes such the position of the rib cage, gait, size of the pelvic girdle, integrity of the abdominal wall or pelvic floor to be disrupted.

Returning to your sport slowly and without judgment will decrease your risk for overtraining, injury and significant frustration. We have to be smart enough to know when we can push through and when we need to take it slow and steady.

Here are some tips for you to return to running in the initial postpartum period (0-12 months):

  1. Walk first. Have you ever heard the phrase “walk before you run?” Walking for the first several weeks after giving birth will help you to transition back to running more smoothly and allow your body some well-deserved time to heal. Begin a run/walk program at eight weeks postpartum.
  2. In the first few weeks after giving birth you can start to activate your core, pelvic floor and hip muscles to get you ready for running. Start with simple diaphragmatic breathing, easy deep core stability and gluteal exercises. Pilates is a great way to tap into the deep core using your breath.
  3. See a Pelvic Health Therapist: At six-eight weeks postpartum we recommend a check up with a pelvic health therapist. They should assess the pelvic floor, check if you have diastasis recti, urinary incontinence or any other pregnancy related impairments. If these issues are not addressed, they can lead to hip, back or other injuries in the future.
  4. Don’t start where you left off. Once you have walked for several weeks begin a walk/run program. Don’t run too much too soon, especially if you are breastfeeding. Stress fractures are common among breastfeeding moms. This is because the calcium that typically goes to your bones instead goes to create the milk you produce. Too much too soon increases the risk for injury.
  5. In order to produce milk women, need an extra 500 calories a day. When you begin running you are burning more calories. If you don’t eat enough your milk supply could deplete and/or you will end up with a stress fracture or other injury.
  6. Talk to yourself like you are talking to a friend. Stop beating yourself up, you are most likely your worst critic. You cannot speed up how quickly your body recovers no matter how hard you will it to return back to “normal.” If you are still breastfeeding then your hormones haven’t normalized yet impacting your bone density, ligament laxity, stride length and more. It takes six-twelve months for your bodies hormones to readjust after you stop breastfeeding.
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It may be a relief or perhaps hard to hear, but I have news for you. Postpartum doesn’t end at 12 months post-delivery. Postpartum is forever. The changes that occur during pregnancy can last a lifetime. When I treat women, who have five or even ten year-olds they are often surprised when I ask about their pregnancies and births. The lasting impact of pregnancy can manifest as weakness or dysfunction in the pelvic floor, poor control of the abdomen and trunk, impaired postural patterns, changes in the size and shape of your pelvis and feet or even a dysfunctional gait pattern. If you find you are continually getting injured don’t underestimate what your body went through during pregnancy and the initial postpartum period. You can still get help from a physical therapist or a pelvic health therapist. You will have to make sure they are aware of these common changes and how to treat them.

Women have to stop comparing themselves with who they were prior to having a baby, that person and that body no longer exists and that is OK. Women are resilient and strong; their bodies can meet the demands of raising children, having a career, staying active, training, running and much more. To effectively return to our sports we must recognize the changes our bodies and our lives have gone through are not minor! If you are newly postpartum, now is the time to take care of yourself. If you have children that are 10 years-old but continue to have nagging injuries, then seek out help in order to prevent further issues down the road. Remember postpartum is forever so give your body what it needs to be successful in the long run!

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Dr. Kate Mihevc Edwards

Dr. Kate Mihevc Edwards PT, DPT, OCS, author of Go Ahead Stop and Pee: Running During Pregnancy and Postpartum, is a doctor of physical therapy, board certified orthopedic specialist and owner of Precision Performance and Physical Therapy in Atlanta Georgia that specializes in the treatment of runners and triathletes’.

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