As we embark on a new year filled with resolutions and fitness aspirations, it's essential to shed light on a crucial aspect often overlooked in the world of health and exercise – pelvic health. For numerous women, engaging in activities like running or high-intensity workouts serves as a powerful outlet for aerobic fitness, mental well-being, and social connection. However, after pregnancy, the journey back to exercise requires thoughtful consideration to safeguard pelvic health. In this blog, we delve into the postnatal realm, exploring guidelines and insights to ensure a smooth and healthy return to running after giving birth.
The transition into motherhood is a transformative experience, with significant implications for a woman's pelvic health. Between 15-30% of first-time mothers may experience urinary incontinence, while 1 in 5 report faecal incontinence at one year postnatal. Additionally, up to 56% of new mothers may demonstrate pelvic organ prolapse at 3-6 months postnatal. The pelvic region undergoes profound changes during and after pregnancy, and it's crucial to recognise the extended recovery period needed for tissues to heal adequately.
In March 2019, the UK released the first-ever guideline specifically addressing postnatal women returning to running. Titled "Returning to running postnatal – guidelines for medical, health and fitness professionals managing this population" (Goom, Donnelly & Brockwell 2019), this guideline outlines evidence-based recommendations to ensure a safe and effective return to running.
Extended Recovery Period: Contrary to the traditional 6-week postnatal check, the guideline suggests waiting at least 12 weeks before planning a return to running. This emphasises the need for a nuanced approach to postnatal recovery, recognising that healing extends well beyond the initial weeks.
Pelvic Health Assessment: All postnatal women, regardless of delivery mode, should undergo an assessment by a pelvic health physiotherapist before returning to high-impact sports. This holistic evaluation helps identify signs or symptoms of pelvic floor dysfunction, ensuring comprehensive management and support.
Relative Energy Deficiency in Sport (RED-S): Recognising the lifestyle changes new mothers face, the guideline emphasises the risk of RED-S. Sleep deprivation, altered eating habits, and the pressure to return to prenatal fitness levels can contribute to an energy deficiency, impacting various aspects of physiological function.
Holistic Approach: The guideline encourages collaboration among health and fitness professionals, spanning roles from sports and exercise medicine physicians to coaches and trainers. This collaborative effort ensures a holistic approach to postnatal recovery, addressing musculoskeletal and pelvic health concerns.
As we embark on a new year of fitness goals, it’s important to prioritise the well-being of postnatal women looking to reintegrate running or returning to high-impact sports into their lives. By embracing the guidelines and understanding the intricate nuances of pelvic health, we can empower and safeguard women, fostering a supportive environment that prioritises long-term physical and mental health. We can change the narrative surrounding postnatal recovery, giving it the attention and consideration, it deserves on par with other aspects of sports medicine.
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