FOR POST-NATAL CLIENTS
Being a new mum may be one of the most rewarding experiences a woman can have, but it can also be one of the most challenging. By gradually progressing your client’s return to high intensity exercise, you can ensure she avoids injury and returns to her pre-baby body as soon as safely possible, says Katrina Cochrane.
Most women want to return to their pre-baby body and levels of fitness as soon as possible after giving birth. As personal trainers we have the ability to manage a safe and effective return to health and fitness through accurate programming and exercise selection.
Being a new mum may be one of the most rewarding experiences a woman can have, but it can also be one of the most challenging, both physically and mentally. Post-natal clients can gain a plethora of benefits by undertaking a fitness regime, including:
- Assistance with hormonal balance
- Tension release and reduction of anxiety and stress
- Enhanced stamina and muscle conditioning
- Improved pelvic and muscular stability and control.
Many points need to be considered in order to develop the most effective training program for post-natal clients. It should always be remembered that exercises you prescribe for your everyday clients are not always suitable for post-natal ones.
Undertaking an exercise program too soon after giving birth can compromise many physiological aspects for your client, in particular the strength and stability of their pelvic floor and core muscles. The lengthening of the abdominal and pelvic floor muscles during pregnancy will vary and must be taken into consideration when prescribing exercises and workout intensity for your client.
Pre-screening and assessment
By conducting a pre-exercise analysis with your post-natal client, you will be able to identify special considerations for her exercise programming. This will enable you to prescribe the most suitable (i.e. safe and effective) exercises to assist her in gaining effective results and avoiding injury.
Some questions that should be asked of your post-natal client include:
- What type of training or exercise did she perform throughout her pregnancy?
- How long ago did she give birth?
- Did she experience any complications throughout her pregnancy or birth?
- Following her 6-week postpartum check-up, was she advised to avoid any particular exercises or types of training?
Abdominal and pelvic floor muscles
Abdominal separation (diastasis) is very common in pregnancy, and for this reason exercises such as abdominal and oblique curls, hovers and even push ups should be avoided until the separation has closed. So, how do you assess if your client has a separation?
- Have your client lie on her back with her knees bent and feet on the floor approximately hip-distance apart
- Place fingers along the linea alba (midline of stomach)
- Lifting head and shoulders gently off the floor, feel for a gap or bulge just above or below the belly button
- If the gap is larger than two fingers-width. then outer abdominal exercises should be avoided until the deeper core and pelvic stability muscles are strengthened. Large rotation and wide stance exercises should also be avoided.
The pelvic floor muscles are responsible for supporting the bladder, vagina and rectum and are stretched and weakened during pregnancy and birth. If not trained correctly after birth, these muscles will remain stretched and may become weaker, potentially leading to incontinence. Poor exercise selection in the post-partum period can also lead to further weakening of the pelvic floor muscles.
Exercises to avoid include: cardio exercises that involve high impact, jumping, running, start jumps, skipping and boxing, as well as resistance training exercises such as crunches, sit-ups, double leg lifts, medicine ball rotations, deep lunges, deep squats, jump squats, high bench step ups, and plyometrics. A good way to assess if an exercise is appropriate is to consider whether or not it increases intra-abdominal pressure or involves impact. If not, then the exercise is most likely pelvic floor safe.
Try to encourage your client to protect against further muscle stretching by activating her pelvic floor muscles while performing everyday activities like lifting her baby or lifting a pram in and out of the car. One way of explaining to clients how they can achieve the necessary muscle action is to tell them to imagine themselves contracting their muscles to stop mid-urination.
Having an open and honest conversation about your client’s pelvic floor is really important! There are some excellent resources available for both clients and fitness professionals at www.pelvicfloorfirst.org.au.
Many physiological changes occur during pregnancy and continue postpartum. One of the most important is the hormonal changes that result in joint laxity. The hormones that have this effect can continue to be produced up to three months after the baby has been born. For this reason, it is important that you pre-screen and assess your client, as every client’s experience will differ. By finding out as much as you can about their individual circumstances, you will be able to prescribe appropriate exercise selection, order, intensity and recovery.
Understanding the physiological repair process post-natal is extremely important for trainers when developing safe and effective programs for their clients. By gradually progressing your client’s return to high intensity exercise, you can ensure she avoids injury and returns to her pre-baby body as soon as safely possible.
- Pelvic floor activation exercises.
- Light walking if client feels comfortable.
- Avoid lifting heavy objects.
- Transverse abdominus (TVA) activation exercises such as supine leg slides, knee fall-outs, four pointer arm and leg extension.
After 6-week check-up
- Commence light intensity walking if comfortable.
- Gradually increase the intensity and look to include hills and stairs when ready.
- Cycling provides a low intensity option when client feels comfortable working with a bike.
- Running should be avoided in the early stages of recovery from childbirth. Your client needs to be sure that their pelvic floor muscles are strong, with no signs of incontinence, before any running is done.
- When introducing running into a program, start with slow steady state training with gradual introduction of interval training.
- Swimming provides a low intensity option and initiates strong core activation. Avoid breaststroke if experiencing pelvic or joint discomfort.
- Heavy lifting should be avoided.
- Start with low resistance and high repetitions.
- Avoid single leg exercises initially, ensuring that weight-bearing exercises are evenly balanced (especially if your client is experiencing pelvic instability issues).
- Gradually increase resistance and add rotational exercises to the program.
Stretching and posture
It is essential to encourage your client to release any tension within the muscles whenever possible, as tight muscles can delay fitness gains and can also result in postural abnormalities and injury.
Breastfeeding and carrying a baby can place a lot of tension on the muscles and joints. Educate your client on the importance of maintaining correct posture and carrying techniques when feeding or carrying her baby. These can be implemented into your session as partner-based stretches, and you can also suggest exercises for clients to perform when they are not training with you. Encourage your client to complete a stretching routine every one to two days if possible.
By pre-screening your clients and identifying postural, muscular and joint instabilities, you will be able to implement safe, effective programs that get your clients back to their pre-baby bodies and levels of fitness.
Katrina Cochrane, BHMS
Katrina has over 16 years' industry experience and has worked both nationally and internationally with elite athletes and sporting teams. She is the managing director of her own personal training and strength and conditioning business and also instructs group exercise. Renowned for her motivational and inspirational skills, Katrina is also a Lead Coach with the Australian Institute of Fitness, NSW.