The postpartum period is defined as the time immediately following birth and is often without a definitive end point. However, many of the physiological and morphological changes of pregnancy persist for four to six weeks postpartum. Pregnancy triggers numerous physical changes in a woman’s body, including water retention and weight gain. After delivery, many women have difficulty returning to their pre pregnancy weight, with an average weight retention of 0.5 to 3.8 kg (1.1 to 8.4 lbs) noted per pregnancy. Nearly 20% of women are more than 5 kg (11 lbs) heavier 6 to 18 months after delivery. Postpartum weight retention is related to inadequate physical activity, poor nutrition, and, in some cases, excessive weight gain during pregnancy. Across time, weight retention, physical inactivity, and poor nutritional choices can lead to a myriad of chronic health conditions, including obesity.

After delivery, women are encouraged to increase their physical activity gradually. Because the delivery course varies and many of the physiological changes of pregnancy persist for 4 to 6 weeks, the process should be individualized. Generally, moms experiencing an uncomplicated delivery will receive a green light to exercise at 4 to 6 weeks after delivery, whereas those healing from a caesarean delivery may need additional time. Women who consistently exercised before pregnancy and remained physically active throughout pregnancy often can return to their pre pregnancy routines quickly once given medical clearance. 

Post natal effects of exercise: A randomised study of the effects of aerobic exercise by lactating women on breast milk volume and composition concluded that aerobic exercise performed 4-5 time/week and commenced 6-8 weeks post-partum had no adverse effects on lactation but Though aerobics at 60-70% of the HRR for 45 minutes/day, 5 times/week for 12 weeks significantly improved the cardiovascular fitness of the post-natal women.

Dewey and McCrory, in a review of literature on dieting and physical activity in pregnancy and lactation, conclude that the available data indicate that moderate aerobic exercise is safe and beneficial for most women if appropriate guidelines are followed moderate exercise for the child-bearing year. One study conducted in 2012concludes that a physical activity intervention based on pedometer is an effective means to increase physical activity; reducing retention of weight gained during pregnancy and can improve anthropometric measures in postpartum women.

Immediate post- natal problems and exercises for those:

-Painful perineum:

1.Pelvic floor exercise.

2.Positioning.

3.Ice: crushed ice and massage

4.Ultrasound: condom as water bag and pulsed US,3 MHz,0.5 W/cm2. (McIntosh).

5.PEME: acute: -40-65 microsecond pulse, rate:10-220 pulse/s, twice/day, 5-20 min.

6.IR: non-luminous, side or crook-lying, 50-70 cm, 20 min.

Back pain:

1.Epidural site pain: hot/ice pack.

2.Lower back pain: tub grip support, prone lying, mobilization.

3.Symphysis pubis: severe: -bed rest, gradual mobilization with crutches. 

Thoracic pain:

Correction of feeding posture, AROM for shoulder, elbow circling, pelvic tilting, back flexion and hyperextension exercises, Hot packs.

Coccydynia:

US, hot/ice packs, TENS, prone-lying, freq. gluteal contraction, rubber ring.

Circulatory problems:

1.Varicose veins: support tights, anti-embolic stockings.

2.Oedema: Feeding with leg raised and vigorous half-hourly leg movements.

Diastasis Recti:  

Diastasis rectus abdominis (DRA), a midline inter-recti separation, is a common health issue afflicting both pregnant and postpartum women. These changes taking place during pregnancy mainly affect the rectus abdominis, which, begins to stretch and lengthen due to the growing fetus.

Deep core stability-strengthening program

This involves the use of abdominal bracing (a large towel or sheet secured around the abdominal section for each patient), diaphragmatic breathing, pelvic floor contraction, plank, and isometric abdominal contraction as well as the traditional abdominal exercise program. Static abdominal contractions, Posterior pelvic tilt, Reverse Sit- Up exercise, Trunk Twist and Reverse Trunk Twist exercise is also some of the exercises for DRA. Abdominal exercises with bracing have proven extremely effective in reducing DRA in early post-partum period. the co-contraction of pelvic floor and transverse abdominis are important core strengthening exercises for any postpartum patient during the first 6 weeks ensuing postpartum. Adding the core exercise routine to abdominal bracing during exercise, could prove effective for treating DRA and useful in closuring the DRA while also potentially reducing back pain caused by DRA.

Experiencing any of the above symptoms? Book an Assessment with a Physiotherapist

If you are experiencing any of the above symptoms, seek an assessment from a qualified physiotherapist near you.

Make sure you book your appointment today and get assessed by our physiotherapist now.