You go to your six-week check up expecting your OBGYN to give you the all-clear to return to exercise so you can start torching calories and lose the baby weight. But did you know that even with clearance from your OBGYN you may still be at risk for injuries or maybe not even ready to return if you are experiencing leaking, pressure, pain, or coning of the abdominals. During those long six-weeks after having your baby, you weren't supposed to be exercising so how would you know the only time you leak is when you're jumping, running, or moving quickly? You aren't supposed to have sex either, so how would you know it's painful? You aren't supposed to be exerting more energy or resistance around the home so how would you know if your abdominals are truly separated? For these reasons, many women can make the problem worse by returning to an exercise program before they are truly ready.
Please, don't get me wrong, go to your OBGYN for your six-week postpartum check up as they are checking other things a physical therapist most definitely doesn't. According to the American College of Obstetrics and Gynecology, here are some of the items your doctor will check for (1) :
1. Mood and Emotional Wellbeing: screening for postpartum depression and providing with resources for help.
2. Infant Care and Feeding: assessing comfort and confidence with caring and nursing your newborn.
3. Sexuality, Contraception, and Birth Spacing: resumption of intercourse, contraceptive options and discussing if you are wanting more children/how far apart you are wanting them.
4. Sleep and Fatigue: suggest coping mechanisms for disrupted sleep and use of family to relieve some of the caretaker duties.
5. Physical Recovery from Birth: checking on incisions (perineum or cesarean) or tearing caused from birth and assure it is healing correctly. Clear to return to exercise if appropriate.
6. Chronic Disease Management: perform glucose testing for those who had gestational diabetes and review medication especially for those who are breastfeeding.
7. Health Maintenance: do pap smear and pelvic exam as indicated.
While your OBGYN already has an extensive list of items to check for your wellbeing, let us not make the mistake that this is not a musculoskeletal screening of issues that could arise after birth, many of which take place later after your six-week appointment. Listed below are some of the areas to check for - some items are not specific to postpartum but equally important to ensure optimal performance when returning to exercise.
1. Single Leg Balance - you need good balance to maneuver over kids toys, baby gates, and exercise activities. Our balance changes A LOT during pregnancy!
2. Full (Deep) Squat - Test your functional mobility to be able to get down to floor with your kids, pick up toys, tie a shoe, etc.
3. Sitting Cross Legged - Tests your lower extremity range of motion.
4. Behind The Back Hand Touch - Tests your shoulder range of motion.
5. Double Limb Hops - check to see if you have incontinence, pain, or pressure which could be problematic as you return to exercise.
6. Diastasis Recti Self Check - check for abdominal separation and what could be contributing towards your low back pain.
If you are unable to successfully complete this quick screen or would like to speak with a Women's Health Physical Therapy Specialist, email us at firstname.lastname@example.org to schedule a free telehealth screening.
(1) Optimizing Postpartum Care. (2016, June). Retrieved from https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/05/optimizing-postpartum-care