Pelvic Floor Physical Therapy Part 4: Return to Sport after Baby

You’ve had a baby.  Whether by cesarean section or vaginal delivery, you will need a plan to get back to your sport.  Whether you are a high mileage runner, casual runner, play sports recreationally or are semi-professional or professional athlete; you need to rehabilitate the pelvic girdle to prevent injuries and pelvic dysfunction.

If you jumped back in once your doctor cleared you for exercise, it might not have gone as easily as it used to. Maybe you are leaking when you run, bound or jump.  Maybe your hip or your back hurts.  Maybe you just didn’t feel like you had the oomph you thought you should. 

Getting back into exercise after baby is exciting and exhilarating, and can be frustrating.  We are here to help you make sure that you can get back into the running shoes or the gym without having an injury or feeling frustrated with pain or leaking. Here are some items that are a MUST before jumping back into high level activities:

Good Motor control: The coordination between deep core, pelvic floor, and diaphragm is crucial for optimal stability through the hips, pelvis, and spine.  When this is solid, the limbs are able to produce higher levels of power on a stable base. This also helps to decrease the risk of injury.

Baseline Pelvic Floor Muscle Strength: The muscle strength of the pelvic floor should be at least a 3/5. This is measured by a pelvic floor physical therapist on exam of the muscles. In addition to a baseline strength, we should also see that you are able to perform:
– 10 pelvic floor muscle contractions in under 10 seconds with good coordination
– 8-10 second endurance over 10 reps
– 60 second sub maximal contraction

Once the top two have been mastered, we want to look at upper or lower extremity strength. These are some good markers for overall strength to return to sport safely:

Core Strength: Perform these with the ability to maintain a neutral spine without holding your breath or bracing.
– Plank
– Single leg stance 30 seconds each side
– Supine Marches with good pelvic stability
– Bird Dog

Lower extremity strength: These are best assessed by a physical therapist to ensure you are maintaining good stability and control across the pelvic girdle and spine.
– Single-leg calf raises
– Squat thighs to parallel with ground
– Single leg sit to stand from a low chair
– Single-leg bridges
– jogging in place for 1 minute
– double leg hopping
– single leg hopping for 30 seconds on each leg
– single leg bridge

You will probably be ready to hit the trails if you have good control of these and don’t experience pelvic symptoms (leakage, pelvic heaviness or pain).  If not, we would encourage you to continue to work on strengthening your core, hips, and pelvic floor. If you are unable to have good stability and coordination of your abdominal wall, hip, and pelvic floor when you return to exercise, it increases the risk of injury or worsening pelvic symptoms.  

What is tricky about this is, often people don’t realize that they aren’t coordinating their core well. That is where a pelvic floor physical therapist can help. Getting in to see a physical therapist can help you know your baseline and understand where your deficits are. Understanding how the core works in conjunction with your spine, and LE musculature. Developing a plan that is individualized and creates balance in your body will ensure your success. Check out this video to begin to connect with your core! If you are struggling to get back to your sport, the very best option is to see a pelvic floor physical therapist.

We want to help all our clients to reach their full potential with whatever their goals are.  That’s what we love to do! We offer a free, 15 minute phone consultation with one of our specialists to help you answer any questions you may have! Click Here to schedule!

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