If you’re used to living an active lifestyle, it may take a little bit of time to adjust to your postpartum body. Your center of gravity may have shifted, you may have aches and pains you never did before — and you may even pee a little (or a lot) when you workout after having your baby. This is really common, but is there a way to stop it from happening? Luckily, there is, and she’s here to help.
Why do some people pee during workouts after having a baby?
First things first: Why does this happen? According to Dr. Blair Green, a physical therapist and co-author of Go Ahead, Stop & Pee: Running During Pregnancy and Postpartum, you need to keep in mind that pregnancy is a time of tremendous physical change for you.
“During pregnancy, the muscles of the pelvic floor adapt to a growing fetus, changes in posture and hormonal changes,” she tells SheKnows. “The pelvic floor muscles serve many functions, one being control of bowel and bladder function. The increased demands placed on these muscles during pregnancy make them susceptible to dysfunction.”
Not only that, but labor and vaginal deliveries also place the pelvic floor muscles at risk because of all the stretching, pressure and sometimes tearing of the muscles and associated soft tissue.
“These changes in length, strength and coordination of the pelvic floor muscles, along with the abdominal muscles and diaphragm, can lead to problems following delivery including leaking urine, which is known as stress urinary incontinence,” Blair explains.
And while stress urinary incontinence is common, Blair says that it is never normal. “In fact, physical therapists trained in the management of pelvic floor dysfunction can help women during and after pregnancy to prevent or eliminate leaking or peeing during workouts, or at other times,” she notes.
Is it possible to strengthen our pelvic floor?
First of all, Blair reiterates that any type of bladder leakage — no matter how light or heavy — is not normal. Ideally, the best way to begin to retrain pelvic floor muscles is to see a physical therapist who specializes in pelvic health.
“Pelvic floor muscle retraining, or what is commonly known as a Kegel exercise, has been shown to help the symptoms of stress urinary incontinence,” Blair explains. “The pelvic floor muscles are primarily endurance muscles but also respond to impact and loading, such as what occurs with exercise such as running and jumping.”
Learning how to activate these muscles as well as relax them is key, she says. After that, exercises should focus on slow and quick repetitions, longer holds, and coordination with functional activities.
“However, this is just one piece of a big picture,” Blair notes. “Exercises should focus not only on strengthening the pelvic floor, but also on coordinating the breath with the pelvic floor muscles and the abdominal muscles with the pelvic floor muscles. These muscle groups work together to provide central stability to the trunk and pelvis.”
What are some good post-baby exercises?
Every person is different, and will move at a different pace after having a baby. Blair says that respecting your body is key; try to follow what it is telling you feels good — or does not feel good.
According to Blair, it is important to start with foundational exercises, which should include general mobility, breathing, pelvic floor muscle activation/relaxation and exercises to help retrain the gluteal muscles (posterior and lateral hip), as well as the muscles that stabilize the shoulder and upper body.
Not sure where to start? Blair suggests deep diaphragmatic breathing, as well as pelvic floor muscle activation while lying down You can also try other positions, like getting down on all fours and rocking back and forth on your hands and knees. You can do progressions including bridging, leg lifts lying on your side, wall pushups and starting to include the abdominals through a curl up exercise.
“Start with low-impact cardiovascular exercise such as walking, biking or swimming, until the core and hips are strong enough to support you with running and jumping,” Blair says. “If at any time you are feeling pain, or symptoms such as pressure in the pelvis, leaking urine, bowel incontinence or anything that just doesn’t feel right, seek help!”
How long will you pee during postpartum workouts?
Again, the answer is different for every person, Blair says. Some will never experience leakage and for others, it may be more severe. “Remember, leakage is not normal,” she explains.
In the first days and weeks following childbirth, you may experience some leakage as the pelvic floor muscles recover, but this should subside over the first month. If any leakage continues, worsens, or starts when previously there was none, this is not normal and you should seek help from a pelvic health physical therapist.
The good news is it’s likely not permanent. “In many situations, the muscles of the pelvic floor and the supporting systems can be retrained so it’s not something you have to live with forever,” Blair says.
A version of this story was published August 2019.
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