Postpartum Return to Activity Guidelines



Returning To Activity After Birth

  • Participating in sports, running or other high-impact activities too early after childbirth may actually reduce pelvic floor muscle strength and contribute to long-term bladder and bowel problems and/or pelvic organ prolapse symptoms.
    • Returning to jumping, running or bouncing type activities too quickly can strain the pelvic floor musculature and ligaments that are still stretched postpartum
    • After delivery, no matter how fit or toned you are, it takes a minimum of 8 weeks for soft tissues and your abdominal muscles to heal to support your lower back and pelvis
      • There is no way your abdominal muscles can go from being overstretched during pregnancy to being shortened and firm enough to provide good support for your back and pelvis without time and safe postnatal abdominal exercises
      • It may take 3-4 months for hormonal changes of pregnancy (primarily relaxin) to decrease (this affects the ligaments that support the pelvic organs)
    • Steady progression of postpartum abdominal bracing and pelvic floor exercises are important to improve the strength and tone in these muscles

Postpartum exercise guidelines

  • 0-3 weeks postpartum
    • Walking
    • Postpartum abdominal muscle bracing
    • Gentle pelvic floor muscle activation
  • 3-8 weeks postpartum
    • Walking
    • Low impact aerobics
    • Low intensity water aerobics or walking in the water (forward, backwards, sideways)
    • Light weight lifting making sure you maintain good breathing (exhale on the load; don’t’ hold your breath)
    • Postpartum abdominal muscle bracing
    • Pelvic floor strengthening exercises
  • 8-12 weeks postpartum
    • Gradually increase intensity and weights with exercises above
    • Pelvic floor safe exercises
  • 12-16 weeks postpartum
    • Visit a Pelvic Physical Therapist for postpartum abdominal and pelvic floor muscle assessment before returning to high impact exercise, running, sport or abdominal strengthening exercise program
  • 16 weeks postpartum
    • Return to previous activity IF you are not experiencing back pain, vaginal heaviness or urine loss during or after exercise

Mobility, Wellness, Independence and You…An Education Event in Nebraska City coming up!

Hip Labral Tears and Pelvic Pain

One cause of chronic pelvic pain symptoms, that frequently gets overlooked, is a tear in the hip labrum.

The hip acetabular labrum is the fibrocartilagenous ring lining of the “socket” part of the hip joint. The hip is a ball and socket joint. The labrum functions to absorb shock, lubricate the joint, distribute pressure, and aide in stability.

Causes of labral tears include trauma, impingement (also known as femoroacetabular impingement or FAI), hypermobility, dysplasia, and degeneration. Hormonal influences such as during pregnancy or underlying collagen disorders can predispose patients to labral tears. Hip labral tears can also occur during delivery due to the extreme external rotation that the hip joint is placed in during vaginal birth. Repetitive rotational sports such as golf or extreme yoga poses can place stress on the hip capsule and iliofemoral ligament and result in a labral tear.

Symptoms of labral tears include hip or groin pain, buttock pain, clicking, locking, loss of range of motion, and giving way. Others may have pain in the vulvovaginal area or testicles/scrotum and have pain with intercourse. Hip labral tear symptoms can mimic or be related to vulvodynia, pelvic floor muscle dysfunction, or pudendal neuralgia.

Although tears can occur in all regions of the hip labrum it is more common to have an anterior acetabular labral tear because the anterior hip joint area has less blood supply, increased vulnerability to wear and degeneration, mechanical weakness, and is subjected to greater stresses. Hip labral tears have low potential to heal on their own due to the lower vascularization. Studies show that some patients can successfully undergo physical therapy and return to their sport without reoccurrence of pain. Many, however, require surgical repair of the labral tear and are prescribed physical therapy to prepare for surgery and also undergo rehab post-operatively.

2019 is the year to feel better!

Statistics may vary but consistently 25-50% of women are known to suffer from some type of pelvic floor dysfunction during their lifetime.

Of those women who have pelvic floor dysfunction, only 7-10% will seek treatment.

This is the year to ask for help and you deserve to feel better!

All you have to do is ask your physician for a prescription for physical therapy and then call 402-477-3110 to make an appointment for evaluation!

Pelvic floor dysfunction can present as:

Pelvic pain

Abdominal pain

Urinary incontinence

Fecal incontinence

Pelvic prolapse

Chronic constipation

Urinary urgency and/or frequency

Urgency of defecation

Loss of control of gas

Pain with intercourse and/or pelvic exams

Pain Symposium has been retired

After 10 years of providing continuing education, the Pain Symposium has been retired and will no longer be offered.

Medicare Cap has been Repealed!!

Two decades of advocacy come to successful fruition, as a 2-year funding deal recently signed into law includes a full repeal of the cap on Medicare outpatient occupational therapy, physical therapy, and speech-language pathology services.

Medicare Cap in place for 2018…take action!

Because of inaction by Congress, the hard cap on outpatient therapy services under Medicare has been implemented. The cap, which began on January 1, 2018, includes no KX modifier exceptions and has created uncertainty for providers, patients, and their families.

Click HERE to take ACTION as a patient!

Click HERE for more information

Speedway Clinic Open House

Join us on Thursday, October 12, 2017 for an open house at our newest Lincoln location at 45 Speedway Circle Suite #3!

10th Annual Multidisciplinary Pain Symposium

Registration is now open for the 10th Annual Multidisciplinary Pain Symposium which will be held on Tuesday, August 29th, 2017.

Click HERE to register!

Speakers this year include:


Adam Gentzler, DC, BS, ART, FDM

Kelly Zach, MD

Callie Engler, DPT

Ben Petersen, DPT

Pat Brinkman-Falter, BSDH, MS, PHRDH, COM

Lyndell White, PharmD, RP

Understanding Pain

Pain is a very complex thing to understand. There are different types of pain and each type has unique properties with pain affecting each person differently.

Recently, a group from Australia produced this video which does an amazing job at simplifying such a complex topic to understand:

Continue reading “Understanding Pain”