Healing & Return to activity…. what gives?
Tissue Healing, Postpartum Healing
Tissues take a long time to heal. In the case of a sprain or tear, a 12-week time frame including rehabilitation is common. Post surgical is 12-18 weeks with a progressive, stage or time dependent rehabilitation protocol. Depending on the severity, some of that is spent with just recovery, range of motion to preserve joint mobility, and keep good circulation to the tissues. Then, very light strengthening, to moderate, and then finally functionally appropriate and endurance strengthening phases are initiated.
Often postpartum you go home from the hospital, unsure what to do for 6 weeks- during which your body feels like it has been through the ringer, fluids are coming out everywhere, pain is persistent, sleep is lacking, and bad postures are adopted during carrying, feeding, and lifting. These do not set the body up for optimal healing. Once you hit the 6 week check up you are given the “good to go” which is great news, but what does that even mean? Basically, your tissues, incisions, stitch areas are checked for any red flags and assuming none are seen, you are asked what method of birth control you prefer and sent on your way. A common mistake is to jump back into what you were doing prior to, or near the end of your pregnancy- but this ends up being a huge mistake.
Your body did some amazing growing, stretching, nourishing, and shifting for nine months. Then went through a marathon event and possibly a major abdominal surgery to deliver that baby. The last 6 weeks haven’t been a cake walk for healing, as you have been providing for your newborn and trying to care for yourself too.
Tissues take months to heal in an ideal environment. They go through phases of building up, breaking down, and building back up again in order to progress loading. Abdominal tissues that were stretched created a diastasis recti which has weakened the core. The ribs and diaphragm were in different positions to accommodate the growing fetus. The pelvic floor had extra pressure sitting on it for months, then stretched to it’s maximum capacity to deliver a baby- and even underwent some of these changes if you had a Cesarian delivery! Speaking of that Cesarian delivery, it took separation of 7 layers of tissue to get to the baby, thus creating scar tissue in order to heal back together which needs to be addressed so it doesn’t cause a host of pulling, pain, and problems later.
Exercise is sometimes what makes you feel like “you” again, and as an athlete it can be the hardest thing to reign it in and not progress too quickly. Parameters used post orthopedic surgery are helpful to determine your body’s ability to accept load to return to your desired activity, say running for example. FYI- It is NOT a good idea to start running after the 6 week check up. You need to have appropriate exercises to progress your body back to that ability. In every other sect, these referrals are automatic, and you are not expected to go the process alone.
A PFPT can guide you through the phases appropriately so that you don’t make your diastasis, pain, or prolapse worse- or cause a new issue in the process- that’s the last thing you have time for!
