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alicannphysio

Podcast Q&A on all things women's health with Female Fit Project

I was invited to chat on the @fitfemaleproject podcast about all things WOMEN'S HEALTH 💪✨ We dove into abdominal separation, strength training, poo talk (yes, we went there 💩), postpartum recovery, nutrition, and supplements. It was such a fun and informative convo—I would love for you to listen and let me know what you think. You can find it here https://open.spotify.com/episode/60TBYp0LTpehzdSlhvRbQY?utm_medium=share&utm_source=linktree


I thought you might find it useful for me to delve a little deeper into the topics we covered, so here goes:


Q) How long does it take for the body to recover after giving birth? Is it different for everyone?


A) Yes, recovery after giving birth is highly individual and depends on various factors such as the type of delivery (vaginal or cesarean), the presence of complications, overall health, and support systems in place. Here’s a general timeline and considerations:


Immediate Recovery (First 6 Weeks):

  • The uterus contracts and begins returning to its pre-pregnancy size (involution).

  • Vaginal bleeding (lochia) tapers off, typically lasting 4–6 weeks.

  • Hormonal shifts can impact mood, energy, and milk production.

  • Post-surgical wounds (e.g., cesarean incision, episiotomy) or perineal tears begin healing.


Intermediate Recovery (6 Weeks to 6 Months):

  • Muscle recovery, particularly in the pelvic floor and abdominal region, starts improving.

  • Hormones continue to stabilise, especially if breastfeeding.

  • Energy levels and sleep patterns may remain disrupted due to your baby!


Long-Term Recovery (6–12+ Months):

  • Pelvic floor and abdominal muscle strength may take months of targeted rehabilitation.

  • Hair, skin, and other hormonal changes typically normalise.

  • It can take a full year or more for some women to feel fully "themselves" again, physically and emotionally.


Key Factors Influencing Recovery:

  1. Delivery type: Vaginal recovery is usually quicker than cesarean, which involves major surgery.

  2. Complications: Significant tearing, haemorrhage, or pelvic organ prolapse may extend recovery time.

  3. Pre-existing conditions: Issues like diastasis recti or pre-pregnancy health challenges can impact recovery.

  4. Lifestyle: Nutrition, hydration, rest, and targeted exercises play a significant role.


How to Support Recovery:

  • Nutrition: High-protein diets, collagen supplements, and good multivitamins can accelerate tissue repair.

  • Exercise: Gradual reintroduction to movement, including pelvic floor and core exercises, is essential.

  • Rest: Sleep is critical, though challenging with a newborn.

  • Professional Support: Seeking guidance from a women’s health physio ensures safe recovery and prevents long-term issues.


Every body is unique, so while some women feel recovered in a few months, others may need a year or more to heal fully.


Q) Many of our clients experienced abdominal separation during pregnancy and feel like they never fully recovered, 5, 10, 20 years later. Is it too late for them? What can they do?


A) It’s never too late to address abdominal separation (diastasis recti) and improve core strength and function, even decades after pregnancy. While the body’s natural healing processes slow with time, targeted interventions can significantly enhance core integrity and reduce symptoms, no matter how long it's been since giving birth. Here's what can be done:


Understanding Diastasis Recti

  • Diastasis recti is the separation of the rectus abdominis muscles along the linea alba, often caused by the abdominal wall's stretching during pregnancy.

  • Left untreated, it can contribute to back pain, pelvic floor dysfunction, hernias, and poor posture.


Steps to Improve Long-Standing Diastasis Recti

1. Work With a Women’s Health Physio

  • A thorough assessment of the core, pelvic floor, and breathing mechanics is essential.

  • Clients often need personalised exercise programs to retrain muscle coordination and address compensatory movement patterns.


2. Core Rehabilitation

  • Start with foundational exercises: These should focus on the deep core muscles (transversus abdominis) and the pelvic floor to improve tension across the linea alba. Examples:

    • Diaphragmatic breathing with core activation.

    • Gentle pelvic tilts or knee lifts.

    • Side-lying or supine exercises.


  • Progress gradually: As strength and control improve, introduce more functional and dynamic movements like planks (modified, then full), standing exercises, and resistance training.


3. Breathing Mechanics

  • Teach optimal breathing patterns, emphasising diaphragmatic breathing and avoiding excessive abdominal pressure during daily tasks (e.g., lifting or bending).


4. Address Whole-Body Movement Patterns

  • Poor posture or alignment can perpetuate diastasis. Strengthening surrounding muscles (glutes, back, and obliques) and improving posture through daily activities can reduce strain on the abdomen.


5. Lifestyle Adjustments

  • Teach proper mechanics for lifting, sneezing, coughing, and getting up from lying down.


6. Use of External Support (Optional)

  • Abdominal binders or wraps can provide temporary support for the core, especially during the early stages of rehabilitation or if a client is symptomatic.


Can the Gap Close Completely?

  • Goal: Functional healing. The focus should be on restoring tension and strength in the linea alba, not necessarily eliminating the gap entirely. A mild gap can remain without causing issues if the core functions well.

  • Surgery: In rare cases of severe diastasis with accompanying hernias or significant functional impairments, surgery may be an option. However, conservative therapy is often effective.


Encouragement for Clients

  • Progress is possible at any stage, even decades later.

  • Improvements in strength, posture, and symptom relief can be achieved with consistent effort.


Q) What do you think the importance is for women to strength train? What exercises do you recommend women to start with postpartum? 


A) Strength training is incredibly important for women at all stages of life, and even more so during postpartum recovery. It helps rebuild the body after pregnancy, supports long-term health, and empowers women to feel strong and capable. Here’s why it’s essential, along with recommendations for safe postpartum exercises:


Importance of Strength Training for Women

1. Restoring Postpartum Strength and Function

  • Pregnancy and birth significantly impact the core, pelvic floor, and overall muscle tone. Strength training restores these areas, reducing the risk of back pain, incontinence, and pelvic organ prolapse.


2. Preventing Injuries and Supporting Everyday Movements

  • Functional strength helps women handle the physical demands of motherhood—lifting children, carrying bags, and maintaining good posture during long days.


3. Bone Health

  • Weight-bearing and resistance exercises promote bone density, reducing the risk of osteoporosis, especially after breastfeeding or hormonal changes.


4. Hormonal Balance and Mental Health

  • Strength training can improve energy levels, regulate hormones, and reduce symptoms of anxiety or depression by releasing endorphins and stabilising mood.


5. Metabolic and Cardiovascular Health

  • Building muscle improves metabolism, supports fat loss, and enhances cardiovascular health, reducing the risk of conditions like diabetes and heart disease.


Recommended Postpartum Strength Training Exercises

When starting postpartum, it’s important to progress gradually and focus on core and pelvic floor rehabilitation before advancing to heavier resistance work.


Phase 1: Foundation and Recovery (0–12 Weeks Postpartum)

These exercises focus on reconnecting with the deep core, pelvic floor, and breathing patterns:

  • Diaphragmatic Breathing with Core Engagement: Relearn breathing mechanics and engage the transversus abdominis.

  • Pelvic Floor Contractions (Kegels): Focus on gentle engagement and relaxation of the pelvic floor.

  • Glute Bridges: Strengthen glutes and pelvic stability.

  • Modified Side Planks: Gentle core strengthening with minimal abdominal pressure.

  • Heel Slides or Marches: Controlled lower-limb movements while engaging the core.

  • Body weight strength training: Once you've mastered the core work you can start adding in squats, DLs, press ups.


Key Considerations for Postpartum Women

  1. Focus on Core and Pelvic Floor First: Avoid exercises that cause coning or doming of the abdomen until the core is fully rehabilitated.

  2. Gradual Progression: Start with bodyweight and lighter resistance, increasing as strength and confidence build.

  3. Listen to Your Body: Fatigue, discomfort, or symptoms like leaking, heaviness, or pain indicate the need to modify or regress.

  4. Seek Professional Support: A women’s health physio can assess readiness for specific exercises and ensure proper form.


Q) Lots of our clients struggle with constipation and aren’t going to the bathroom regularly. How often should we be going? What can help us all be more regular?


A) Constipation is a common issue postpartum and can affect anyone at any stage of life. Ideally, bowel movements should occur anywhere from three times a day to three times a week, depending on the individual. However, what’s more important is ease of passing stools—regular doesn’t just mean frequency but also comfort and consistency.


How Often Should We Be Going?

  • Normal frequency: 3 times per day to 3 times per week. But I would always say getting into a routine of going once a day is best.

  • Signs of constipation:

    • Straining or pain during bowel movements.

    • Hard, dry, or pellet-like stools.

    • Feeling of incomplete evacuation.

    • Bloating or discomfort.


Tips to Improve Regularity

1. Hydration

  • Why it helps: Water keeps stools soft and easier to pass.

  • Goal: Aim for at least 2-3 liters per day, especially if breastfeeding or active.


2. Fibre Intake

  • Why it helps: Fibre adds bulk to stools and supports gut health.

  • Sources: Include a mix of soluble fibre (e.g., oats, fruits like apples and berries) and insoluble fibre (e.g., whole grains, vegetables, nuts, seeds).

  • Caution: Introduce fibre gradually and increase water intake alongside to avoid worsening constipation.


3. Physical Activity

  • Why it helps: Movement stimulates intestinal motility.

  • Activities: Walking, yoga, or gentle postpartum exercises can encourage bowel movements.


4. Pelvic Floor and Breathing Exercises

  • Why it helps: The pelvic floor plays a key role in proper bowel function. Strengthening and relaxing the pelvic floor (e.g., through diaphragmatic breathing) can prevent straining.

  • Teach clients the “blowing a balloon” method:

    • Imagine blowing up a balloon and you should feel your abdomen harden.


5. Dietary Adjustments

  • Probiotics and fermented foods: Support a healthy gut microbiome (e.g., yogurt, kefir, sauerkraut).

  • Magnesium-rich foods: Acts as a natural stool softener (e.g., leafy greens, nuts, seeds).


6. Establish a Routine

  • Why it helps: Consistency trains the body. Encourage clients to take time after meals (the gastrocolic reflex is strongest after eating) to sit on the toilet without rushing. I think the best time of the days is 30 minutes after having breakfast.


7. Posture on the Toilet

  • Why it helps: Aligning the body properly can make bowel movements easier.

  • Encourage the “squatty potty” position:

    • Knees higher than hips (use a stool).

    • Lean forward slightly, resting elbows on thighs.


When to Seek Help

If a client is experiencing chronic constipation or symptoms like pain, bleeding, or a noticeable prolapse, encourage them to:

  • Speak to a women’s health physio or GP.

  • Rule out conditions like pelvic organ prolapse, rectocele, or bowel dysfunction.


Specific to Postpartum Clients

  • Hormonal changes (e.g., progesterone slows digestion), healing perineal tears, or c-section recovery can exacerbate constipation.

  • Postpartum clients may benefit from a gentle stool softener or laxative (e.g., lactulose) initially, as recommended by their GP.


Q) When it comes to diet, is there any advice you give you clients to keep them as strong as possible?


A) Absolutely! Nutrition plays a vital role in helping clients stay strong, recover well postpartum, and maintain energy for the demands of motherhood. Here’s some practical advice I often share with clients to keep their bodies as strong as possible:


1. Prioritise Protein

  • Why it helps: Protein supports muscle repair, tissue healing, and hormone production—key for postpartum recovery and strength building.

  • How much: Aim for 1.2–2.0g per kg of body weight daily, depending on activity levels and goals.

  • Sources:

    • Animal: Chicken, fish, eggs, lean red meat, Greek yogurt.

    • Plant: Lentils, beans, tofu, tempeh, quinoa, chia seeds.

  • Tip: Include a source of protein in every meal and snack for steady energy.


2. Incorporate Healthy Fats

  • Why it helps: Fats are crucial for hormone regulation, brain health, and long-lasting energy.

  • Sources: Avocado, nuts, seeds, olive oil, oily fish (salmon, mackerel), nut butters.

  • Tip: Add avocado to breakfast, sprinkle seeds on salads, or snack on almonds.


3. Focus on Fibre-Rich Carbohydrates

  • Why it helps: Complex carbs provide sustained energy, prevent crashes, and support gut health.

  • Sources: Whole grains (brown rice, quinoa, oats), sweet potatoes, fruits, and vegetables.

  • Tip: Swap white bread or rice for whole-grain alternatives to keep energy stable.


4. Stay Hydrated

  • Why it helps: Hydration supports digestion, muscle function, and milk supply for breastfeeding clients.

  • Goal: 2–3 liters per day, more if active or nursing.

  • Tip: Encourage clients to drink water with meals and keep a bottle handy. Adding slices of lemon, cucumber, or berries can make it more enjoyable.


5. Don’t Forget Micronutrients

  • Iron: Prevents fatigue and supports energy levels. Found in lean meats, spinach, fortified cereals, and legumes. Pair with vitamin C for better absorption.

  • Calcium: Strengthens bones and supports muscle function. Found in dairy, fortified plant milks, leafy greens, and almonds.

  • Vitamin D: Essential for bone health and immunity. Encourage safe sun exposure and consider supplements if needed.

  • Omega-3s: For anti-inflammatory benefits and brain health. Found in oily fish, chia seeds, walnuts, and flaxseeds.


6. Use Supplements if Needed

  • Collagen: Supports tissue healing, joint health, and skin elasticity.

  • Multivitamin: A high-quality prenatal/postnatal multivitamin fills in any gaps.

  • Magnesium: Helps with muscle recovery, relaxation, and bowel regularity.


7. Eat for Recovery and Energy

  • Postpartum clients: Eating enough is critical. Undereating can delay healing, weaken muscles, and increase fatigue.

  • Encourage frequent, balanced meals with a mix of protein, fat, and carbs to stabilize energy levels.


8. Meal Prep Tips

  • Why it helps: Many clients struggle to eat well due to time constraints.

  • Suggest quick, nutrient-dense snacks like:

    • Hard-boiled eggs and fruit.

    • Greek yogurt with granola and berries.

    • Energy balls made with oats, nut butter, and seeds.


9. Manage Stress and Sleep

  • While not strictly dietary, stress and sleep deprivation can lead to overeating, cravings, or skipping meals. Suggest simple meals and support systems to help clients stay nourished during tough days.


Q) Supplementation- what do you think is beneficial for us to take?


A) Supplementation can be an excellent way to fill nutritional gaps, especially for postpartum women and women in general, given the unique demands of different life stages. I talked a little about this earlier but…


My top 4 would be:

  1. A good multi-vitamin - Covers a wide range of vitamins and minerals to support recovery and lactation.

  2. Collagen - Supports tissue healing, joint health, and skin elasticity.

  3. Creatine - It helps to build that lean muscle mass and can help balance our hormones. 

  4. Protein powder - I already mentioned how important protein is for recovery but also for building lean muscle and it can be hard to get in the right amount from “normal” food alone. Plus, women need to take in protein within 30 minutes of exercise, so a protein shake is an ideal way of doing this.

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