Featured in Outside's Backpacker Magazine: Returning to Hiking Postpartum

Our very own Katherine Koch, PT, DPT was featured in Outside’s Backpacker magazine offering tips and advice for pregnant and postpartum moms on how to stay on the trails and how to return to the trails. Read the full article here, or read our key points below:

Postpartum Hiking Exercises: Strengthening Your Pelvic Floor for Trail Readiness

Returning to hiking after childbirth offers numerous physical and mental benefits, but it also requires careful attention to your body's unique needs during the postpartum period. The article "Postpartum Hiking Exercises: Strengthening Your Pelvic Floor for Trail Readiness" from Outside's Backpacker provides expert guidance on safely reintroducing hiking into your routine by focusing on pelvic floor health.

Understanding the Postpartum Body

Dr. Katherine Koch, an orthopedic and pelvic floor physical therapist, emphasizes that postpartum bodies undergo significant changes due to hormonal fluctuations, particularly in estrogen, progestin, and relaxin. These changes can affect ligament stability and muscle strength, making it essential to approach physical activity with mindfulness. She advises, "Just because a symptom is common does not make it normal."

Shifting Your Perspective

Brooke Froelich, co-founder of Wild Kind, a community for adventurous moms, highlights the importance of adjusting expectations during postpartum recovery. She suggests, "Instead of expecting to immediately return to pre-pregnancy activity and ability, I had to learn to shift my mindset to love being outside, for the sake of being outside." This mindset fosters a healthier relationship with physical activity and promotes long-term well-being.

When we rehab our bodies postpartum, we can get back to the great outdoors without issue

Pelvic Floor Exercises for Hiking Readiness

To prepare for hiking, incorporating specific pelvic floor exercises can be beneficial:

• Kegel Exercises: These exercises involve contracting and relaxing the pelvic floor muscles to improve strength and control. Performing kegels can enhance bladder control and support pelvic organs during physical activities. Remember we need to be able to contract the pelvic floor as well as relax the pelvic floor. Issues can arise when we’re too contracted, too relaxed, or not able to coordinate the muscles.

  • Most people have heard of kegels, but many don’t perform them correctly! A kegel should be isolated to your pelvic floor and not include any other muscles such as your glutes or inner thighs.

  • Squeeze your pelvic floor like you are sitting on a marble and want to pick it up. Then lower the marble back down to release the kegel.

  • Try to squeeze and release for two sets of ten as well as hold for ten seconds. The pelvic floor needs to be strong, have endurance, and react quickly!

• Sidelying hip abduction: Lie on your side with your bottom knee bent and your top leg straight. Flex your ankle and lift your top leg straight up and back on a slight diagonal. Lower back down to resting position. Try two sets of ten and feel your gluteus medius working; this muscle is on the side/back of your hip. It’s a very important pelvic and hip stabilizer and weakness in this muscle can transfer more force into your pelvic floor. This may cause pelvic floor symptoms like leakage or heaviness that aren’t the fault of your pelvic floor; this is the fault of a gluteus medius muscle who isn’t doing its job and is passing along too much force to the pelvic floor to deal with.

• Deep lower core activation: Lying on your back with knees bent or seated upright in a chair, place your fingertips on both sides just inside your front hip bones. This area should feel soft and squishy when the deep lower core muscles are turned off. To activate the deep lower core, try to pull those front hip bones together. This should feel like a firming under your fingertips and you should feel activation or tension across your lower abdomen. You might also feel some pelvic floor engagement here; this is a good thing as your deep lower core and pelvic floor muscles are supposed to co-contract together. 

  • The deep lower core is an important pelvic stabilizer that is different from your rectus abdominis, or your six-pack muscles. The deep lower core is made up of the transverse abdominis and the oblique muscles. You shouldn’t feel your center superficial abs contracting when you do this exercise; it should be focused on your deep lower core.

  • To add more challenge to this exercise, you can add marches or leg reaches.

• Inner thigh activation: The inner thigh muscles, or adductors, are important pelvic stabilizers that are often forgotten in traditional exercise. Pilates tends to have a great focus on these muscles, but other forms of exercise often leave them behind. Weakness and tightness in the adductors can lead to pain including lightning crotch and pubic symphysis dysfunction. Let’s prevent and/or fix those by strengthening these muscles!

  • Lie on your back with a small yoga ball or yoga block in between your knees with your feet flat. Squeeze the ball and feel your inner thigh muscles activate. Hold for a count of 5-10 seconds, then relax and repeat. Bonus if you can coordinate a pelvic floor contraction (kegel) and deep lower core activation at the same time!

• Posture correction: During pregnancy, your posture shifts due to the growing baby changing your center of gravity. This happens slowly (though it may seem fast!) and your brain and body adapt to this by thinking it has a new normal. When your center of gravity returns back to normal postpartum, your brain and body don’t necessarily shift back into that normal posture on their own. 

  • This is a tough one to get on your own, but even trying to identify where your posture isn’t aligned can help you start to correct this. If your hips are sitting forward and your shoulders are sitting back, try pulling your hips back underneath you and feel your shoulders stack better over your hips. Stack this on top of a better foot posture where you find a tripod stance through your feet for a better base of support.

This becomes even more important as babes grow and get heavier!

Tips for Hiking with Pelvic Floor Health in Mind

When returning to hiking postpartum, consider the following tips to protect and strengthen your pelvic floor:

• Start Slowly: Begin with short, flat trails and gradually increase the difficulty as your strength improves. This approach allows your body to adapt without overloading the pelvic floor.

• Use Supportive Gear: Wear comfortable, moisture-wicking clothing and supportive footwear to reduce impact and provide stability during hikes.

• Stay Hydrated: Proper hydration supports overall health and helps maintain bladder function during physical activities.

• Take Breaks: Rest as needed to prevent fatigue and give your pelvic floor muscles time to recover.

• Listen to Your Body: Pay attention to any signs of discomfort or strain, and adjust your activity level accordingly. Other pregnancy and postpartum symptoms that we want to pay attention to include leakage and heaviness/pressure. An increase in these symptoms are signals that you might be overdoing it and pushing your muscles into fatigue. Fret not; we can rehab those problems and get you back to doing what you love without issue!

Seeking Professional Guidance

If you experience pelvic floor issues, you want to figure out what’s at the root of the issue and get help solving it. That’s where we come in. We’re expert specialists in pelvic floor, pregnancy and postpartum, and bladder/bowel dysfunction. We’ll give you a thorough education and assessment of your specific issue, provide an accurate diagnosis as well as a treatment plan that includes exercises, hands on manual therapy, and more. Remember “common not normal” is what we say around here. Plenty of people deal with issues in this area, but we can’t write them off as normal or something you have to deal with. Just like any other musculoskeletal issue (think of pulling a muscle in your back or tweaking your knee!) the pelvic floor is a group of muscles that can be rehabilitated and healed back to normal after an injury or dysfunction.

Final Thoughts

Returning to hiking postpartum is an empowering journey that reconnects you with nature and your body's strength. By focusing on pelvic floor health and incorporating targeted exercises, you can enhance your hiking experience and overall well-being. Remember to progress at your own pace, listen to your body, and seek professional guidance when needed to ensure a safe and enjoyable return to the trails.