If you google pelvic floor + cycling, postpartum exercises, pregnancy safe exercises etc etc you’ll almost always encounter the recommendation that cycling is a safe form of exercise for your pelvic floor.
Recently I’ve been testing this theory out.
Pushing your pedals down is a similar move to a seated leg press machine. Seated leg press machine is not recommended if you are postnatal, have pelvic floor dysfunction or prolapse.
Why? There is a huge downward push/pressure into the pelvic floor muscles. Also, the act of sitting to standing exerts the highest level of Intra abdominal pressure (more than a single sit up) of any exercise that have been tested in the study that was conducted. Riding a bike usually involves a fair bit of sit to stand action, even if you are just cycling on a flat surface.
So why is cycling still being recommended?
I am a mountain biker. I rode my bike until I was just about to hit my 3rd trimester and my first ride postpartum was when my baby was six weeks. I was so desperate to get back on my bike!
However, I now have prolapse. I was diagnosed at 12 months postpartum. I thought I had done everything “right” regarding my postpartum recovery and my pelvic floor. I thought it would never happen to me.
When I was diagnosed I racked my brain as to why this had happened. I’m sure everyone goes through this thought process. Im sure there were a number of contributing factors – the hormonal changes that occur around 12 months PP, my poor pelvic alignment, my stress breathing – but one thing that stood out was my mountain biking, particularly the fact that my set up was not optimal, that I started back too early, and that I did a lot of sit to stand (to go over roots and rocks). Basically it is your typical case of “too much too soon”.
I’m pretty well recovered now, I am managing my pelvic floor dysfunction well and I am able to ride. Some days it feels worse than others and some trails make me more uncomfortable than others. Changing my seat set up has been the best advice. Its awesome having a really good reason to travel downhill rather than climb uphill!! However, even on a flat surface (and during a spin class) I feel there is a still too much downward pressure to be recommending it to postnatal women.
I think there needs to be more clarity on the type of cycling that is deemed “safe” for the postnatal population, so that they can avoid pelvic floor weakness and dysfunction. Like, the kind of ride that you do with your toddler who is learning to ride might be more suitable.
It is 100% impossible to avoid rough terrain that requires a sit to stand maneuver when riding off road, and in road cycling, I still think its pretty unlikely that you won’t be required to stand up occasionally or encounter a little hill. I’m pretty sure none of the Roadie or MTB population would be seen dead to get off their bikes just to go avoid a small boulder or hill. (if you care more about your pelvic floor than maybe you should…..)
Here is what doesn’t feel right for Me:
- Really steep inclines whether sitting or standing, although, sitting is the better option, as long as you are sitting with your pelvis in neutral
- Really heavy gears – whether you are on a flat road and pedalling hard or during a spin class when you are asked to increase the resistance
- In off road riding when suddenly I need to stand to get over a log or boulder or to pedal through tough terrain like sand or mud and I’ve not prepared my PF muscles
- Long rides – just like any muscles, pelvic floor muscles fatigue
- Poor bike set up – if the seat is too low or high, too far back or too far forward or if it is on an angle
- Holding my breath!
What does feel better is this:
- Descending while standing – I feel this is like holding a tall squat position. I squat a lot in my training and am able to control my pelvic floor muscles. I contract when I exhale and relax when I inhale. Although it is pretty hard to sync the core breath up with whatever is coming at me on the terrain, it’s still beneficial
- Upright bikes – leaning forward will put more strain on the PF muscles
- Get your bike set up by a professional who understands the pelvic floor. You need to “spread the load” evenly through your sit bones
- Wearing a pessary. If you are considering cycling or mountain biking you cannot forsake a pelvic floor assessment with a women’s health physiotherapist. If you have prolapse, a pessary will give your pelvic floor the support that it needs and hopefully prevent further straining of the prolapse
- Riding at certain times of the month. The menstrual cycle and the hormonal cycle can mean good or bad for your pelvic floor. Cycle your training and go easy on the bike during the weeks leading up to your period
- Doing my pelvic floor exercises and strengthening my core – learn the “core breath” here
- Not holding my breath
- Chiropractic to relieve stress and adjust my pelvic alignment.
It’s also what you do the other 23 hours of the day that affects your pelvic floor. Do you hold your breath? Do you have poor posture? Do you bear down? Do you forget to do your pelvic floor exercises? Do you strain on the toilet?
What I’m trying to say is this – that the longer you stay off your bike after pregnancy and childbirth, whether it is mountain biking, road cycling or spin classes the better! If I could do it all over again, I would opt for walking and swimming for postpartum exercise until at least 9months postpartum. (And put away the dumbbells too).
Learn from my mistakes and restore your core first before re introducing cycling into your exercise routine! I have collated everything I have learnt, know and experienced here into the “ultimate core restore” eBooks.
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