Ten steps to getting ‘back on the bike’ after baby

This post is written by Hannah Geelan - Physiotherapist, Cyclist and Bike Fitter. 

**For all our non-cycling enthusiasts who assumed that 'bike' was a euphemism for something else, we have that post here on The EMP Journal with psychologist Dr Rosie Pajak.

For everyone else who is actually interested in returning to cycling after birth, we hope that this post covers everything you need to return to the saddle safely and confidently. 

Image Credit: James Raison. @rideadelaide

Ten tips to support your postnatal return to cycling

It’s well known that cycling is a fantastic form of low-impact cardio exercise. In fact, seated cycling puts significantly less pressure on the pelvic floor than walking (Dietze-Hermosa et al., 2020). 

Cycling can be a great option for women looking to recommence a fitness journey after birth or for anyone with pelvic floor issues such as incontinence, muscle injury or prolapse.

1. Ensure you are at least 6 weeks postpartum

Allow at least six to twelve weeks to recover from your birth before returning to any form of cycling. If you require any sutures after birth, please ensure any stitching has healed before you return to the saddle.  We recommend returning to stationary cycling to build your fitness and endurance where possible. Your centre of gravity, balance and control are all affected in the early postnatal period, which can increase your risk of falls. Riding a stationary bike will also place less pressure on your pelvic floor in the early stages of your postnatal recovery. 

If you are within 6-12 weeks postpartum and want to return to exercise safely, we recommend Levels 1 and 2 of the Empowered Motherhood Program. These physio-led workouts are designed to help you heal from birth and rehabilitate your core and pelvic floor. Choose from specific postnatal programs for vaginal delivery, C-Section birth or the pelvic floor safe program for women with pelvic floor injuries such as prolapse or OASI.  

2. Understand how your hormones will impact your return to cycling 

If you are breastfeeding and your menstrual cycle has not yet returned, you will likely be in a low-oestrogen state. This can cause reduced lubrication and vulval tissue health, which may contribute to skin breakdown when cycling, for example, cuts or sores around the vulva. Speak to your health care provider for advice, which may include intra-vaginal oestrogen cream and/or topical creams to help improve tissue health.

Image Credit: James Raison. @rideadelaide

3. Cycling can be a great way to incorporate cardio for women with pelvic floor dysfunction

As a low-impact form of cardio, cycling can greatly improve your cardiovascular fitness if you are living with pelvic floor complications. However, like all pelvic-floor safe movement, it is important to have the foundations right. The Empowered Motherhood Program has a specific week-by-week program for women who are living with pelvic floor injuries and complications such as prolapse, urinary incontinence, avulsion or OASI. In this program, you will learn how your posture, breathing, pelvic floor and core control can all impact your symptoms over the long term. See Tip #6 below for tips on posture and breathing on the bike.

If you are living with prolapse, we have written a super post here to help you to navigate life with prolapse and return to the type of exercise you love. 

If you are experiencing any of these conditions or general feelings of heaviness or bulging in the vagina, we recommend seeking support from a Pelvic Health Physiotherapist. 

Image Credit: James Raison. @rideadelaide

4. Terrain makes a difference! 

Road riding tends to put less pressure on your pelvic floor than rough terrain, e.g., mountain biking. Research from Dietze-Hermosa et al. (2020) also shows much greater pelvic floor pressure when cycling out of the saddle compared to riding in the saddle. This is likely due to the lack of external support to the perineum. So consider riding road or flatter, less technical fire trails before building back into hills or single track as your body feels ready.

5. Bike Fit - the Technical Stuff 

Your bike fit should change as your body does. Ideally, you’d work with a professional bike fitter who can assess and address a position most comfortable for your postpartum body. Some of the factors that are likely to need adjustment include:

The saddle itself

Your sit bones are often a little wider after giving birth, so you may need a size wider than before. The saddle's shape, whether you have a cutout, and where that cutout might need to change. If you need to tilt the nose of the saddle down by more than 1-2 degrees to be comfortable, that’s often a sign the saddle is no longer the best one for you.

The saddle height.

You may feel quite tight in your lower back and hamstrings from less overall exercise and increased static postures like feeding. So, you may need to drop the saddle accordingly, e.g., 5-10 mm.

The saddle fore-aft

The saddle fore-aft refers to how far forward or backwards the saddle is on the rails. This change facilitates your pelvic position. Too far forward, and you’ll be in a lot of what we call anterior pelvic tilt. This, along with a low handlebar position, could really load up your labia. So if you’ve had any trauma like stitching, swelling, or bruising in this area, you may want to adjust your saddle back on the rails slightly, which will tuck your tailbone under a little. This will reduce that pressure at the front of the saddle and redistribute the saddle pressure more onto your sit bones. Too far back, though, and you’ll load up your back and hamstrings too much. It’s a fine line!

Handlebar height.

Initially, you might want to have those handlebars raised a little, which will tip you more onto your sit bones rather than your labia. If you’re experiencing reduced mobility in your neck and lower back, this would also help. However, if you lift it up too much, you may feel too much pressure on your sit bones, so monitor how they are coping. Signs they aren’t coping include saddle sores and excessive localised tenderness. The bars' height also needs to align with your cycling goals. If you’re looking for more recreational riding and your sit bones are coping ok, you can keep your bars that bit higher. However, if you’re looking to return to racing and have the flexibility and tissue healing to do so, you’ll want to lower that front end again.

Shoe size and cleat position

This one can be expensive and frustrating! But your foot length and width might increase during pregnancy and remain so after birth! If you feel like your foot is now too close to the end of the shoe or pushing against the width of your foot, you will need new shoes in a different size. The issue with riding with shoes that are too small is that you’re more likely to end up with foot numbness, tingling or ‘hot spots’ due to the lack of room in the shoe as your feet swell slightly as you exercise. This can constrict the nerves and circulation. Regarding the cleat position, a general guide to aim for is to have the line of your first and fifth metatarsal heads in line with your pedal spindle. The rotation of the cleat should also mimic your natural foot stance, e.g. toes out or in. The stance width (side-to-side movement of the cleat) may need to be adjusted to ensure your knees are tracking over your toes.

6. Posture and Breathing 

Focusing on thoracic mobility and breathing to reduce the load on the pelvic floor is important due to the close relationship between the thorax, diaphragm, and pelvic floor.

It is easy to become stiff in your spine and tight in your chest and hip flexors with all those feeding, carrying and rocking positions that we often adopt for many hours with young babies. Add in time on a bike, which means even more bent over postures, then we can really exacerbate these areas of stiffness and tightness. When possible, taking time pre- and post-ride to stretch out your pecs, mid-back, and hip flexors can help keep you limber! Laying down lengthways along a foam roller is a very time-efficient way to mobilise the spine and to practice your diaphragmatic breathing.

7. Cycling kit

Investing in a good riding kit is paramount. Also, ensure that the chamois (padding) of your knicks are in direct contact with your skin to reduce friction, i.e., no undies. There is a good selection for women these days, but it still comes down to personal preference. We recommend trying them on and picking the most comfortable pair for you!

8. Build your fitness progressively and patiently 

Be kind to yourself, especially when first returning to the bike. Between pregnancy, birth, postpartum, raising a newborn, possibly juggling other children, a reduction in sleep, changing hormones and often tricky schedules with naps and feeding, there is already a huge demand on your body. Add time off the bike or from other exercises, and returning can feel difficult. Just like our Postnatal Return to Running program, we recommend starting small, e.g. 15-30 minutes and ensuring at least one day off between rides to allow your tissues and muscles to rest and recover. Begin with easier rides, and as your body copes, you could add in intensity, whether that be effort or hillier terrain. Increase the time of rides as you feel comfortable.

9. Whole body strengthening

Building full body strength will transfer less load through your pelvic floor. This is where the EMP Postnatal program can really complement and enhance your riding. With 5 stages of postnatal safe workouts (from early rehabilitation to advanced fitness), the EMP will help you build strength safely and confidently - all from the comfort of your home. Engaging with a Women’s Health Physio and gradually progressing your postnatal rehab safely into a gym program will really help you to progress the intensity of your riding.

10. Don't forget about your Hydration and Nutrition

Many cyclists will know the awful feeling of hunger flatting! Getting enough nutrition throughout the ride is really important to prevent this. For those who are breastfeeding, you might be surprised at how much extra food and water you’ve got to consume. It’s best to begin eating and drinking early in the ride rather than waiting until you’re hungry or thirsty, as this is often when it’s too little, too late!

Goodluck! 

It can be daunting to get back on the bike after birth. But considering each of these steps will help you return to a light-impact form of cardio and, importantly, time for yourself!

About the Author

Hannah Geelan is an experienced physiotherapist and bike fitter who works for Sportsmed in Adelaide, South Australia. Hannah is currently undergoing her APA Women’s Health training. Hannah has raced on the road and in triathlon to an elite level and has a 9-month-old daughter.

Instagram: @hannahgeelan_physiobikefit and @sportsmedau

Bio: https://www.sportsmed.com.au/practitioners/hannah-geelan/

REFERENCES

Dietze-Hermosa, Martin & Hitchcock, Robert & Nygaard, Ingrid & Shaw, Janet. (2020). Intra-abdominal Pressure and Pelvic Floor Health: Should We Be Thinking About This Relationship Differently? Female Pelvic Medicine & Reconstructive Surgery. 26. 1. 10.1097/SPV.0000000000000799.