Reframing return-to-sport postpartum: the 6 Rs framework

Donnelly, G. L.; Moore, Isabel S.; Brockwell, Emma; Rankin, Alan; Cooke, Rosalyn

doi:10.1136/bjsports-2021-104877

Cited by 23 publications

(53 citation statements)

References 8 publications

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“…Currently, few evidence-informed recommendations on postpartum return to sport exist; there is often a strong reliance on medical clearance at the 6-week postpartum checkup before resuming activity, with little guidance afterwards [ 26 ]. In 2019, a group of physiotherapists developed return-to-running guidelines for the postpartum period presenting the first evidence-based framework for health professionals [ 27 , 28 ]. They highlighted the need to reach specific milestones prior to resuming high-impact/intensity exercise, and provided key considerations about common postpartum complaints including musculoskeletal pain and urinary incontinence.…”

Section: Discussionmentioning

confidence: 99%

We’re not Superhuman, We’re Human: A Qualitative Description of Elite Athletes’ Experiences of Return to Sport After Childbirth

et al. 2022

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Background A growing number of athletes return to elite sport following childbirth. Yet, they face significant barriers to do so safely and successfully. The experiences of elite athletes returning to sport following delivery are necessary to support evidence-informed policy. Objective The purpose of this qualitative description was to describe the experiences of elite athletes as they returned to sport following childbirth, and to identify actionable steps for research, policy and culture-change to support elite athlete mothers. Methods Eighteen elite athletes, primarily from North America, who had returned to sport following childbirth in the last 5 years were interviewed. Data were generated via one-on-one semi-structured interviews that were audio-recorded, transcribed verbatim, and analyzed through a process of content analysis. Results The findings of this study are represented by one overarching theme: Need for More Time, and five main themes: (a) Training “New Bodies” Postpartum, (b) Injuries and Safe Return to Sport, (c) Breastfeeding While Training, (d) Critical Supports for Return to Sport, (e) Navigating Motherhood and Sport. The athletes identified the urgent need to develop best-practice policies and funding to support return to sport, as well as develop evidence-based return-to-sport protocols to support a safe and injury-free return. Conclusion Athletes shared detailed stories highlighting the challenges, barriers and successes elite athletes experience returning to elite-level sport following childbirth. Participants provided clear recommendations for policy and research to better support the next generation of elite athlete mothers. Supplementary Information The online version contains supplementary material available at 10.1007/s40279-022-01730-y.

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Section: Discussionmentioning

confidence: 99%

We’re not Superhuman, We’re Human: A Qualitative Description of Elite Athletes’ Experiences of Return to Sport After Childbirth

et al. 2022

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“…• Play in round one of the national competition at 16 weeks post-partum 1). 9,15,17 Early post-partum physical performance tests were compared to pre-partum data (Appendix B) provided by GT's sports physiotherapist, and which were relevant to early intervention (Table 2). Evidenced-informed screening for high level neuromuscular performance in netball 8,15,29,30 was planned to be completed by the sports physiotherapist at eight weeks post-partum.…”

Section: Patient Historymentioning

confidence: 99%

“…A recent editorial advocates for a multidisciplinary, biopsychosocial injury rehabilitation model for postpartum return to high impact activities yet such a model has not been investigated. 9 Evidence suggests that 71% of athletes return to training within six weeks post-partum. 10 Similarly, survey data indicates that 40% of post-partum recreational runners return to running at four weeks 11 and 78% at 12 weeks.…”

Section: Introductionmentioning

confidence: 99%

The “Mother Load” and Return to Sport: A Case Report of Returning to Professional Netball Following Cesarean Section

Diggles¹

2023

International Journal of Sports Physical Therapy

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Background Increasing numbers of elite female athletes are competing in professional sport, and many wish to become pregnant and return to competitive sport after childbirth. Athletes have a higher risk of pelvic floor dysfunction (PFD) than non-athletes (54% versus 7%) and there is also an increased prevalence in post-partum women compared to nulliparous women (35% versus 2.8-7.9%). Additionally, PFD has been shown to influence athletic performance. High quality evidence for elite athletes is lacking, and there are no exercise guidelines specifically for these women to prepare or effectively guide their safe return to sport (RTS). The purpose of this case report is to detail the management of an elite athlete who presented following cesarean section (CS) with the goal of RTS within 16 weeks. Case Description A 27-year-old primiparous Caucasian professional netballer presented at four weeks post- caesarean section (CS) for RTS screening and assessment of pelvic floor muscle (PFM) function. Assessment included readiness and fear of movement screening, dynamic pelvic floor muscle function, structural integrity of the CS wound, levator hiatal dimensions, bladder neck descent, and early global neuromuscular screening. Measures were collected at four weeks, eight weeks, and six months post-partum. The post-partum athlete demonstrated alterations in pelvic floor muscle function, reduced lower limb power and psychological readiness. A functionally staged dynamic and sport specific pelvic floor muscle training program was implemented and adapted to the patient for her early post-partum timeline. Results Rehabilitation strategies were effective in achieving the primary outcome of RTS at 16 weeks post-partum with no adverse events reported at 6 months follow-up. Discussion This case highlights the need for a holistic and individualised RTS management approach that includes women’s and pelvic health risk factors in a professional athlete. Level of Evidence 5

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“…Inspired by The Back Facts and The 6Rs Framework infographics for clinical research knowledge translation, we have proposed three key terms to reframe PPGP care—Stable, Safe and Self Manageable 8 9. These terms were chosen to help dispel the unhelpful beliefs that certain activities are unsafe, that the pelvis is unstable and that there is no management available for this condition.…”

Section: Reframing Beliefs About Ppgp To Stable Safe and Self Manageablementioning

confidence: 99%

Reframing beliefs and instiling facts for contemporary management of pregnancy-related pelvic girdle pain

Pulsifer¹,

Britnell²,

Sim³

et al. 2022

Br J Sports Med

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Reframing return-to-sport postpartum: the 6 Rs framework

Cited by 23 publications

References 8 publications

We’re not Superhuman, We’re Human: A Qualitative Description of Elite Athletes’ Experiences of Return to Sport After Childbirth

We’re not Superhuman, We’re Human: A Qualitative Description of Elite Athletes’ Experiences of Return to Sport After Childbirth

The “Mother Load” and Return to Sport: A Case Report of Returning to Professional Netball Following Cesarean Section

Reframing beliefs and instiling facts for contemporary management of pregnancy-related pelvic girdle pain

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