Bone and tendon adaptations to 18-weeks rehabilitation and endurance and resistance training in postpartum British Servicewomen: a non-randomised controlled trial

Women experience musculoskeletal changes following pregnancy that may increase musculoskeletal injury risk. This trial explored 18-weeks combined rehabilitation and endurance and resistance training (Intervention, n = 17) compared with standard-of-care (Control, n = 14) on areal bone mineral density (aBMD), tibial bone, and patella tendon properties in postpartum UK Servicewomen. Intervention received standard care plus pelvic floor and core strength exercises from week 1 to 18 (week 6 to 24 postpartum), and combined high-intensity interval and resistance training from week 6 to 18 (week 12 to 24 postpartum). Control received standard care. Whole-body DXA and tibial HRpQCT scans (4% and 30% sites) were taken at week 1 and 18. Patella tendon properties at rest and during isometric contractions were measured by ultrasound at weeks 1, 6, and 18. There was no effect of training on aBMD (p ≥ 0.100) but trunk (-1.6%) and spine (-2.3%) aBMD decreased from week 1 to 18, irrespective of group (p ≤ 0.021). There was no effect of training on tibial bone (p ≥ 0.151) or patella tendon properties (p ≥ 0.185). An 18-week rehabilitation and endurance and resistance training programme had no effect on bone or tendon properties in postpartum Servicewomen.