RETURNING TO EXERCISE POSTPARTUM

Women are often given next to no guidance on how to return to exercise in the postpartum period. At the 6-week follow-up after childbirth, OBGYNs will tell their patient that they are safe to return to exercise, and from a tissue-healing perspective that’s totally correct. But ask most women at 6 weeks postpartum if they feel physically ready to start running, weightlifting, etc., and the majority are going to say, “Absolutely not!”

So, what are some common things a woman may experience postpartum that can lead to avoiding exercise?

·      Orthopedic pain (i.e. low back or hip pain, pubic bone pain, or abdominal pain after cesarean section)

·      Pelvic floor symptoms (pelvic floor heaviness, urinary leakage)

·      Diastasis recti abdominous (in short, separation of the abdominal muscles that happens during pregnancy and may persist postpartum)

·      Increased stress or depression

·      Pelvic pain after vaginal childbirth due to perineal tearing

The good news

The good news is that strength training and cardiovascular exercise can potentially help with all of these. Now, there is a wide variation when it comes to what the timeline looks like for returning to your exercise of choice postpartum. Some women may feel comfortable returning to running around 3 months, others will return to it beforehand, and others not until 6+ months postpartum, and all of those are OK! One of the best guidelines to returning to activity is to do what feels good, so long as it doesn’t increase any of your current symptoms (e.g., incontinence, diastasis recti, low back pain).

The reason for inactivity

The 6-week period postpartum can be difficult for many reasons and leads many women to be inactive during that time. However, physical activity during this time is important and necessary for most women. Women need to be physically capable of caring for their babies, which includes lifting/holding them, carrying them in their car seat, and possibly lifting or carrying other children. Modified exercise during these first 6 weeks has both physical and psychological benefits for the mother, AND can potentially prevent persistent pelvic floor symptoms. With that said, here are some things that women can do in those first 6 weeks that can potentially help with healing and prepare to return to the exercise they love:

·      Diaphragmatic breathing in various positions

·      Core and pelvic floor activation

·      Gentle hip strengthening

·      Modified upper body exercises

·      Gentle walking

After clearance from your OBGYN at 6 weeks, you may consider:

• Gradual return to strength training and cardiovascular exercise – begin lower impact and progress towards higher impact

• If returning to running, begin with walk-run intervals and then into longer distance running. Begin with a low weekly volume, and gradually increase. If running initially isn’t feeling great, consider other exercises to build up strength and tolerance to activity.

• If returning to lifting, gradually expose your body to load / weight and impact. Begin with exhaling on exertion (e.g., bringing the bar up to the hips during a deadlift or on the ascent of a squat), and gradually return to using Valsalva for higher-effort lifts. Focus on rebuilding your core control prior to returning to using a belt.

Some final thoughts…

• Everyone’s pregnancy and postpartum experience is different. If you have questions or feel like you need more guidance, reach out to your OBGYN, a pelvic floor therapist, or a trainer with experience training women during this stage of life.

• Get going with some gentle physical activity as soon as you feel ready postpartum to help with healing, mood, and prevention of postpartum complications such as low back pain or pelvic floor symptoms.

• Let your body be the guide when it comes to returning to exercise postpartum! If an exercise is making your symptoms worse, modify as needed.

• IF you continue to have persistent pelvic floor or orthopedic complaints, get in touch with a physical therapist! We can help you manage your symptoms and figure out how to return to exercise in a way that’s safe and feels good.