Whether you’ve been an avid lifelong exerciser or you’re just looking to incorporate daily movement into your life, postpartum exercise can have tremendous benefits in the postpartum period.
Potential benefits include but are not limited to:
-Improved psychological well being (Larson‐Mayer, 2003)
– improved risk factors for chronic diseases like cardiovascular disease, metabolic syndrome, and obesity (Davenport et al., 2011)
-inspiring physically active children
– and of course assistance attaining a healthy weight
You may be reading this while nursing your new baby in the middle of the night, absolutely exhausted, and recovering from a cesarean delivery; you’re probably thinking: not possible? Or how do I even start?
This is where we can help you out at Hudson Valley Physical Therapy
Our pelvic health specialists can help you navigate a return to exercise and of course get you there leak and pain free
Our team will be leading a special event on September 18th through the Peanut Moms of Westchester Facebook Group where our experts talk about returning to exercise safely after baby.
When to return
If you exercised during pregnancy and had an uncomplicated vaginal delivery, a gradual return can be started when you’re home and feeling well enough.
With a cesarean delivery or a complicated vaginal delivery, wait at least six weeks and for clearance from your healthcare provider (Mottola, 2002; Pivarnik et al., 2003)
If you had complications like preeclampsia, pregnancy induced renal failure or liver disease, or other pre-existing conditions please consult with your physician before returning to exercise (Mottola, 2002; Scott, 2006).
What to do
Your body did something amazing, respect healing time.
Even if you were in spin class up until a day before you delivered, day 3 postpartum is not the time to get back on the bike.
We have a whole entire blog going into more detail coming soon so stay tuned, but for now here are a few morsels.
Try breathing with intention, stretching, light yoga and walking.
In the beginning, the name of the game is to bring a little movement that feels good into your life.
That time between just getting moving and returning or initiating higher intensity activity can be tricky.
6 weeks and beyond
The CDC recommends 30 minutes a day or 150 minutes a week of moderate intensity aerobic activity at least 5 days a week AND 2 days of strength training per week.
These are the recommendations for general health and a great goal if you weren’t an “exerciser” before.
Now if you were an “exerciser” before, you may be very eager to get back to spin, Pilates, HIIT training or whatever it is you love to do.
Have no fear you’ll get there, but the CDCs recommendation is a good starting point.
And of course if you worked out during pregnancy, you may be very comfortable walking even one hour at this point and that’s okay too.
So what is moderate intensity?
We like to explain moderate intensity with the “talk test”. You can hold a conversation but you wouldn’t be able to sing.
Amp up the gentle walking you’ve been doing with a little incline or bursts of brisk walking. Or hop on a bike for a moderate ride.
What about strength training?
Strength training can be body weight, baby weight (ie holding your baby), or with some dumbbells.
Where you start depends on what you did pre baby and depending on delivery type. Start lighter after cesarean or complicated vaginal delivery.
We recommend full body exercises but especially love those that focus on posture, the glutes, and core stability.
See some of our favorites below
Single leg work is great for building up glute, hip, and core stability
The traditional bird dog works your shoulder in a weight bearing position and is a great, simple way to work your core. Try to resist rotation in this position
You can do this one weightless or with a light weight. Hold the weight and slowly rotate to the right and left. Rotation during walking is often lost in the third trimester. Rotation really gets your core fired up.
With a new baby, you’re up and moving all day. Endurance type strength training is the way to go over trying to lift your heaviest in short bursts.
Keep weight light to moderate and try higher repetition sets ie 2 x 15
At this point we recommend low impact.
How to transition to high impact activity?
Emma Brockwell, Tom Goom, and Grainne Donnelly published guidelines to fill the gap in misinformation and ambiguity about running after a baby. The guidelines can be found here: https://www.researchgate.net/publication/335928424_Returning_to_running_postnatal_-_guidelines_for_medical_health_and_fitness_professionals_managing_this_population.
They created these guidelines for running, but they have great carryover into high impact activities in our opinion.
The guidelines specifically cite tissue healing and restoring tensile strength as an indication to start high impact activity no sooner than 12 weeks postpartum.
In addition they provide this nice little load impact test to make sure your body is ready to start high impact activity:
-Walking 30 minutes
⁃ Single leg balance 10 seconds
⁃ Single leg squat 10 repetitions each side
⁃ Jog on the spot 1 minute
⁃ Forward bounds 10 repetitions
⁃ Hop in place 10 repetitions each leg
⁃ Single leg ‘running man’: opposite arm and hip flexion/extension (bent knee) 10
repetitions each side
Are you leaking? Any low back pain, pelvic pressure or heaviness? Do you notice a bulge or gap in your abdomen?
This is a nice transition to where we come in as pelvic health specialists
When to see us?
The guidelines recommended that EVERY postpartum person gets a pelvic floor assessment and even has specific pelvic floor strength criteria.
But seeing us is crucial if you’re experiencing any signs of pelvic floor dysfunction.
Leaking, while common, is never normal…not even a few drops. A healthy pelvic floor should not leak urine or stool.
If you’re experiencing pressure, heaviness, or pain that may be a sign of pelvic organ prolapse which could worsen left untreated.
Hunting for a bathroom every 10 minutes on your walk? We can help you too.
You may feel sore after a good workout, but your back shouldn’t be hurting. We can assess you for diastasis (abdominal separation) and help you improve your core stability.
If you’re experiencing any of the former signs of pelvic floor dysfunction we do not recommend starting high impact activity.
Come see us. We will provide individualized treatment to get you where you want to be.
Want to learn more? Come on out to our event on September 18th for an in depth talk about safely returning to exercise postpartum.
Ready for a plan and treatment tailored to your goals? Come see one of our pelvic health physical therapists in the office.
Davenport, M. H., Giroux, I., Sopper, M. M., & Mottola, M. F. (2011). Postpartum exercise regardless of
intensity improves chronic disease risk factors. Medicine & Science in Sports & Exercise, 43(6),
951–958.
Larson‐Mayer, D. E. (2003). The effects of regular postpartum exercise on mother and child.
International SportMed Journal, 4(6), 1–14.
Mottola, M. F., Davenport, M. H., Brun, C. R., Inglis, S. D., Charlesworth, S., & Sopper, M. M. (2006).
VO2peak prediction and exercise prescription for pregnant women. Medicine & Science in
Sports & Exercise, 38(8), 1389–1395.
Pivarnik, J. M., Perkins, C. D., & Moyerbrailean, T. (2003). Athletes and pregnancy. Clinical Obstetrics and
Gynecology, 46(2), 403–414.