I am getting to that age where people are getting married and having babies…except me…so I wanted to share some guidelines for returning to exercise after you have the baby! Now, I have no experience in this field, so I took it upon myself to ask someone who does have experience!
Victoria Dosen is a colleague of mine that specializes in coaching women pre and postpartum, so I thought her sharing her knowledge would be much better than me just researching for you! If you are someone who is pregnant or just recently had your baby, she is a great resource for not only exercise in general, but restoring your core!
So, baby is here, you’re settling into your new way of life, and you’re anxious to get back into the gym. Maybe you’ve even gotten the “green light” from your healthcare professional to resume normal activity again. Not so fast! I know this may not be what you want to hear, but I say this with the highest regard for your health and wellbeing as a new mom. I see all too often what can happen when a new mom is made to believe that she’s okay to jump right back into her typical fitness routine post pregnancy. Resuming your pre-pregnancy routine prematurely can result in nagging lower back and hip pain, a diastasis that hasn’t healed properly, leaking, an umbilical hernia, pelvic organ prolapse of varying degrees. Any of these unfortunate results can further lead to feelings of insecurity, confusion, and failure as a woman starts to lament the fact that her body didn’t “bounce back” like many told her it would after baby.
After having gone through the physical demands of carrying and birthing a child, we need to look at the postpartum period as a time of essentially recovering from injury. When someone goes through a knee or hip replacement surgery, breaks a bone, or sprains an ankle, we proceed with caution and provide them with a plan of action as it pertains to resuming physical activity and exercise. But when a woman is pregnant or has just given birth, we merely tell her to “listen to her body”, make no mention of the need for ANY type of rehabilitative measures for her body, and provide her with a list of VERY general recommendations that leave room for all kinds of interpretation as to how she should proceed with getting back into fitness. This, of course, often sets her up to prematurely return to certain activities when her body isn’t exactly ready for them! Hopefully, you can see that returning to fitness postpartum isn’t as simple as resuming normal activity after the 6 week check-up. We need to approach things with well-thought-out, more specific, and progressive guidelines that will enable a new mom to establish a foundational level of strength, stability, coordination, and function, and then gradually progress her through the first year postpartum (so that she can return to the activities she enjoyed pre-pregnancy with confidence and without worry of complications later down the line).
These are guidelines that I use with all of new moms I work with, whether in-person or through distance coaching. I believe these to be the safest and most effective guidelines for healing the body and returning to exercise postpartum. Regardless of whether you are a CrossFit athlete, a runner, a boot camp fanatic, a Body Pump enthusiast, a powerlifting or weightlifting athlete, or if bodybuilding or physique training are your jams…the same principles still apply!
This piece IS NOT about how to speed up your postpartum recovery so that you can get back in the gym and begin setting new PR’s at 9 weeks postpartum, so that you can get out there and go run a half marathon, or so that you can be ready by three months postpartum to go compete in a local fitness competition. Instead, I am going to teach you how to approach fitness during the first YEAR postpartum in a way that ensures your body is healing and functioning well, and gaining strength in a progressive manner so that we can layer on more intense exercise when the time is right. Sound good? Okay…let’s dive in!
Before we continue, there is one big consideration that I want you to keep in mind here:
• Postpartum is a recovery PROCESS. It’s important to make sure that you’ve got your alignment dialed in, your breathing mechanics dialed in, and your core and pelvic floor are functioning well again, with good muscle tone, strength, and endurance to FIRST support your body through simple everyday activities. We have to do this before we layer on more stressful activities like weightlifting, running, plyometric training, gymnastic movement, etc.
There are also a few more factors that we need to take into account to help us determine how and when you will return to fitness postpartum:
• How did your labor and delivery go?
• Did you have any tears, or stitches?
• Any bleeding?
• How well are your core and pelvic floor healing? Are you doing any of sort of restorative exercises for the core and pelvic floor?
• Are you breastfeeding?
• How are you adjusting to life as a new mom?
• How much sleep per night are you getting? Sleep plays a huge role in our overall recovery, not to mention our ability to recover from exercise as well.
• Any signs of a prolapse, incontinence, hip, back, or pelvic pain? Any feelings of heaviness or bulging in your pelvis?
• Have you booked an appointment to see a pelvic floor physical therapist in your area?
I strongly recommend that you spend most of your time resting as much as possible during those first few weeks postpartum. Maybe even longer, depending on how you feel.
Regardless of how fit or how much you worked out during your pregnancy, you are essentially starting from scratch here in terms of building up your fitness again. We need to give the body adequate time to rest and heal in order to handle more load and stress. With that said, I absolutely believe that you can begin GENTLE workouts before your 6-week check-up if you are feeling good, healing well, and there is no increase in symptoms (pain, bleeding) after working out.
Your healthcare provider will usually want to see you around 1- 2 weeks postpartum (barring no complications), so I prefer to have my clients simply focus on resting, bonding with baby, and adjusting to their new way of life until that first check-up. During those first few weeks, you can begin practicing good alignment and posture (like I mentioned above) as well as some gentle diaphragmatic breathing throughout the day.
Once you’ve had that initial check-up and your healthcare professional says that you are healing well, then we can start incorporating some restorative work for the core and pelvic floor. Usually after the first month or so, you can start to incorporate more leisurely walking and some short strength training sessions. (Please note though that when I say strength, I mean learning how to use your own bodyweight again. Believe it or not, there is an initial learning curve for figuring out how to move your own bodyweight again postpartum.) After this, we can start adding in some light strength work (e.g. resistance band training, modified TRX and ring training, and LIGHT dumbbell and kettlebell training).
PLEASE NOTE: Regardless of all the social media posts you may see of women “bouncing back” and doing all sorts of crazy ab work and high intensity exercise like running, heavy weightlifting, and plyometric work…NOW is not the time for this. The joints and tissues of the body still remain very lax, stretched out, and weak at this time, which means they are highly susceptible to injury when placed under high stress and heavy load!! This is not the time to earn a badge of honor or be out to prove anything to anybody. Your long-term health is in jeopardy if you come back too hard too fast. And also remember: just because you CAN do something, it doesn’t mean that you SHOULD do it.
Frequency: 1 – 3 days per week
Time: 10-30 minutes per session…depending on how you are feeling that day. Remember to start small and build up your window of time per session.
Intensity: Light to Moderate Intensity (2-5 on a 1-10 Rate of Perceived Exertion scale)
Activities: Bodyweight exercises (squats, stationary lunges, stationary reverse lunges, step-ups to a low box, rear foot elevated split squats to a low box, inverted rows, wall push-ups), light resistance band training (lat pulldowns, rows, chest presses, band pull-aparts, band face pulls, banded squats, banded glute bridges, banded hip thrusts, band pull-throughs, Pallof Press variations, etc.), LIGHT weight training (incline chest press, floor press, dumbbell or kettlebell goblet squats, lateral and front raises goblet stationary lunges/reverse lunges, etc.), some core training (modified side planks, heel slides, modified dead bugs, farmer’s carry holds and walks, tall kneeling or 1/2 kneeling band pullovers, glute bridge variations, clamshells, hip thrusts).
*Please keep in mind that as you begin to load exercises, be sure to pay close attention to how you are feeling through your core and pelvic floor both during and after your workouts. And remember to roll to your side when needing to get up and down as you continue to heal your Diastasis Recti.
Leisurely walking should be your activity of choice during those first few weeks/months postpartum. Feel free to walk as many times per week as you feel up to it. Leisurely walking helps to keep your cortisol levels down so that healing can occur without a hitch.
Other forms of cardio that you can start to include as you get closer to the 3-month mark include biking (watch your alignment and breathing), rowing with the damper set at a low setting (again watch your alignment and breathing), and swimming.
Frequency: 1-2 times per week (this includes any activity outside of leisurely walking)
Time: 10 – 30 minutes per session. Gradually building up the duration of each session.
Intensity: Light to Moderate (3-5 on a 1-10 Rate of Perceived Exertion scale)
Please understand that at this point, I am assuming that you have worked your way through all of the steps for 0-3 months postpartum. Even if you’re at 4 months postpartum, if you haven’t done the 0-3 month work, you need to go back and do it now. Again, we want to re-establish better breathing patterns, regain function, strength, endurance, and coordination in the core and pelvic floor, develop a solid level of strength, and be able to control our own body weight first before adding on more intense and advanced exercise progressions.
Hopefully, by this stage in the game, learning how to lift your baby, weights, and everyday items has become like second nature to you. We also want to ensure that your diastasis is healing well, and that you aren’t experiencing any pain or dysfunction through the core and pelvic floor. One last thing: if you haven’t had a chance to get in to see a women’s health physical therapist…then now is THE time to do it (before we start adding in more challenging exercises like running, plyometric work, heavier weightlifting). I always tell my coaching clients that even though your healthcare provider may have told you everything looks good inside and down below, we need to have a more detailed picture about what’s really going on with your core, pelvic floor, and body. Most physical therapists will tell you that it can take up to 2 years for the female body to ENTIRELY recover from pregnancy.
4-6 Months Postpartum Strength Training:
Frequency: 2-3 days per week
Time: 15-45 minutes per session (depending on your energy levels and schedule, because we all know how mom life can be sometimes!).
Intensity: Moderate Intensity (4-6 on a 1-10 Rate of Perceived Exertion scale)
Activities: We continue on with many of the same exercise as before, but now we can start sprinkling in slightly more challenging variations like some LIGHT barbell work (deadlifts, back squats, front squats, bench press , overhead presses), LIGHT kettlebell work, bodyweight exercises (push-ups and front planks on an incline, pull-up and chin-up progressions), moderate resistance band training (slightly more challenging lat pulldown variations, rows, chest presses, band pull-aparts, band face pulls, banded squats, banded glute bridges, banded hip thrusts, band pull-throughs, Pallof Press variations, etc.), dumbbell training and medicine ball training with more moderate amounts of weight.
*Please keep in mind as you begin to load exercises, be sure to pay close attention to how you are feeling through your core and pelvic floor both during and after your workouts.
As far as plyometric-type exercises (box jumps, jump rope, burpees, broad jumps, tuck jumps, bounding exercises, skipping exercises, etc.) and running are concerned, there are a few considerations to keep in mind here before adding these activities back into your program:
• Your diastasis is healed
• You’re not experiencing ANY sort of pain or discomfort
• You’re not leaking (in any amounts)
• You’re NOT breastfeeding
• You’ve been seen by a pelvic floor physical therapist (and they have said everything has healed well and you’re cleared for these types of exercises)
ONLY THEN may it be okay for you to add them back in at this time. I will also add that I prefer you have at least 3 months of solid strength training under your belt before adding back these high impact activities. Every woman heals differently from pregnancy and birth, but I like to take a more conservative approach to returning to fitness postpartum. I’m more comfortable with adding these types of activities back into your program (and in low volume) after the 6-month mark, provided all the considerations mentioned above are met!
If you want to learn more about exercising postnatal and see her training recommendations for 6+ months postpartum, check out her blog here!