Disclaimer: This information provided is not medical advice but general information for you and your healthcare team. All women should speak with their providers prior to initiating any sort of exercise postpartum. We advise all mothers looking to initiate exercise to work with a pelvic floor specialist and postpartum exercise specialist to help the navigate this time.
I believe that the current road back to exercise is a misunderstood area that most people get wrong. Many women’s experience consists of the following: after baby, there is no specific work towards fitness and at the very quick 6 week postpartum follow up, they are told as the doctor is leaving the room “you are fine to get back to full exercise and you can start having sex too.” This is normally done with no pelvic floor or abdominal wall exam as well as no deeper conversation of the type of exercise a mom is looking to perform. There are a few things wrong with this scenario:
1. In the first few days after baby, women are told to not exercise, but they are picking up their 6-10# baby out of cribs, off the floor, in their insanely heavier carrier while also potentially caring for larger siblings, doing laundry and walking around. What SHOULD happen is women should be instructed on the benefits of early movement to help heal and restore. Focus should be on the daily tasks that we know moms are required to do with a newborn in hopes to not only help them feel stronger and more confident in their day to day, but help mitigate injury and symptoms by doing too much, too soon.
2. Due to the severe lack of information on return to exercise timeline paired with the extremely disappointing focus and attention we give to postpartum moms leave women in the dark when it comes to fitness, what is appropriate and how they should approach it. What SHOULD happen is more education needs to take place around what is exercise, the benefits as well as the risks and reasonable timelines for women to expect when looking to return to fitness. Pelvic Floor Therapy should be automatic for women in order to evaluate their tissues have a better understanding of their situation and when is true return to exercise appropriate for them.
As opposed to giving into this unfortunate situation, we like to lean into a different way of thinking. We believe that exercise SHOULD be started as soon as possible after baby – but this type of exercise might be much different than what you would expect.
It is important to note that the American College of Obstetrics has published a committee opinion on the benefits of early exercise postpartum. Engaging in early physical activity has shown to combat postpartum depression anxiety, increase energy levels, decrease musculoskeletal pain as well as directly impact healing our body. Now before you tie up your laces and go for a run 2 weeks after you deliver, let’s chat more about exercise, the postpartum period and what it should really look like.
Exercise, defined as physical activity consisting of planned, structured, and repetitive bodily movements done to improve one or more components of physical fitness.
Exercise is a very blanket term for any structured and repetitive movement we do throughout the day. These structured movements also need to improve one or more components of physical fitness. The mistake we make is by having a very narrow view of our components of fitness. Most people consider aerobic capacity and strength the only worthwhile buckets we should work on during fitness. This normally ends in people jumping right into long walks or even jogs and strength routines the first time they are allowed to move. We know that these components can be hard on our bodies. We suggest in the early days, focusing on other components of fitness that are more restorative and lay the ground work to higher levels of fitness
Flexibility, range of motion, balance, muscular endurance and muscular coordination are all very important components that can be and should be worked on in the early days postpartum.
Early exercise postpartum should include first and foremost breathing. Let’s go back to the definition of exercise here: planned, structured, and repetitive bodily movements. So I am not talking about your natural breath pattern, but a planned and structured work on breathing. The muscles, bones and fascia all surrounding our lunges and bellies have been greatly injured through pregnancy labor and delivery. 3D breathing and connection breathing exercises are our most favorite to give moms in the early days after baby to work on muscular coordination of our cores. These are simple but not easy when you have a sad, injured vagina or an angry c-section incision. Breath and connection practice can help with pelvic and abdominal pain, decrease stress levels and improve mood.
Other exercises that should begin early are flexibility and mobility exercises that target specific areas. Most PP women are spending lots of time sitting, feeding, holding and cuddling so addressing tight hip flexors, chests and mid-backs are crucial in order to keep our bodies feeling good. Gentle mobility work has shown to decrease musculoskeletal pain as well as primitively sets you up for better muscle function when it is time to fully exercise. Some of our favorite exercises to target these areas are the couch stretch and mid back mobility on the foam roller.
Balance and control are two components of exercise that are frequently overlooked and underestimated. Our balance is greatly affected during pregnancy due to the massive and quick changes to our bodies as well as our lack of core strength. Exercises like single leg balancing and hip airplanes are a wonderful way to increase our balance, heal our cores and are a starting point to return to things like running and jumping.
Control and coordination can be gained through purposeful practice of functional movement. Performing exercises like body weight squats, hip hinging and lunges allows us the time to coordinate our cores along with functional movement we are doing already! (think getting up from a chair, bending over a crib or getting up from the floor.) These are all to be done methodically, slowly at first and not with the goal of increasing heart rate or strength.
Lastly, endurance or our aerobic systems as well as our bodies can and should be achieved by a methodical return to walk. Going out and walking a mile (or even walking around Target to browse) is not given and should not be attempted first. A planned and gradual exposure back to walking will allow us to gain the benefits from walking without pushing into symptoms or dysfunction. We created a PostPartum Walking Schedule to give you an idea of a typical schedule that could be appropriate that you can download here!
So for those that are chomping at the bit to get back to the gym and desperately looking for ways to exercise – start here. Take advantage of this vulnerable time to work on the little things. Be patient. Put in the work. Respect the timeline. Exercise isn’t always what you think.
And for those that feel overwhelmed with exercise being the very last thing on your mind – don’t sweat it. Start small, use a few minutes a day to try some of these things so you can reap the rewards of exercise such as decreased depression, decreased pain and increased energy. These things put you in the best position to be the mom you want to me!