So, you are “cleared” for exercise after baby. Now what?
After that “all clear” I know it’s hard to fight the temptation to jump (literally) back into your
old fitness routines, or a new fitness routine that promises to drop the pounds, flatten the
stomach, and get you back into those pre-baby jeans. But doing so could actually do more harm than good. Your body has been through a lot with pregnancy and childbirth. In fact, the impact on your body is similar to a serious injury and, as such, should be treated that way.
I spoke to Dr. Jenn Parker, PT, DPT, who is a pelvic health physical therapist and asked her more about postpartum healing and the timeline for returning to exercise after childbirth. She says, “Traditionally, we know that it takes about 6-8 weeks for normal tissue healing to occur when there's been a trauma or injury. So, it was believed that this healing process was the same during childbirth, either vaginally or with cesarean. However, the pelvic and abdominal anatomy DOES NOT heal at a similar timeline. After a vaginal delivery, the pelvic floor muscles,
connective tissue, and nerves take 4-6 months to heal."
Unfortunately, postpartum exercise isn’t given much attention from doctors. Even though you
get the exercise clearance at your one and only postpartum appt (likely virtual now), the
guidance is limited or non-existent. And exercising postpartum really can help so much.
According to the American College of Obstetrics and Gynecology, exercise after pregnancy helps strengthen and tone abdominal muscles, boosts energy, may help prevent postpartum depression, promotes better sleep, relieves stress, and can help you lose the extra weight that you may have gained during pregnancy (1). But, it can actually do more damage in the long run if you choose the wrong path and do the wrong things.
“We need time to heal and regain strength— rushing back into activity, especially high-intensity
exercise can lead to permanent body changes including pain and dysfunction. As a pelvic health physical therapist, when I ask female clients when their symptoms of their pelvic floor
dysfunction started, the majority of the time the answer is during the prenatal/postpartum
period” says Jenn (2).
The best piece of postnatal exercise advice is to build the foundations first. Doing so will make
your future exercise that much more effective. Because if you go too far, too fast you risk
serious and possibly lasting injury and then you have to take many, many steps backward or
even have your future exercise options changed forever.
The first 4 months after having a baby matter the most in building a solid base. Spend this time
working on rebuilding your strength from the inside-out and avoiding exercises that create the
following symptoms that suggest you are pushing yourself too far too fast:
1) Incontinence/leakage is a sign that your pelvic floor muscles and deep abdominals are
not yet strong enough to handle the exercises you are doing.
2) Pelvic pain, pressure or a feeling of heaviness in your pelvic floor is a sign of pelvic
floor dysfunction or prolapse. If you have these symptoms, it is important that you visit
a pelvic health physical therapist to assess what is going on and work with you to
remedy the situation.
3) Doming or coning through the middle of your abdomen is a sign of a possibly diastasis
recti, or separation of the linea alba between the two sides of the rectus abdominus (6-
pack abs). Diastasis Recti is actually normal for all women after pregnancy but doing the
wrong exercises that create this doming can result in a prolonged or permanent
diastasis that can lead to the low belly mommy pooch, back pain, and pelvic floor
dysfunction.
4) Low back or hip pain is pretty common as a new mom but if exercise causes you more
discomfort in these areas, then take that as a sign that you need to slow down or modify
your workout routine.
5) Exhaustion, being out of breath, or having overly sore muscles are obvious signs that you’ve
pushed it too far. Remember you are recovering from a major physical change and
possibly major abdominal surgery as well if you had a c-section. Give yourself some
grace and slow down so you can properly recovery.
Here are 5 exercises I suggest avoiding until you’ve spent the time building your foundations:
1. Running – Running within the first 4 months after giving birth can put added stress on
an already strained pelvic floor, potentially resulting in or exacerbating a prolapse or
incontinence. Even after 4 months if you haven’t done what is needed to rebuild a
strong pelvic floor and deep core muscles, leaping back into running could still result in
these things. If you have any symptoms like leaking, pressure, or feelings of heaviness then
you probably aren’t ready to train for that first after baby 5k.
2. Plyometrics (jumping jacks, box jumps) – Same as running, these high impact exercises
put pressure downward and outward on weak and injured pelvic floor muscles and deep
core muscles. Best to avoid until you have done the work to rebuild this strength and
connection.
3. Planks or Burpees – Planks and burpees can also create additional intra-bdominal
pressure. Which is basically, when you don’t coordinate your breath and core activation
and create pressure that pushes down and out on the pelvic floor and rectus abdominus
(6-pack ab muscles)– creating or exacerbating diastasis recti, pelvic floor symptoms, or
even hurting your low back.
4. Ab flexion against gravity (sit-ups) – I know many women want to get rid of that baby
belly pooch and it seems like sit-ups would be the exact way to do that, but in all
honesty doing these too soon and incorrectly can actually make that pooch worse,
exacerbate a diastasis recti, and cause harm to your low back. Check out the list below
for a better place to start in flattening out your tummy if that is your goal.
5. Hot anything (pilates, yoga, etc.) – Working out in a heated room relaxes your muscles
and ligaments which may seem like something you want given how tight and sore you
are from breastfeeding and baby carrying. But you will still have the hormone relaxin
surging through your body, especially if you are breastfeeding, creating laxity and
instability in your joints. Adding heat to these exercises can create additional instability resulting in injury, particularly in shoulders and hips. Best to do these exercise without the heat.
Note: If you are in a group class that includes any of these moves consider skipping or modifying until you no longer have symptoms. You will be able to progress back to these things when the time is right. But only after you create a solid foundation from the INSIDE-OUT!!
Here are 5 exercises I recommend starting with instead:
1. Hug the belly - transverse abdominus/pelvic floor activation with breath
2. Leg slides
3. Side-lying hip abduction/adduction
4. Mini swan with rib lift
5. Side lift
While these exercises may seem small, they will help to rebuild your core from the inside-out
and will aid not only in gaining back that flat tummy after having a baby, but also building the
most important muscles for you to be a strong and resilient mom. Because ladies, MOMMING
IS HARD WORK! You need your body to work for you and not against you. So, let’s get you
there!
For more in-depth support and guidance on healing your core, strengthening your body and
returning to exercise after having a baby check out my 8-week Postnatal Core Kickstart
Program.
And for regular pre and postnatal exercise, motherhood and lifestyle advice, follow me on
Instagram @conscious_core_caitlin.
About the author:
Caitlin Hatzenbuhler is a nationally certified Pilates teacher, pre and postnatal pilates and
movement specialist, integrative nutrition health coach in training and owner of Conscious
Core - a California-based Pilates studio and online wellness company. She is a believer in the
power of movement to heal and stay strong, centered and move with more ease through a
crazy life as a mom. Throughout her training she realized there was an important need to better help soon-to-be and new moms be strong, healthy and active. To fill this critical gap she now
specializes in prenatal and postnatal Pilates to help discouraged moms connect with their core
so they can keep up with the demands of motherhood, feel confident in their body and live
vibrant and joyful lives.
IG: @conscious_core_caitlin
Facebook: @consciouscorepilatesstudio
Website: www.consciouscore.co
Link to free download: 14 Daily Postnatal Exercise Guide
Link to course: 8-week Postnatal Core Kickstart Program