How to Safely Return to Exercise Postpartum
This article is proudly brought to you in partnership with Move It Mama.
Firstly, everybody is different. Not only are we genetically different with different health and exercise histories, but we also all experience different pregnancies, births, and postpartum recoveries. Returning to exercise can therefore look different for everyone however, there are some fundamentals for ensuring a safe pathway to reestablishing exercise postpartum.
Where to begin
There’s a blanket rule thrown around and that is that six weeks after birth you can start exercising. The issue is that it’s just that – a blanket rule – and while suited to one person, it might not apply to another.
Check with your qualified healthcare provider about when they think the right time for you to get back into exercise is. This could be your LMC, obstetrician/gynaecologist, or GP, but in some cases, this might not give you the most comprehensive assessment you need. This is where the role of a pelvic health physio (PHP) comes in. Having a thorough assessment with a PHP will put you in the most empowered position, knowing exactly where your body stands in terms of what exercise is safe and what rehabilitation is required. This should be your first step.
Why is this important?
Our bodies experience drastic changes throughout pregnancy and the postnatal period. Many factors should be taken into account before resuming an exercise regime, even if you’re feeling strong and motivated. Important things to consider are hormonal changes, cardiovascular changes, respiratory changes, musculoskeletal changes, and metabolic and thermoregulatory changes. You should also consider postural changes and the significant pressure placed on the joints, pelvic floor, and the abdominals.
Postnatally, the body continues experiencing or readjusting from these changes which should be taken into account too, such as the relaxin hormone continuing to be released into the bloodstream which can make postpartum people more susceptible to injury. Exercise is so powerful in making us feel strong, confident, and accomplished. With that and the above in mind, being assessed by someone qualified puts you in the best possible position when resuming exercise postnatally.
What exercise should I do?
We advise people to commence pelvic floor exercises as soon as possible post-birth (preferably pre-birth, too). Although not necessary, a PHP can assist with this in prescribing an individualised pelvic floor programme, and also check you’re performing the exercises correctly.
We also advise that in the early stages, when ready, light core activation and breathing exercises are established to help reconnect to your core, as well as reconnect your pelvic floor. The focus is on reconnecting to your deep core muscles (TVA) and encouraging your body to get the diaphragm, core, and pelvic floor working together. These exercises will help in progressing to more vigorous activity as you rebuild not only your core system but your overall strength.
EXERCISE EXAMPLE: DEEP BELLY BREATHING
Focus on a gentle rise of the stomach on inhale, and lifting the pelvic floor and contracting the TVA on exhale.
From here, adding in gentle, low impact and functional exercise is advised. As we remind our members, there’s no rush. You might be tempted to jump in where you were pre-pregnancy… slow down. Pregnancy and postpartum is not a time to set or strive toward aspirational fitness goals. Instead, enjoy the lighter pace and intensity and take it one day at a time.
In most cases, there are modifications or regressions to exercises as you work on rebuilding strength. For example, a lot of bodyweight, upper body, and plank-based exercises can be performed using an incline (bench, couch, etc.). In bringing the ‘ground’ up, there is likely less intra-abdominal pressure on the core and less weight bearing down onto the pelvic floor. If getting back to lifting weights, try starting off with just bodyweight or lighter/scaled back weights. Walking is also an amazing low impact, low intensity option that can be made more strenuous later on (think hills, pace, etc.). If you prefer running, we advise spending a good period rebuilding strength before pounding the pavement (everyone will differ on how long they need).
A lot of people continue exercising without dealing with issues like pelvic floor dysfunction (incontinence/leaking, prolapse, pelvic pain, etc.) or abdominal separation, when this doesn’t have to (and shouldn’t) be the case. The reality is that help is available and there are ways to improve pelvic and core health while still being active.
EXERCISE EXAMPLE: GLUTE BRIDGE
Again, focus on the breath throughout the exercise by exhaling, lifting the pelvic floor, and activating the TVA while the hips lift upward. Avoid pushing the hips so far up that the back arches, instead focus on maintaining a posterior pelvic tilt.
Want to progress a little? Try a single leg glute bridge, with the same technique cues.
Some people will progress from completing just pelvic floor and breathing exercises for a few weeks postpartum to including low impact exercise at about 6-10 weeks, and then by ~12 weeks or so be able to lift the intensity. Others mightn’t be anywhere near this and instead may follow a completely different pathway back to exercise.
All bodies are different. Tune into your body over this period and remember – it’s nobody else’s postpartum but yours. Exercise is so powerful in benefiting both our physical and mental health; be kind to yourself, move your body and seek guidance from a professional.
Move it Mama’s newest workout is postpartum-specific and a great place to start once cleared. Join us every Friday at 9:15 am, or complete it in your own time.