Returning to exercise was the one thing I was most eager to do postpartum.
I had exercised throughout my pregnancy 1-2 hours/day and had remained in my triathlon training group for the first four months of pregnancy. I had felt so strong during my pregnancy. Postpartum however I was a totally different person. My body felt weak, tired, and my stomach hollow. Being a pelvic floor PT for the last 12 years, I knew my road back to high intensity exercise was going to be harder than I wanted.
The current guidelines from the American College of Gynecology are if you had a normal vaginal delivery it is safe to begin exercising a few days after giving birth or when you feel ready. Cesarean delivery and other postpartum complications need to cleared by their health care provider. The recommendation is to first return with 20-30 mins a day of postpartum exercise that focus on core strength. Healthcare provider approval is recommended for patients to return to vigorous activity such as running and jumping which is usually around the 6 week postpartum visit.
What happens to your pelvic floor during delivery?
Postpartum women experience may experience decreased pelvic stability after a vaginal delivery, due to the increase in the hormone relaxin experienced in order to allow your ligaments to relax for you deliver the baby. The pelvis plays an integral role in stability and alignment as its job is to transmit the weight of your upper body to your lower body. The pelvis is comprised of your hip bones, sacroiliac joint, pelvic floor muscles, and supporting ligaments.
With the core and pelvic muscle being weakened, it is important to strengthen this group to increase the pelvic stability needed for high intensity exercise like running. The pelvic floor muscles support your bladder uterus and bowels, and connect to your transverse abdominals and pelvic bones. These muscles can be affected by weak core and tight hip muscles including your hamstrings, adductors and gluts. Signs of pelvic floor dysfunction postpartum include deep pain in your groin, pelvic floor and/or abdomen, urinary, gas or fecal incontinence, and painful intercourse. If any of these are happening it’s time to see you OBGYN and come in for a pelvic floor PT consult.
Good guidelines for postpartum exercise
The Department of Health and Human Services recommends that postpartum women (once cleared by their OBGYN) try to get around 2 hours of moderate intensity exercise a week. Since our bodies have changed a lot in a short period some good guidelines to follow are:
- Give yourself warmup and cool down time
- Slowly increase your pace and intensity to avoid injury
- Drink plenty of fluids especially if you are breast feeding.
- Wear a good sports bra! Your breasts have changed so get yourself some supportive swag!
- If you feel pain STOP, this is not the time to push yourself
- Find your fitness tribe! A few of our favorite NYC programs are PROnatal Fitness and Stroller Power Fitness, and for those of you who prefer to exercise in the comfort of your own home, MommaStrong is a fantastic and affordable online platform with a great community to boot.
What my postpartum recovery taught me was to have patience with myself, and my body. I had to remember that even though I mentally was ready to return to high intensity exercise at 6 weeks postpartum my body was still recovering and needed time to heal. I slowly returned to exercise at 6 weeks with spin classes, easy pilates, core strengthening with at home videos when baby was napping, and easy jogging. In my first year post-baby I was plagued with mastitis, carpal tunnel, a sprained ankle, and a toe ligament injury. I now understand when people tell me ‘it takes 9 months for your body to grow your baby and 9 months or longer to get back to pre-baby you’. My body finally felt ready to start intense training for my first post baby half marathon at 12 months postpartum. It was a long journey but motherhood was definitely worth all of it!