Postpartum Return to Exercise: 0-6 Weeks
Always contact your pelvic floor physical therapist before beginning a new exercise program, with any changes in symptoms or with uncertainties on form/ intensity.
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Postpartum Return to Exercise
Part One; 0-6 weeks
Just had a baby?!?! Congratulations, and welcome to the Fourth Trimester!
If you aren’t familiar, the Fourth Trimester is the first 12 weeks after giving birth which are just as crucial to the mother’s health as each of the trimesters during pregnancy. This is a time for healing, recovery and adjusting to life with a newborn either as your first or as a new member to your growing family. Unfortunately, this can also be a time when all the attention can suddenly shift off the mother and all the focus go to the baby. And despite American College of Obstetricians and Gynecologists (ACOG) recommendation that postpartum care should be an ongoing process, not just a single follow up visit, many women are still navigating this time mostly on their own.
There is also still a lot of misunderstanding on the postpartum physical recovery and progression back towards an active lifestyle. Some women feel scared to do much of anything fearing they may hurt themselves, while others might be too active thinking that they are feeling good but instead might be setting up a risk for injury. Some women hear from their medical provider that they are “cleared for exercise” during their postpartum appointment and jump right back to their previous fitness routine running and lifting heavy weights like nothing has happened.
A women’s health or pelvic physical therapist can be so invaluable during the Fourth Trimester helping safely guide the way through so many challenges of postpartum physical recovery. Not everyone’s postpartum journey is the same, so it can be overwhelming trying to exercise on your own or follow an online program if there is no interaction with a professional to answer questions, confirm you are doing an exercise correctly and help determine what is “normal” or not.
Whether you are working with a postpartum specialist or not, let’s review some generalized guidelines to help set your expectations of postpartum return to activity and exercise. Each phase has week timelines as a reference, but everyone has their own factors that will impact how long it. might take to progress through each phase including: pregnancy experience, birth experience, vaginal or cesarean birth, sleep quantity and quality, fluctuating hormones, breastfeeding, nutritional status, and so on!
Let go of the “bounce back” mindset, instead focus on each step at a time. During the first 0-6 weeks, you are setting the foundation to build on. Focus on quality over quantity as you reconnect with your body. Save the intensity for later!
Phase 2: Gradual Increase
Phase 1: Early Recovery
3 - 6 weeks
0 - 3 weeks
Continue with everything in Early Recovery Phase gradually increasing activity around your home and running short errands.
This can also be a time for easy exercises that don’t overly stress your abdominal or pelvic floor
muscles such as bridges, bird-dog, or heel slides. These early exercises will depend on your own familiarity with the movements and your body awareness with correct form.
Working with a postpartum health or fitness specialist can help develop an individualized routine tailored specifically to you!
When in doubt, keep the movements simple continuing to emphasize reconnecting with your body coordinating with your deep pelvic and abdominal muscles.
Prioritize rest, healing and acclimating to newborn care.
Begin with gentle diaphragmatic breathing (“belly breathing”), gentle abdominal and pelvic floor muscle activations, and walking.
Details of how to perform proper diaphragmatic breathing below!
Start with short walks close to home.
Gradually increase by a few minutes as you feel up to it.
Do not over do it, this time is for your to get adjusted to newborn care and your growing family.
Only increase activity if you don’t have any change in pain, bleeding, vaginal or pelvic heaviness or incontinence.
Diaphragmatic Breathing
*Diaphragm breathing – inhale deeply through your nose, let your belly and lower ribs expand in every direction, slowly exhale
*Deep abdominal muscle activation – with pursed lips, slowly exhale as if you are blowing out a hundred birthday candles through a straw – notice your waist narrowing, your ribs drawing down and your lower belly drawing in
*Pelvic Floor Muscle Activation, “Kegels,” – try a few of these visualizations to see what works best for you. Imagine trying to stop the flow of urine or hold in gas, then release. Imagine picking up a marble lifting it up into your vagina then placing it back down. Imagine drinking a thick smoothie through a straw through your vagina, then let go.
